目的 探討程序性死亡受體1（PD-1）/程序性死亡配體1（PD-L1）抑制劑在非黑色素瘤治療中所致白癜風的臨床特點。方法 檢索中國知網(wǎng)、萬方醫(yī)學、PubMed、Embase、Web of Science建庫至2022年7月31日收錄的PD-1/PD-L1抑制劑在非黑色素瘤中所致白癜風的病例報告類文獻進行描述性統(tǒng)計分析。結(jié)果 納入分析的患者共25例，其中男性18例，女性7例；年齡32～79歲；25例患者首次使用PD-1/PD-L1抑制劑至發(fā)生白癜風最短時間為6 d，最長時間為5年，中位發(fā)生時間為用藥后5個月。白癜風主要分布在頭皮、面部、手部、四肢和軀干，可伴有其他免疫相關(guān)性不良事件，以甲狀腺居多；皮膚活檢表現(xiàn)為病變及病灶周圍皮膚黑色素細胞及黑色素的缺失。20名患者進行了療效評估，完全緩解6例，部分緩解3例，疾病穩(wěn)定8例，疾病進展3例。結(jié)論 白癜風是PD-1/PD-L1抑制劑在非黑色素瘤治療中的一種罕見不良反應，白癜風的發(fā)生可能與良好的臨床結(jié)果相關(guān)。

Objective To investigate the clinical characteristics of programmed death receptor 1 (PD-1)/programmed death ligand 1 (PD-L1) inhibitors induced vitiligo in the treatment of non-melanoma. Methods Case reports of vitiligo caused by PD-1/PD-L1 inhibitors in non-melanoma patients were retrieved from CNKI, Wanfang Medical, PubMed, Embase, and Web of Science until July 31, 2022. Descriptive statistical analysis was performed. Results A total of 25 patients were included in the analysis, including 18 males and 7 females. The age ranged from 32 to 79 years. The shortest time from the first use of PD-1/PD-L1 inhibitor to the development of vitiligo in 25 patients was 6 days, the longest time was 5 years, and the median time was 5 months after the treatment. Vitiligo is mainly distributed in the scalp, face, hands, limbs and trunk, and can be accompanied by other immune-related adverse events, most of which are thyroid. Skin biopsy showed the absence of melanocytes and melanin in the skin surrounding the lesion. A total of 20 patients were evaluated, including 6 with complete response, 3 with partial response, 8 with stable disease and 3 with progressive disease. Conclusions Vitiligo is a rare adverse reaction of PD-1/PD-L1 inhibitors during non-melanoma treatment, which may be correlated with favorable clinical outcome.

R979.1

河北省重點研發(fā)計劃項目（20377769D）；河北省醫(yī)學科學研究課題計劃（20220891）