西南医科大学学报2026，Vol.49Issue(3)：265-268,4.DOI:10.3969/j.issn.2096-3351.2026.03.001
肝癌免疫治疗相关肝损伤及其临床管理
Immunotherapy-Associated Liver Injury in Hepatocellular Carcinoma and Its Clinical Management
摘要
Abstract
Hepatocellular carcinoma(HCC)is a malignant tumor with high morbidity and mortality worldwide,imposing a heavy disease burden.Immune checkpoint inhibitors(ICIs)exert antitumor effects by activating the immune system through blocking the PD-1/PD-L1 or CTLA-4 pathway,and have become the core regimen for first-and second-line treatment of advanced HCC.How-ever,while breaking immune tolerance,ICIs tend to induce multi-system immune-related adverse events(irAEs),among which immune-mediated hepatitis(IMH)is one.This review systematically summarizes the epidemiological characteristics and heteroge-neous manifestations of IMH,discusses the related risk factors,diagnostic pathways and graded treatment strategies for IMH,and ana-lyzes the impact of ICI therapy on hepatitis B virus(HBV)reactivation.It aims to provide references for the early prediction,accurate diagnosis,individualized treatment of IMH and the safety management of immunotherapy in HCC patients with HBV infection,and to offer directions for clinical practice and future research in this field.关键词
免疫检查点抑制剂介导的免疫性肝损伤/免疫治疗/免疫检查点抑制剂/肝细胞癌Key words
Immune checkpoint inhibitor-mediated immune-related liver injury/Immunotherapy/Immune checkpoint inhibi-tors/Hepatocellular carcinoma分类
医药卫生引用本文复制引用
卢明芹,罗绿琦..肝癌免疫治疗相关肝损伤及其临床管理[J].西南医科大学学报,2026,49(3):265-268,4.基金项目
浙江省自然科学基金(LTGY23H030002) （LTGY23H030002）
