比较非小细胞肺癌（NSCLC）合并轻度和重度检查点抑制剂相关性肺炎（CIP）患者的预后差异，探讨合并重度CIP的NSCLC患者的死亡原因和预后危险因素。 2016 年 4 月至 2022 年 8 月期间，对 116 名患有任何级别 CIP 且不可切除的 III 期或 IV 期 NSCLC 患者进行了队列研究。分析不同CIP分级患者的临床特征，根据CIP分级将患者分为轻度CIP组（1~2级，n=49）和重度CIP组（3~5级，n=67）。为了探讨重度CIP组的OS相关危险因素，将患者分为预后良好（GP）组（≥中位OS，n=30）和预后不良（PP）组（<中位OS，n= 37) 基于他们的总生存期 (OS) 是否高于中位 OS。收集基线临床和实验室数据进行分析。所有合并CIP的NSCLC患者的中位OS为11.4个月（95%CI，8.070-16.100），轻度CIP和重度CIP的中位OS分别为22.1个月和4.4个月（ HR=3.076，95%CI，1.904-4.970，P<0.0001）。结果显示，PP组中重度CIP患者最常见的死因是CIP，GP组中最常见的死因是肿瘤。单因素回归分析显示，暂停抗肿瘤治疗是预后不良的危险因素（OR=3.598，95%CI，1.307-9.905，p=0.013）。多变量logistic回归分析显示，暂停抗肿瘤治疗（OR=4.24，95%CI，1.067-16.915，p=0.040）和升高KL-6（OR=1.002，95%CI，1.001-1.002，p< 0.001）是预后不良的独立危险因素。综上所述，重症CIP患者预后不良，尤其是KL-6升高的患者，其主要死因是免疫检查点抑制剂相关性肺炎并发感染。另外，重症CIP患者应及时恢复抗肿瘤治疗，不宜拖延太久。Copyright © 2024 Sun, Li, Deng, Li, Deng, Zhu, Mo,guan, Hu, Liu, Xie,林和周。

To compare the prognostic differences between non-small cell lung cancer (NSCLC) patients with mild and severe checkpoint inhibitor-associated pneumonitis (CIP), and explore the causes of death and prognostic risk factors in NSCLC patients with severe CIP.A retrospective study of a cohort of 116 patients with unresectable stage III or IV NSCLC with any grade CIP from April 2016 to August 2022 were conducted. To analyze the clinical characteristics of patients with different CIP grades, patients were divided into mild CIP group (grade 1-2, n=49) and severe CIP group (grade 3-5, n=67) according to the grade of CIP. To explore the OS-related risk factors in the severe CIP group, the patients were divided into a good prognosis (GP) group (≥ median OS, n=30) and a poor prognosis (PP) group (< median OS, n=37) based on whether their overall survival (OS) were greater than median OS. Baseline clinical and laboratory data were collected for analysis.The median OS of all NSCLC patients combined with CIP was 11.4 months (95%CI, 8.070-16.100), The median OS for mild CIP and severe CIP was 22.1 months and 4.4 months respectively (HR=3.076, 95%CI, 1.904-4.970, P<0.0001). The results showed that the most common cause of death among severe CIP patients in the PP group was CIP and the most common cause in the GP group was tumor. The univariate regression analysis showed that suspension of antitumor therapy was a risk factor for poor prognosis (OR=3.598, 95%CI, 1.307-9.905, p=0.013). The multivariate logistic regression analysis showed that suspension of anti-tumor therapy (OR=4.24, 95%CI, 1.067-16.915, p=0.040) and elevated KL-6 (OR=1.002, 95%CI, 1.001-1.002, p<0.001) were independent risk factors for poor prognosis.In conclusion, patients with severe CIP had a poor prognosis, especially those with elevated KL-6, and the main cause of death is immune checkpoint inhibitor-associated pneumonitis complicated with infection. In addition, anti-tumor therapy for severe CIP patients should be resumed in time and should not be delayed for too long.Copyright © 2024 Sun, Li, Deng, Li, Deng, Zhu, Mo, Guan, Hu, Liu, Xie, Lin and Zhou.