Analysis of thyroid dysfunction induced by PD-1/PD-L1 inhibitors and its influencing factors in patients with advanced gastric cancer
WANG Juanjuan
TANG Ming
TANG Xiaohui
YANG Lei
Abstract：Objective To analyze the occurrence of thyroid dysfunction in patients with advanced gastric cancer treated with programmed death receptor-1(PD-1)/programmed death ligand-1(PD-L1)inhibitors,and to analyze its influencing factors.Methods The clinical data of 118 patients with advanced gastric cancer admitted from January 2022 to June 2024 were retrospectively collected.All patients received PD-1/PD-L1 inhibitor treatment.The abnormal thyroid function induced by PD-1/PD-L1 inhibitors was statistically analyzed,and the patients were divided into the abnormal thyroid function group and the normal thyroid function group.Univariate and multivariate analyses were conducted to analyze the influencing factors of thyroid dysfunction caused by PD-1/PD-L1 inhibitor treatment.Results Among 118 patients with advanced gastric cancer,42 developed abnormal thyroid function during the treatment period,with an incidence rate of 35.59%.It included 11 cases(26.19%)of hyperthyroidism,18 cases(42.86%)of subclinical hyperthyroidism,4 cases(9.52%)of hypothyroidism,and 9 cases(21.43%)of subclinical hypothyroidism.The severity was evaluated as grade 1 in 16 cases(38.10%),grade 2 in 18 cases(42.86%),and grade 3 in 8 cases(19.05%).Multivariate logistic regression analysis showed that the patient's gender,disease duration,and the titers of anti-thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPOAb)before treatment,and thyroid stimulating hormone(TSH)before treatment were all independent influencing factors for thyroid dysfunction in patients with advanced gastric cancer treated with PD-1/PD-L1 inhibitors(P<0.05).Conclusion The risk of thyroid dysfunction in patients with advanced gastric cancer treated with PD-1/PD-L1 inhibitors is relatively high,including hyperthyroidism,subclinical hyperthyroidism,hypothyroidism,and subclinical hypothyroidism.This is mainly related to the patient's gender,disease duration,and the titers of TPOAb before treatment,TGAb before treatment,and TSH before treatment.Clinically,special attention should be paid to female patients with a disease course of more than one year.In the meantime,TPOAb titer,TGAb titer and TSH levels should be monitored.Early intervention measures should be taken to reduce thyroid dysfunction and ensure the quality of life of patients.
Keywords：gastric tumoradvanced stagePD-1/PD-L1 inhibitorsthyroid functionanti-thyroglobulin antibodythyroid peroxidase antibodythyroid-stimulating hormoneinfluencing factor analysis
Publication Date：2025-12-13
Online Publishing Date：2025-12-25(First online date of this platform, not the publication date of the document)
Pages：6( 70-75 )