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简介：AbstractBackground:Response to immune checkpoint inhibitors (ICIs) is affected by multiple factors. This study aimed to explore whether sites of metastasis are associated with clinical outcomes of ICIs in advanced non-small-cell lung cancer (NSCLC) patients.Methods:The data of NSCLC patients with high programmed death-ligand 1 expression and good performance status receiving first-line ICIs monotherapy from Guangdong Provincial People’s Hospital between May 2019 and July 2020 were retrospectively analyzed. Metastatic sites included liver, bone, brain, adrenal gland, pleura, and contralateral lung. Progression-free survival (PFS) and overall survival (OS) were compared between different metastatic sites and metastatic burden by the Kaplan-Meier method. Organ-specific disease control rate (OSDCR) of different individual metastatic sites was evaluated.Results:Forty NSCLC patients meeting the criteria were identified. The presence of liver metastasis was significantly associated with shorter PFS (3.1 vs. 15.5 months, P = 0.0005) and OS (11.1 months vs. not reached, P = 0.0016). Besides, patients with bone metastasis tend to get shorter PFS (4.2 vs. 15.5 months, P = 0.0532) rather than OS (P = 0.6086). Moreover, the application of local treatment could numerically prolong PFS in patients with brain metastasis (15.5 vs. 4.3 months, P = 0.1894). More metastatic organs involved were associated with inferior PFS (P = 0.0052) but not OS (P = 0.0791). The presence of liver metastasis or bone metastasis was associated with more metastatic organs (Phi[φ]: 0.516, P = 0.001). The highest OSDCR was observed in lung (15/17), and the lowest in the liver (1/4).Conclusions:Metastases in different anatomical locations may be associated with different clinical outcomes and local tumor response to ICIs in NSCLC. ICIs monotherapy shows limited efficacy in patients with liver and bone metastasis, thus patients with this type of metastasis might require more aggressive combination strategies.

简介：摘要对2020年11月华中科技大学同济医学院附属同济医院儿科收治的1例代理性孟乔森综合征(MSBP)病例的临床资料进行回顾性分析。患儿，女，4岁4个月，因"胸骨后疼痛、腹痛1个月，加重伴多器官痛20 d"入院，自述"胸骨后反酸、疼痛，牙齿、食管、腹部等多部位均有疼痛"，住院期间常诉多器官疼痛，其母多次诉患儿髋关节痛，夜间哭叫，难以行走。但体格检查无阳性体征，辅助检查无明显异常。结合患儿病史特点及照顾者的行为特点，临床诊断为MSBP。提示当临床遇有主诉复杂、严重、医学术语多，既往就诊频繁，而体格检查及辅助检查无明显异常，且照顾者就医及住院意向强烈的儿童，需考虑MSBP的可能。

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