免疫相关性肝损伤与肝脏的基本状态密切相关。晚期胆道癌(BTC)患者肝功能较差。我们在北京大学第一医院于2019年2月至2022年7月期间，评估了晚期胆道癌和胃癌(GC)患者接受免疫检查点抑制剂(ICI)治疗期间的免疫相关性肝损伤的临床数据。证实了25例晚期胆道癌患者，其中15例(60%)在ICI治疗期间发生免疫相关性肝损伤。我们还评估了另一个接受免疫疗法的胃癌患者组的临床状况。结果表明，在BTC患者中，免疫相关性肝损伤的发生率高于胃癌(p=0.040)。多元分析显示，肿瘤类型和基线肝功能状况是2级及更高级别免疫相关性肝损伤的高危因素。两例患者被诊断为免疫相关性胆管炎。皮质类固醇和硫氧嘧啶胆酸(UDCA)治疗能在一定程度上减少胆汁酶，但难以降低到正常水平。通过局部治疗(支架置入或PTBD)，肝功能恢复，症状改善。我们观察到在晚期胆道癌患者中，ICI治疗后免疫相关性肝损伤的发生率较高。基线肝功能对免疫治疗相关性肝损伤的发生率产生影响。介入治疗为缓解胆汁淤积提供了迅速的缓解，是治疗免疫相关性胆管炎的不可或缺且有效的方法。©2023年作者，独家授权给Springer Science+Business Media, LLC, part of Springer Nature.

Immune-related liver injuries are closely associated with the liver's fundamental state. Patients with advanced biliary tract carcinoma (BTC) have poor liver function. We evaluated the clinical data of immune-related liver injury in patients with advanced BTC and gastric cancer (GC) during immune checkpoint inhibitor (ICI) treatment between February 2019 and July 2022 at Peking University First Hospital. Twenty-five patients with advanced BTC were identified. Fifteen patients (60%) experienced immune-related liver injury during ICI treatment. We also evaluated the clinical status of patients with GC in another group receiving immunotherapy. The results demonstrated that the incidence of immune-related liver injury was higher in patients with BTC than in GC cancer (p=0.040). Multivariate analysis suggested that the type of malignant tumor and baseline liver function status were high-risk factors for grade 2 and higher immune-related liver injuries. Two patients were diagnosed with immune-related cholangitis. Both biliary enzymes can be decreased to a certain degree by corticosteroid and ursodeoxycholic acid (UDCA) therapy but are difficult to reduce to normal levels. Liver function normalized, and symptoms improved after local treatment for cholestasis (stent implantation or PTBD). We observed a higher incidence of immune-related liver injury after ICI treatment in patients with advanced BTC. Effect of baseline liver function on the incidence of liver injury associated with immunotherapy. Interventional therapy provides rapid relief from cholestasis and is an indispensable and effective approach to the treatment of immune-related cholangitis.© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.