| Objective:To explore the risk factors of immune checkpoint inhibitor-induced liver injury in patients with lung cancer.Methods:A nested case-control study was conducted to analyze 202 patients with lung cancer treated with immune checkpoint inhibitors in the affiliated Hospital of Hangzhou normal University from October 2018 to August 2022.They were divided into liver injury group and control group according to the occurrence of liver injury during the observation period.The clinical data were collected and the medication,severity and clinical classification of liver injury were analyzed.The independent risk factors of ICIs-induced liver injury were determined by univariate analysis and multivariate logistic regression analysis.Results:Among the 202 patients included in this study,40 patients with ICIs-induced liver injury were in the liver injury group,and the other 162 patients were in the control group.In the liver injury group,the patients were(65.65±9.61)years old,and the BMI was(22.65±3.79)Kg/m~2,including 32 males and 8 females.The control group was(67.25±9.82)years old,and the BMI was(21.65±3.36)Kg/m~2.There were 135 males and 27 females.The median onset time of liver injury was 28days.PD-1 inhibitors were the main drugs for liver injury.The severity of liver injury was grade 1 in most patients.Cholestatic injury was the most common pattern of liver injury.After univariate analysis and multivariate logistic regression analysis,obesity,fatty liver and elevated baseline LDH were independent risk factors for ICIs-induced liver injury in patients with lung cancer(P<0.05).Conclusion:Obesity,fatty liver and elevated baseline LDH are independent risk factors for ICIs-induced liver injury in patients with lung cancer.For patients with these risk factors,clinicians should closely monitor liver function indicators. |
