免疫检查点抑制剂相关内分泌不良事件

免疫检查点抑制剂（immune checkpoint inhibitors，ICIs）是一类新型抗肿瘤药物，通过增强抗肿瘤免疫应答产生抗肿瘤作用，已经在多种恶性肿瘤治疗中表现出显著疗效。由于免疫检查点抑制剂特定的作用靶点和机制，可引起自身免疫和炎症效应，称为免疫相关不良事件（immune-related adverse events，irAEs）。随着免疫检查点抑制剂的广泛应用，其导致的irAEs也越来越受到重视，其中内分泌相关不良事件（如甲状腺功能障碍、垂体炎、肾上腺功能不全等）起病时表现隐匿，不易被发现，导致治疗延误，往往带来严重不良后果甚至危及患者生命。本文将总结既往文献，对免疫检查点抑制剂相关内分泌不良事件的发生率、可能的发病机制、临床表现、诊断等进行述评。

Immune checkpoint inhibitor-related endocrine adverse events

Immune checkpoint inhibitors (ICIs) is a new type of anti-tumor drugs that produce anti-tumor effects by enhancing the anti-tumor immune response, and have shown significant efficacy in the treatment of various malignant tumors. Due to the specific targets and mechanisms of immune checkpoint inhibitors, they can cause autoimmune and inflammatory effects, known as immune-related adverse events (irAEs). With the wide application of ICIs, irAEs are attracting more and more attention. Among them, endocrine-related adverse events (thyroid dysfunction, hypophysitis, and adrenal insufficiency, etc.) are hidden at the onset, which is difficult to be found, leading to treatment delay, often bringing serious adverse consequences and even endangering patients'' lives. This article summarizes the previous literature and reviews the incidence, possible pathogenesis, clinical manifestations, and diagnosis of ICIs-related endocrined adverse events.