ty -jour a2 -coppola，vincenzo au -möhn，nora au -mahjoub，susann au -gutzmer，ralf au -satzger -satzger，imke au -beutel -au -beutel，gernot au -ivanyi -ivanyi，philipp au -philipp au -golpon，golpon，heiko au -wattjes，heiko au -wattjes，mike p.P.Au -Stangel，Martin au -Skripuletz，Thomas PY -2020 DA -2020/12/07 Ti-免疫检查点抑制剂治疗期间神经不良事件的诊断和差异诊断SP -8865054 VL -2020 AB - 使用免疫检查点抑制剂治疗（ICIS））即使在预后不良的癌症实体中，癌症治疗的总体生存率和与癌症相关的发病率也提高了。自2011年获得第一个ICI iPilimumab的批准以治疗食品药品监督管理局（FDA）以来，适应症和认可的ICIS的范围迅速增长。到目前为止，有七个不同的ICI可用于20多个指示。但是，它们的作用机理可能导致与免疫相关的不良事件（IRAE）。特别是，神经伊拉斯在临床上具有相关性。尽管它们很少见，但早期且准确的诊断具有挑战性，神经疾病病程和后遗症可能致命。在08/2017和03/2020之间，31名患者在汉诺威医学院接受了ICI治疗，并出示了神经系统不良事件（N-IRAES）。治疗的恶性肿瘤是转移性黑色素瘤，支气管癌和尿路上皮细胞癌。所有患者都接受了全面的神经系统诊断，包括临床检查和磁共振成像（MRI）。 Cerebrospinal fluid (CSF) analysis was obtained in 21 patients and electroneurography was performed in 22 patients. Although N-irAEs were suspected in all 31 patients, 11 patients had other conditions leading to neurological symptoms including tumor metastases in seven patients and hemorrhagic or ischemic stroke in four patients. In the following, these patients are referred to as the differential diagnosis (DD) group. Patients with N-irAEs suffered from immune mediated neuropathy (9/20), myositis and/or myasthenic syndrome (6/20), or encephalitis/cerebellitis (5/20). Except for cell count, CSF results did not differ between the N-irAEs and the DD group. Symptoms related to N-irAEs are rather unspecific potentially mimicking other tumor-related symptoms such as metastases. Patients with malignancy are predominantly not treated by neurologists. Because of the complexity of neurological symptoms, detailed neurological investigations in specialized institutions are necessary in patients with new neurological symptoms and need to be critically discussed with treating oncologists. SN - 1687-8450 UR - https://doi.org/10.1155/2020/8865054 DO - 10.1155/2020/8865054 JF - Journal of Oncology PB - Hindawi KW - ER -