1例60岁男性患者因肺癌先后行一线和二线治疗26个月，因肿瘤进展，予特瑞普利单抗200 mg+贝伐珠单抗500 mg+培美曲塞1 g静脉滴注、第1天，21 d为1个周期。治疗前患者甲状腺功能正常。第2次特瑞普利单抗治疗后（首次用药后第30天），患者出现心率加快、畏热、多汗、体重减轻等症状；甲状腺功能检查结果：三碘甲状腺原氨酸（Tn 3）3.4 nmol/L，甲状腺素（Tn 4）305.0 nmol/L，游离三碘甲状腺原氨酸（FTn 3）13.1 pmol/L，游离甲状腺素（FTn 4）55.7 pmol/L，促甲状腺激素（TSH）0.02 mU/L，甲状腺球蛋白（Tg）32.7 μg/L，抗甲状腺球蛋白抗体（TgAb）531.0 kU/L，抗甲状腺过氧化物酶抗体（TPOAb）318.0 kU/L，促甲状腺激素受体抗体（TRAb）1.00 U/L。考虑甲状腺功能亢进，暂停抗肿瘤治疗，予美托洛尔治疗后好转。首次用药后第97天，患者出现畏寒、头晕、乏力、眼睑浮肿、体重增加等症状，实验室检查示Tn 3 0.3 nmol/L、Tn 4 20 nmol/L、FTn 3 1.0 pmol/L、FTn 4 1.8 pmol/L、TSH>100.00 mU/L，癌胚抗原251 μg/L。考虑甲状腺功能减退。因肿瘤进展，重启特瑞普利单抗治疗，同时补充甲状腺素，患者甲状腺功能逐渐好转并保持正常。首次用药13个月余后复查，Tn 3 1.3 nmol/L，Tn 4 137.0 nmol/L，FTn 3 3.8 pmol/L，FTn 4 21.1 pmol/L，TSH 6.03 mU/L，Tg 3.9 μg/L，TgAb 432.0 kU/L，TPOAb 222.0 kU/L。n “,”A 60-year-old male patient with lung cancer received IV infusions of toripalimab 200 mg, bevacizumab 500 mg, and pemetrexed 1 g (the treatment was given on day 1 and 21 days was a cycle) due to the progression of tumor after 26 months of first-line and second-line chemotherapy successively. His thyroid function was normal before treatment. After the second medication of toripalimab (on day 30 after the first medication), the patient developed symptoms such as increased heart rate, fear of heat, hyperhidrosis, and weight loss. The reexamination of thyroid function showed triiodothyronine (Tn 3) 3.4 nmol/L, thyroxine (Tn 4) 305.0 nmol/L, free triiodothyronine (FTn 3) 13.1 pmol/L, free thyroxine (FTn 4) 55.7 pmol/L, thyroid stimulating hormone (TSH) 0.02 mU/L, thyroglobulin (Tg) 32.7 μg/L, antithyroglobulin antibody (TgAb) 531.0 kU/L, antithyroid peroxidase antibody (TPOAb) 318.0 kU/L, and thyroid stimulating hormone receptor antibody (TRAb) 1.00 U/L. Hyperthyroidism was considered, anti-tumor treatment was suspended, and symptoms were improved after metoprolol treatment. Ninety-seven days after the first toripalimab treatment, the patient developed symptoms such as chills, dizziness, fatigue, eyelid edema, weight gain, etc. The laboratory tests showed T n 3 0.3 nmol/L, Tn 4 20 nmol/L, FTn 3 1.0 pmol/L, FTn 4 1.8 pmol/L, TSH>100.00 mU/L, and carcinoembryonic antigen 251 μg/L. Hypothyroidism was considered, but the tumor progressed, so the treatment of toripalimab was restarted and thyroxine was supplemented at the same time. The patient′s thyroid function was gradually improved and then remained normal. More than 13 months after the first medication of toripalimab, the laboratory tests showed Tn 3 1.3 nmol/L, Tn 4 137.0 nmol/L, FTn 3 3.8 pmol/L, FTn 4 21.1 pmol/L, TSH 6.03 mU/L, Tg 3.9 μg/L, TgAb 432.0 kU/L, and TPOAb 222.0 kU/L.n