DC-CIK自体回输对化疗后胃癌患者T淋巴细胞亚群及NK细胞的影响
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摘要
目的探讨树突细胞-细胞因子诱导杀伤细胞(DC-CIK)自体回输对化疗后胃癌患者T淋巴细胞亚群及NK细胞的影响。方法前瞻性选取2016年2月至2017年2月陕西中医药大学附属医院胸外科收治的156例胃癌患者,采用随机数字表法将患者分为观察组和对照组,每组各78例。对照组予以单纯化疗治疗,观察组在此基础上辅以DC-CIK自体回输治疗。对比两组患者临床近期疗效,并分别于治疗前后对比两组患者外周血T淋巴细胞亚群及NK细胞的变化及治疗安全性。结果观察组患者有效率(RR)、疾病控制率(DCR)分别为47. 4%、66. 7%,对照组RR、DCR分别为41. 0%、51. 3%,两组患者RR比较差异无统计学意义(P> 0. 05),两组患者DCR比较差异具有统计学意义(P <0. 05)。观察组患者治疗后外周血CD3~+(61. 27±3. 18%)、CD4~+(36. 45±4. 25%)、CD4~+/CD8~+(1. 55±0. 12%)、自然杀伤(NK)细胞百分比(21. 43±3. 17%)均高于对照组(53. 49±3. 75%、28. 17±3. 38%、1. 17±0. 15%、15. 28±3. 32%)(P <0. 05)。两组患者治疗期间均未发生严重不良反应。结论对晚期胃癌患者在化疗后辅以DCCIK自体回输治疗有助于提高T淋巴细胞亚群及NK细胞水平并有利于保障近期抗肿瘤的疗效。
Objective To explore the effect of DC and CIK autologous return on T lymphocyte subsets and NK cells in patients with gastric cancer after chemotherapy. Methods A total of 156 patients with gastric cancer underwent surgery in the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine during February 2016 to February 2017 were enrolled. These patients were divided into observation group and control group by random number table method,with 78 cases in each group. Patients in control group only received chemotherapy,and patients in observation group were supplemented with DC-CIK autologous reinfusion treatment. The short-term clinical effect of these two groups had been compared,and changes in peripheral blood T lymphocyte subsets and NK cells in these two groups were compared before and after treatment and the safety of treatment. Results The effective rate( RR) and disease control rate( DCR) of observation group were 47. 4% and66. 7%,respectively. The RR and DCR of control group were 41. 0% and 51. 3%,respectively. There was no significant difference in RR between these two groups( P > 0. 05). The difference in DCR between these two groups was statistically significant( P < 0. 05). Peripheral blood CD3~+( 61. 27 ± 3. 18%),CD4~+( 36. 45 ± 4. 25%),CD4~+/CD8~+( 1. 55 ± 0. 12%),and the percentage( 21. 43 ± 3. 17%) of natural killer( NK) cells was higher in observation group than that of control group. Groups( 53. 49 ± 3. 75%,28. 17 ± 3. 38%,1. 17 ± 0. 15%,15. 28 ±3. 32%)( P < 0. 05). No serious adverse reactions occurred in these two groups during the treatment course. Conclusion For patients with advanced gastric cancer,dc-cik autologous treatment can raise the level of T lymphocyte subgroup and NK cells and help to protect the efficacy of anti-tumor treatment.
Objective To explore the effect of DC and CIK autologous return on T lymphocyte subsets and NK cells in patients with gastric cancer after chemotherapy. Methods A total of 156 patients with gastric cancer underwent surgery in the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine during February 2016 to February 2017 were enrolled. These patients were divided into observation group and control group by random number table method,with 78 cases in each group. Patients in control group only received chemotherapy,and patients in observation group were supplemented with DC-CIK autologous reinfusion treatment. The short-term clinical effect of these two groups had been compared,and changes in peripheral blood T lymphocyte subsets and NK cells in these two groups were compared before and after treatment and the safety of treatment. Results The effective rate( RR) and disease control rate( DCR) of observation group were 47. 4% and66. 7%,respectively. The RR and DCR of control group were 41. 0% and 51. 3%,respectively. There was no significant difference in RR between these two groups( P > 0. 05). The difference in DCR between these two groups was statistically significant( P < 0. 05). Peripheral blood CD3~+( 61. 27 ± 3. 18%),CD4~+( 36. 45 ± 4. 25%),CD4~+/CD8~+( 1. 55 ± 0. 12%),and the percentage( 21. 43 ± 3. 17%) of natural killer( NK) cells was higher in observation group than that of control group. Groups( 53. 49 ± 3. 75%,28. 17 ± 3. 38%,1. 17 ± 0. 15%,15. 28 ±3. 32%)( P < 0. 05). No serious adverse reactions occurred in these two groups during the treatment course. Conclusion For patients with advanced gastric cancer,dc-cik autologous treatment can raise the level of T lymphocyte subgroup and NK cells and help to protect the efficacy of anti-tumor treatment.
引文
[1]罗社文,毛积分,赵风翎,等.自体肿瘤抗原负载的树突细胞联合细胞因子诱导的杀伤细胞治疗中晚期非小细胞肺癌[J].肿瘤研究与临床,2011,23(9):588-590,597.
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[4]方娜,满昌峰,徐娟,等.树突状细胞联合细胞因子诱导的杀伤细胞对人大肠癌SW620细胞增殖和端粒酶活性的影响[J].中华实验外科杂志,2013,30(11):2302-2304.
[5]王赛男,高海燕,潘欣,等. DC-CIK治疗对肾癌患者淋巴细胞亚群的影响[J].中国肿瘤生物治疗杂志,2012,19(3):309-312.
[6]李辉,毛伟征,安岗,等.细胞因子诱导杀伤细胞杀伤胃癌的特异性与非特异性研究[J].中华实验外科杂志,2010,27(4):428-430.
[7]张宏,袁晔,沈诚,等.树突状细胞共培养细胞因子诱导的杀伤细胞联合培美曲塞或吉西他滨单药化疗治疗老年NSCLC的疗效和安全性[J].临床和实验医学杂志,2017,16(11):1107-1110.
[8]唐家平,李锦毅.负载胃癌干细胞抗原的树突细胞对胃癌细胞免疫作用的研究[J].中国医学工程,2013,21(3):1-2,5.
[9]宫妍婕.四种多糖对细胞因子诱导的杀伤细胞和树突状细胞抗肿瘤作用的影响[D].济南:山东大学,2016.
[10]张成磊,陈耀平,杨宝珍,等. CIK、DC-CIK细胞杀伤胃癌MKN-28细胞的作用比较[J].宁夏医学杂志,2012,34(1):7-9,前插1.
[11]王美清,彭大为,程小珍,等.自体免疫细胞治疗前后胃癌患者外周血免疫功能测定及临床意义[J].中国现代医学杂志,2014,24(35):35-38.
[12]高作文,郑劼,娄金书,等. DC-CIK细胞免疫治疗胃癌的临床疗效及预后分析[J].中国肿瘤生物治疗杂志,2017,24(2):174-179.
[13]吕刚,张庆军,史玉琪,等.化疗联合CIK细胞和树突细胞治疗对晚期胃癌的疗效观察[J].解放军医学杂志,2015,40(6):475-478.
[2]中国华人民共和国卫生部.中国常见恶性肿瘤诊治规范[S].北京医科大学、中国协和医科大学联合出版社,1991:85-87.
[3]杨晓亚,高裕华,刘素蕊,等.肝癌特异性靶标致敏DC诱导CIK细胞对肝癌HuH-7细胞及移植瘤的抑制[J].中国肿瘤生物治疗杂志,2014,21(5):505-509.
[4]方娜,满昌峰,徐娟,等.树突状细胞联合细胞因子诱导的杀伤细胞对人大肠癌SW620细胞增殖和端粒酶活性的影响[J].中华实验外科杂志,2013,30(11):2302-2304.
[5]王赛男,高海燕,潘欣,等. DC-CIK治疗对肾癌患者淋巴细胞亚群的影响[J].中国肿瘤生物治疗杂志,2012,19(3):309-312.
[6]李辉,毛伟征,安岗,等.细胞因子诱导杀伤细胞杀伤胃癌的特异性与非特异性研究[J].中华实验外科杂志,2010,27(4):428-430.
[7]张宏,袁晔,沈诚,等.树突状细胞共培养细胞因子诱导的杀伤细胞联合培美曲塞或吉西他滨单药化疗治疗老年NSCLC的疗效和安全性[J].临床和实验医学杂志,2017,16(11):1107-1110.
[8]唐家平,李锦毅.负载胃癌干细胞抗原的树突细胞对胃癌细胞免疫作用的研究[J].中国医学工程,2013,21(3):1-2,5.
[9]宫妍婕.四种多糖对细胞因子诱导的杀伤细胞和树突状细胞抗肿瘤作用的影响[D].济南:山东大学,2016.
[10]张成磊,陈耀平,杨宝珍,等. CIK、DC-CIK细胞杀伤胃癌MKN-28细胞的作用比较[J].宁夏医学杂志,2012,34(1):7-9,前插1.
[11]王美清,彭大为,程小珍,等.自体免疫细胞治疗前后胃癌患者外周血免疫功能测定及临床意义[J].中国现代医学杂志,2014,24(35):35-38.
[12]高作文,郑劼,娄金书,等. DC-CIK细胞免疫治疗胃癌的临床疗效及预后分析[J].中国肿瘤生物治疗杂志,2017,24(2):174-179.
[13]吕刚,张庆军,史玉琪,等.化疗联合CIK细胞和树突细胞治疗对晚期胃癌的疗效观察[J].解放军医学杂志,2015,40(6):475-478.