Article(id=1309635226712760612, tenantId=1146029695717560320, journalId=1227999776411738115, issueId=1309635220643607372, articleNumber=null, orderNo=null, doi=10.12048/j.issn.1674-229X.2026.02.006, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1741104000000, receivedDateStr=2025-03-05, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1790170969894, onlineDateStr=2026-09-23, pubDate=1771948800000, pubDateStr=2026-02-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1790170969894, onlineIssueDateStr=2026-09-23, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1790170969894, creator=13701087609, updateTime=1790170969894, updator=13701087609, issue=Issue{id=1309635220643607372, tenantId=1146029695717560320, journalId=1227999776411738115, year='2026', volume='36', issue='2', pageStart='81', pageEnd='160', issueExtLink='null', onlineDate='null', pubDate='1771948800000', pubDateStr='2026-02-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1790170968446, creator='13701087609', updateTime=1790219084169, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1309837032671772868, tenantId=1146029695717560320, journalId=1227999776411738115, issueId=1309635220643607372, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1309837032671772869, tenantId=1146029695717560320, journalId=1227999776411738115, issueId=1309635220643607372, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=118, endPage=123, ext={EN=ArticleExt(id=1309635226884727077, articleId=1309635226712760612, tenantId=1146029695717560320, journalId=1227999776411738115, language=EN, title=Early Characterization of Immune Checkpoint Inhibitor-Related Thyroid Dysfunction, columnId=null, journalTitle=Pharmacy Today, columnName=null, runingTitle=null, highlight=null, articleAbstract=
OBJECTIVE To investigate the early laboratory and clinical manifestations of thyroid dysfunction induced by immune checkpoint inhibitors (ICIs) in the treatment of malignant tumors.
METHODS A retrospective analysis was conducted on malignant tumor patients who received ICIs treatment during hospitalization between January 1, 2020, and December 31, 2021. Data collected included patients'general information, ICIs treatment regimens, and thyroid function indicators, including the initial onset time of treatment-related thyroid dysfunction, patterns of abnormal manifestations, and thyroid imaging findings.
RESULTS Among 156 enrolled patients, the five most frequently used ICIs were sintilimab (n =40), camrelizumab (n =38), tislelizumab (n = 32), toripalimab (n =25), and pembrolizumab (n =14). The overall incidence of thyroid dysfunction was 55.13% (86/156). The median time to initial thyroid laboratory function abnormality was 104 days (14.86 weeks), with the shortest being 4 days and the longest 2.4 years. The most frequent onset period of initial thyroid index abnormality was >112 days (16 weeks), accounting for 47.89%. Thyroid laboratory index abnormality presented in various forms, with one or more indices being elevated or decreased. In terms of the number of abnormal indicators, single indicator abnormality was the most common (72.09%), among which hyroid-stimulating hormone (TSH) abnormality (including elevation and reduction) was the most prevalent, accounting for 41.86%. In terms of TSH change patterns, elevated TSH accounted for the highest proportion (44.19%), followed by normal TSH (33.72%), and low TSH (20.93%). After ICIs treatment, 16.28% of patients had conversion of thyroid autoantibodies to positive. Thyroid B-ultrasound findings were abnormal in four patients, mainly presenting as diffuse thyroid changes (n =2), bilateral thyroid volume reduction (n =1), and bilateral thyroid echo hanges (n=1), all of whom had abnormal thyroid antibodies. The thyroid function abnormalities included in this study were all Grade 1 or 2, and most patients had no obvious clinical symptoms. Finally, only three patients continued to take levothyroxine half a year after the end of immunotherapy.
CONCLUSION Thyroid dysfunction caused by ICIs often presents as atypical clinical symptoms and mainly manifests as abnormal laboratory tests. Initial thyroid index abnormalities present various manifestations, with TSH abnormalities being the most common. Understanding the early manifestations of thyroid dysfunction caused by ICIs is helpful for oncologists in the diagnosis and treatment of this adverse reaction.
, authors=Guofei REN
*, Lingdi ZHANG, authorsList=Guofei REN, Lingdi ZHANG, authorCompany=null, correspAuthors=Guofei REN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1309635227224465702, articleId=1309635226712760612, tenantId=1146029695717560320, journalId=1227999776411738115, language=CN, title=免疫检查点抑制剂诱导的甲状腺功能异常的早期特征描述, columnId=1228268588277105398, journalTitle=今日药学, columnName=临床药学, runingTitle=null, highlight=null, articleAbstract=
目的 探讨在恶性肿瘤治疗中免疫检查点抑制剂（ICIs）引起的甲状腺功能异常的早期实验室表现及临床表现。
方法 收集2020年1月1日~2021年12月31日住院期间接受ICIs治疗的恶性肿瘤患者，对治疗相关的甲状腺功能异常情况进行回顾性分析。收集患者的一般信息，所接受的ICIs治疗和甲状腺指标情况，包括甲状腺指标异常的初始时间以及异常的表现类型，甲状腺影像学表现等。
结果 共纳入156例，使用最多的5种ICI药物分别为信迪利单抗（n =40）、卡瑞利珠单抗（n =38）、替雷利珠单抗（n =32）、特瑞普利单抗（n =25）、帕博利珠单抗（n =14）。出现甲状腺指标异常的总发生率为55.13%（86/156）。经ICIs治疗后，初始出现甲状腺实验室指标异常的时间中位值为104 d（14.86周），最短为4 d，最长可达2.4年。甲状腺指标异常的初始发生时间段以>112 d（16周）最多，为47.89%。甲状腺实验室指标异常的表现形式多样，可出现一个或多个指标的升高或降低。从指标异常数量上，以单一指标异常最为多见，比例为72.09%；其中又以TSH的异常（包括升高和降低）为最多，比例为41.86%。从指标异常的表现类型上，TSH升高占比最高，为44.19%，其次分别为TSH正常（33.72%）、TSH降低（20.93%）。在ICIs治疗后，甲状腺自身抗体转阳也有存在，占比16.28%。有4例患者的甲状腺B超结果出现异常，主要表现为甲状腺弥漫性改变（n =2）、双侧甲状腺体积缩小（n =1）及双侧甲状腺回声改变（n =1），均为甲状腺抗体异常者。本研究中纳入的甲状腺功能异常均为1级或2级，大部分患者无明显临床症状，最终仅有3例在免疫治疗结束半年后仍继续服用左甲状腺素。
结论 ICIs引起的甲状腺功能异常往往临床症状不典型，以实验室检查异常为主要表现。初始甲状腺指标异常表现形式多样，以TSH异常最为多见。了解ICIs引起的甲状腺功能异常的早期表现，有助于肿瘤专科医生对这一不良反应的诊断和治疗。
, authors=任国飞
*, 张玲娣, authorsList=任国飞, 张玲娣, authorCompany=null, correspAuthors=任国飞, authorNote=null, correspAuthorsNote=
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