Anti-thyroglobulin antibodies (TgAb) and/or anti-thyroid peroxidase antibodies (TPOAb) positivity at baseline is a risk marker for thyroid immune-related adverse events (thyroid-irAEs) in anti-programmed cell death-1 antibody (PD-1-Ab) treatment; however, it is unknown if TgAb and TPOAb titers are associated with clinical characteristics of thyroid-irAEs. Among 586 patients treated with PD-1-Ab at Nagoya University Hospital between 2 November 2015 and 30 September 2021, 57 patients developed thyroid-irAEs (thyrotoxicosis [n = 38]; hypothyroidism without prior thyrotoxicosis {isolated hypothyroidism} [n = 19]) in whom thyroid function, and TgAb and TPOAb titers were determined at baseline and at the onset. The changes in TgAb (median, 54.8 vs. 0.2 IU/mL; p = 0.002) and TPOAb titers (31.6 vs. 0 IU/mL; p = 0.032) from baseline to onset of developing thyroid-irAEs were greater in patients with thyrotoxicosis than patients with isolated hypothyroidism. Higher TgAb and TPOAb titers, and the TgAb titer at baseline were associated with an earlier onset of thyrotoxicosis and higher peak free thyroxine levels, respectively. Twenty-eight patients who developed hypothyroidism after thyrotoxicosis had higher TgAb (54.5 vs. 10.7 IU/mL; p = 0.011) and TPOAb titers at baseline (46.1 vs. 9.0 IU/mL; p < 0.001) and greater changes in TgAb (61.7 vs. 7.8 IU/mL; p = 0.025) and TPOAb titers (52.8 vs. –0.8 IU/mL; p < 0.001) than patients who did not develop hypothyroidism. The TgAb titer at baseline and changes in the TgAb and TPOAb titers were greater in patients with thyrotoxicosis than patients with isolated hypothyroidism, suggesting that the magnitude of the thyroid autoimmune response reflects the clinical types of thyroid-irAEs.

基线时抗甲状腺球蛋白抗体 (TgAb) 和/或抗甲状腺过氧化物酶抗体 (TPOAb) 阳性是抗程序性细胞死亡 1 抗体 (PD-1) 中甲状腺免疫相关不良事件 (甲状腺-irAE) 的风险标志物-Ab) 治疗；然而，TgAb 和 TPOAb 滴度是否与甲状腺-irAE 的临床特征相关尚不清楚。 2015年11月2日至2021年9月30日期间，在名古屋大学医院接受PD-1-Ab治疗的586名患者中，57名患者出现甲状腺-irAE（甲状腺毒症[ n = 38]；既往没有甲状腺毒症的甲状腺功能减退症{孤立性甲状腺功能减退症}[ n = 19] ）在基线和发病时测定甲状腺功能、TgAb 和 TPOAb 滴度。甲状腺毒症患者中，从基线到出现甲状腺-irAE 的TgAb（中位数，54.8 vs. 0.2 IU/mL；p = 0.002）和 TPOAb 滴度（31.6 vs. 0 IU/mL；p = 0.032）变化更大高于单纯甲状腺功能减退症患者。较高的 TgAb 和 TPOAb 滴度以及基线时的 TgAb 滴度分别与较早发生甲状腺毒症和较高的游离甲状腺素峰值水平相关。甲状腺毒症后出现甲状腺功能减退症的 28 名患者在基线时具有较高的 TgAb（54.5 vs. 10.7 IU/mL；p = 0.011）和 TPOAb 滴度（46.1 vs. 9.0 IU/mL；p < 0.001），且 TgAb 变化较大（61.7与7.8 IU/mL；p = 0.025）和 TPOAb 滴度（52.8与–0.8 IU/mL；p < 0.001）相比，未发生甲状腺功能减退的患者。甲状腺毒症患者的基线 TgAb 滴度以及 TgAb 和 TPOAb 滴度的变化大于单纯甲状腺功能减退症患者，表明甲状腺自身免疫反应的程度反映了甲状腺-irAE 的临床类型。