| Autor: |
Yasuteru Kondo, Yukihiro Toi, Yasuhito Tanaka, Mareyuki Endo, Tatsuki Morosawa, Junichi Akahira, Akashi Endo, Hiroaki Satio, Shunichi Sugawara |
| Rok vydání: |
2021 |
| Předmět: |
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| DOI: |
10.21203/rs.3.rs-831424/v1 |
| Popis: |
Background and AimsIt has been reported that various kinds of immune checkpoint inhibitors (iCIs) could induce immune-related liver damage. We should focus on the programmed cell death-receptor-1 (PD-1) antibody and non-small cell lung cancer (NSCLC) to analyze the characteristics of hepatitis related to iCIs and find the factors that could be useful biomarkers for the diagnosis. MethodsA single-center retrospective study of 252 NSCLC patients who received PD-1 antibody (nivolumab or pembrolizumab). Some of the biochemical markers and immunological markers were analyzed during PD-1-antibody treatment with or without ALT elevation. Histopathological features were reviewed by a single expert of hepatic pathology focusing on the following features: fibrosis, portal inflammation, lobular inflammation, lobular necrosis. The formation of macro- and micro- granulomas was also evaluated. ResultsThe frequency of liver damage induced by nivolumab including grade 1 to 4 (ALT) was 41.9% (78/186 patients). The positive rate of anti-nuclear antibody in the nivolumab group with iCIs-related hepatitis was significantly higher than that in the nivolumab group without iCIs-related hepatitis (p). Granulomatous changes were significantly increased in patients with iCIs-related hepatitis compared with DILI and AIH patients (p). The ratios of inflammatory cells CD4/CD8, and CD138/CD3 in ICIs-related hepatitis were significantly lower than in those of AIH or DILI patients (p).ConclusionsWe demonstrated that the pre-existing ANA and characteristic liver histology including CD8+ cells dominancy and granulomatous hepatitis could be biomarkers for the diagnosis of iCIs-related hepatitis in the NSCLC with anti-PD-1 therapy. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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