Clinical significance of colonoscopy in the evaluation of immune checkpoint inhibitor-associated colitis
10.12354/j.issn.1000-8179.2024.20240935
- VernacularTitle:肠镜检查在评估免疫检查点抑制剂相关结肠炎中的临床意义
- Author:
Yu TAO
1
;
Wang XIN
;
Cao XIAOCANG
;
Liu XIA
;
Wang DAN
;
Zhong DIANSHENG
Author Information
1. 天津医科大学总医院肿瘤内科(天津市 300070)
- Keywords:
immune checkpoint inhibitors(ICIs);
adverse reaction;
colitis;
colonoscopy
- From:
Chinese Journal of Clinical Oncology
2024;51(17):909-914
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To determine the value of colonoscopy in the diagnosis and treatment of patients with immune checkpoint inhibitor-induced colitis.Methods:Patients who developed colitis and underwent colonoscopy after receiving immune checkpoint inhibitors(ICIs)therapy at Tianjin Medical University General Hospital between December 2020 and December 2023 were reviewed,according to the guidelines of the Chinese Society of Clinical Oncology for the management of ICI-related toxicity.The effect of the treatment and the rela-tionship between prognosis and the pathological features of colonoscopy were analyzed.Results:Patients with ICI-associated colitis who un-derwent colonoscopy had a more than 3 degrees diarrhea,and diffused inflammatory features such as mucosal erythema,exudate,erosion,loss of vascular markings,and edema were observed under the microscope,and the presence of ulcers greater than 1 cm in diameter and/or more than 2 mm deep indicate a poor prognosis for enteritis.Histopathological studies showed changes in glandular structures,such as cryptitis and crypt abscess.The pathological colonoscopic manifestations of patients with microscopic enteritis were inconsistent,and more deep samples should have been taken.Conclusions:The toxicity grading of ICI-associated colitis is not limited to clinical manifestations,but refers to the multi-dimensional analysis of colonoscopic features and histopathological characteristics.Soft colonoscopy can be used as an important follow-up method for patients with colitis,owing to its ease of operation and good tolerance.
