Abstract：
Gastritis has recently been reported to be associated with nivolumab, and the clinical characteristics of nivolumab induced gastritis remain unclear. To explore the clinical characteristics of nivolumab induced gastritis, and to provide reference for the classification and treatment guidelines of immune checkpoint inhibitors -related gastritis. Case reports, case series, and clinical studies of nivolumab induced gastritis were retrospectively analyzed by searching the database from the establishment of the database until September 30, 2023. Forty-seven were included, with a median age of 57 years (range 16, 93). The median time of symptom onset was 6 months (range 0.5,36) and 6.5 cycles (range 2, 62). Nausea (29 cases, 61.7%), vomiting (29 cases, 61.7%), and epigastric pain (28 cases, 59.6%) were the most common complaints. Esophagogastroduodenoscopy mainly showed erythema (28 cases, 59.6%). Gastric mucosa biopsy showed epithelial inflammatory cell infiltration (22 cases, 46.8%) and apoptosis (15 cases, 31.9%). Most patients\' symptoms and gastric mucosa improved or recovered after receiving systemic steroid and proton pump inhibitor therapy regardless of whether nivolumab was discontinued. Two patients died from gastritis related events. Gastritis should be considered as the cause of unexplained epigastric symptoms in the administration of nivolumab. Understanding the clinical features of nivolumab induced gastritis is very important for accurate diagnosis and timely management of these patients.
摘要：
最近有报道称胃炎与纳武单抗有关，Nivolumab诱导的胃炎的临床特征仍不清楚。探讨纳武单抗致胃炎的临床特点,为免疫检查点抑制剂相关性胃炎的分型和治疗指导提供参考。病例报告,案例系列,从数据库建立到2023年9月30日，通过检索数据库对nivolumab诱导的胃炎的临床研究进行回顾性分析。包括47人，年龄中位数为57岁（范围16，93）。症状发作的中位时间为6个月（范围0.5、36）和6.5个周期（范围2、62）。恶心（29例，61.7%)，呕吐（29例，61.7%)，和上腹痛（28例，59.6%)是最常见的投诉。食管胃十二指肠镜检查主要显示红斑(28例,59.6%）。胃黏膜活检显示上皮性炎症细胞浸润(22例,46.8％）和凋亡（15例，31.9%）。大多数患者在接受全身性类固醇和质子泵抑制剂治疗后症状和胃粘膜改善或恢复，无论是否停用纳武单抗。2例患者死于胃炎相关事件。在使用nivolumab时，应将胃炎视为无法解释的上腹部症状的原因。了解纳武单抗诱导的胃炎的临床特征对于准确诊断和及时治疗这些患者非常重要。
