Abstract：
BACKGROUND: Pembrolizumab is associated with the development of gastritis, but its clinical features have not been characterized. To explore the clinical features of pembrolizumab induced gastritis and provide reference for the prevention and treatment of gastritis.
METHODS: Case reports and case series related to pembrolizumab induced gastritis were retrospectively analyzed by searching the database from inception to September 30, 2023.
RESULTS: Thirty-nine patients with gastritis entered the study with a median age of 63 years (range 34, 81). The median time to gastritis was 11.1 months (range 0.3, 60) and 7 cycles (range 1, 27) after administration. Epigastric pain (24 cases, 61.5%), nausea (17 cases, 43.6%), and vomiting (16 cases, 41.0%) were the most frequently complained symptoms. Esophagogastroduodenoscopy mainly showed erythematous (16 cases, 41.0%), hemorrhage (14 cases, 35.9%) and erosions (11 cases, 28.2%). Gastric mucosal biopsy shows chronic active gastritis with lymphocytic infiltration. These patients\' symptoms and gastric mucosa improved or recovered after receiving systemic steroid and proton pump inhibitor therapy regardless of whether pembrolizumab was discontinued. These patients\' symptoms and gastric mucosa improved or recovered after treatment with systemic steroids, proton pump inhibitors, and biological agents.
CONCLUSIONS: Gastritis is an extremely rare adverse effect of pembrolizumab. When patients receiving pembrolizumab complain of abdominal symptoms, endoscopy, tissue biopsy, and immunohistochemical staining should be actively performed for early identification and diagnosis of gastritis.
METHODS: Case reports and case series related to pembrolizumab induced gastritis were retrospectively analyzed by searching the database from inception to September 30, 2023.
RESULTS: Thirty-nine patients with gastritis entered the study with a median age of 63 years (range 34, 81). The median time to gastritis was 11.1 months (range 0.3, 60) and 7 cycles (range 1, 27) after administration. Epigastric pain (24 cases, 61.5%), nausea (17 cases, 43.6%), and vomiting (16 cases, 41.0%) were the most frequently complained symptoms. Esophagogastroduodenoscopy mainly showed erythematous (16 cases, 41.0%), hemorrhage (14 cases, 35.9%) and erosions (11 cases, 28.2%). Gastric mucosal biopsy shows chronic active gastritis with lymphocytic infiltration. These patients\' symptoms and gastric mucosa improved or recovered after receiving systemic steroid and proton pump inhibitor therapy regardless of whether pembrolizumab was discontinued. These patients\' symptoms and gastric mucosa improved or recovered after treatment with systemic steroids, proton pump inhibitors, and biological agents.
CONCLUSIONS: Gastritis is an extremely rare adverse effect of pembrolizumab. When patients receiving pembrolizumab complain of abdominal symptoms, endoscopy, tissue biopsy, and immunohistochemical staining should be actively performed for early identification and diagnosis of gastritis.
摘要：
背景：Pembrolizumab与胃炎的发展有关，但其临床特征尚未明确。探讨派姆单抗致胃炎的临床特点，为胃炎的防治提供参考。
方法：通过检索从开始到2023年9月30日的数据库，回顾性分析与pembrolizumab诱导的胃炎相关的病例报告和病例系列。
结果：39例胃炎患者进入研究，中位年龄为63岁（范围34，81）。给药后，胃炎的中位时间为11.1个月（范围0.3、60）和7个周期（范围1、27）。上腹痛（24例，61.5%），恶心（17例，43.6%），呕吐（16例，41.0%）是最常见的主诉症状。食管胃十二指肠镜检查主要表现为红斑（16例，41.0%），出血（14例，35.9%)和糜烂(11例,28.2%）。胃粘膜活检显示慢性活动性胃炎伴淋巴细胞浸润。这些患者的症状和胃粘膜在接受全身性类固醇和质子泵抑制剂治疗后得到改善或恢复，无论派姆单抗是否停用。这些患者的症状和胃粘膜在全身类固醇治疗后得到改善或恢复，质子泵抑制剂,和生物制剂。
结论：胃炎是pembrolizumab极为罕见的不良反应。当接受pembrolizumab的患者抱怨腹部症状时，内窥镜检查,组织活检,应积极进行免疫组织化学染色，以早期识别和诊断胃炎。
方法：通过检索从开始到2023年9月30日的数据库，回顾性分析与pembrolizumab诱导的胃炎相关的病例报告和病例系列。
结果：39例胃炎患者进入研究，中位年龄为63岁（范围34，81）。给药后，胃炎的中位时间为11.1个月（范围0.3、60）和7个周期（范围1、27）。上腹痛（24例，61.5%），恶心（17例，43.6%），呕吐（16例，41.0%）是最常见的主诉症状。食管胃十二指肠镜检查主要表现为红斑（16例，41.0%），出血（14例，35.9%)和糜烂(11例,28.2%）。胃粘膜活检显示慢性活动性胃炎伴淋巴细胞浸润。这些患者的症状和胃粘膜在接受全身性类固醇和质子泵抑制剂治疗后得到改善或恢复，无论派姆单抗是否停用。这些患者的症状和胃粘膜在全身类固醇治疗后得到改善或恢复，质子泵抑制剂,和生物制剂。
结论：胃炎是pembrolizumab极为罕见的不良反应。当接受pembrolizumab的患者抱怨腹部症状时，内窥镜检查,组织活检,应积极进行免疫组织化学染色，以早期识别和诊断胃炎。
