DC-CIK细胞过继免疫治疗联合XELOX方案化疗对进展期结直肠癌患者的疗效分析
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摘要
目的探讨树突状细胞-细胞因子诱导杀伤细胞(DC-CIK)细胞过继免疫治疗联合奥沙利铂+卡培他滨(XELOX)方案化疗对进展期结直肠癌(CRC)患者的疗效。方法将104例进展期CRC患者按随机数字表法分为观察组和对照组各52例,观察组行DC-CIK联合化疗,对照组行化疗。检测患者治疗前后血清糖类抗原242(CA242)、糖类抗原19-9(CA19-9)、癌胚抗原(CEA)、T淋巴细胞亚群[自然杀伤性T(NKT)细胞、自然杀伤(NK)细胞、CD4~+、CD3~+、CD8~+]及白细胞介素-6(IL-6)、白细胞介素-2(IL-2)、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)水平,评价患者近期疗效。结果观察组患者的缓解率(RR)为61.54%(32/52),疾病控制率(DCR)为75.00%(39/52),分别高于对照组的40.38%(21/52)和55.77%(29/52),差异均有统计学意义(P<0.05)。治疗后,两组患者血清CEA水平均低于治疗前,差异均有统计学意义(P<0.05);治疗后,观察组患者血清IL-2、IFN-γ、TNF-α、CD4~+、CD3~+、CD8~+及NKT细胞水平均高于对照组,差异均有统计学意义(P<0.05)。结论 CRC患者行DC-CIK细胞过继免疫治疗联合XELOX方案化疗可改善机体免疫功能,弥补单纯化疗所造成的免疫抑制,为安全有效的疗法。
Objective To analyze the efficacy of adoptive cellular immunotherapy of dendric cell and cytokine-induced killer cell(DC-CIK) combined with oxaliplatin + carboplatin(XELOX) chemotherapy in patients with advanced colorectal cancer(CRC). Method A total of 104 patients with CRC were randomized into observation group or control group by a random number table, with 52 cases in each, the observation group was treated with DC-CIK combined chemotherapy, while the control group was administered with simple chemotherapy. The level of serum carbohydrate antigen 242(CA242), CA19-9 and carcinoembryonic antigen(CEA), as well as the T lymphocyte subsets [natural killer T(NKT)cells, natural killer(NK) cells, CD4~+, CD3~+, CD8~+] and interleukin-6(IL-6), IL-2, interferon-γ(IFN-γ), and tumor necrosis factor-α(TNF-α) were measured before and after treatment, and the efficacy was evaluated. Result The response rate(RR) in observation group was 61.54%(32/52), and disease control rate(DCR) was 75.00%(39/52), and both were higher than that in control group at 40.38%(12/52) and 55.77%(29/52), respectively, with statistically significant differences observed(P<0.05). After treatment, the serum level of CEA in both groups were decreased significantly(P<0.05); and the serum level of IL-2, IFN-γ, TNF-α, CD4~+, CD3~+, CD8~+, and NKT cells in observation group were evidently higher than those in the control group, with statistically significant differences noted(P<0.05). Conclusion DC-CIK adoptive cellular immunotherapy combined with XELOX chemotherapy can significantly improve the immune function of CRC patients and compensate for the immunosuppression caused by chemotherapy alone, with acceptable safety and efficacy.
Objective To analyze the efficacy of adoptive cellular immunotherapy of dendric cell and cytokine-induced killer cell(DC-CIK) combined with oxaliplatin + carboplatin(XELOX) chemotherapy in patients with advanced colorectal cancer(CRC). Method A total of 104 patients with CRC were randomized into observation group or control group by a random number table, with 52 cases in each, the observation group was treated with DC-CIK combined chemotherapy, while the control group was administered with simple chemotherapy. The level of serum carbohydrate antigen 242(CA242), CA19-9 and carcinoembryonic antigen(CEA), as well as the T lymphocyte subsets [natural killer T(NKT)cells, natural killer(NK) cells, CD4~+, CD3~+, CD8~+] and interleukin-6(IL-6), IL-2, interferon-γ(IFN-γ), and tumor necrosis factor-α(TNF-α) were measured before and after treatment, and the efficacy was evaluated. Result The response rate(RR) in observation group was 61.54%(32/52), and disease control rate(DCR) was 75.00%(39/52), and both were higher than that in control group at 40.38%(12/52) and 55.77%(29/52), respectively, with statistically significant differences observed(P<0.05). After treatment, the serum level of CEA in both groups were decreased significantly(P<0.05); and the serum level of IL-2, IFN-γ, TNF-α, CD4~+, CD3~+, CD8~+, and NKT cells in observation group were evidently higher than those in the control group, with statistically significant differences noted(P<0.05). Conclusion DC-CIK adoptive cellular immunotherapy combined with XELOX chemotherapy can significantly improve the immune function of CRC patients and compensate for the immunosuppression caused by chemotherapy alone, with acceptable safety and efficacy.
引文
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[2]俞雷来.CEA、CA19-9水平与晚期结直肠癌化疗预后的关系[J].中华全科医学,2017,15(5):905-907.
[3]刘睿,史南.树突状细胞和细胞因子诱导的杀伤细胞联合化疗治疗结肠癌的临床疗效及其对免疫功能变化的影响[J].中国肿瘤临床与康复,2016,23(4):401-404.
[4]Radomski M,Zeh HJ,Edington HD,et al.Prolonged intralymphatic delivery of dendritic cells through implantable lymphatic ports in patients with advanced cancer[J].J Immunother Cancer,2016,4:24.
[5]杨学宁,吴一龙.实体瘤治疗疗效评价标准--RECIST[J].循证医学,2004,4(2):85-90.
[6]高玉芹,卫刚要,魏军功,等.贝伐珠单抗联合化疗治疗结直肠癌肝转移的疗效观察[J].中国肿瘤临床与康复,2018,25(3):262-265.
[7]周勇,杨勇.两种同步放化疗方案对复发性结直肠癌患者生存时间及不良反应的影响[J].检验医学与临床,2017,14(11):1565-1567.
[8]朱克祥,王锦明,袁得峰,等.结肠癌细胞裂解物致敏的树突状细胞-细胞因子诱导杀伤细胞抗自体结肠癌细胞效应研究[J].临床军医杂志,2018,46(8):878-881.
[9]王晓辉,张俊,惠玲,等.化疗联合DC-CIK细胞免疫治疗对晚期结直肠癌的临床疗效及免疫功能的影响[J].西北国防医学杂志,2017,38(6):351-356.
[10]Mosińska P,Gabryelska A,Zasada M,et al.Dual functional capability of dendritic cells-cytokine-induced killer cells in improving side effects of colorectal cancer therapy[J].Front Pharmacol,2017,8:126.
[11]杨华,肖刚,吴国举.CEA和CA19-9在结直肠癌患者中的诊断及预后价值[J].中国现代普通外科进展,2017,20(7):518-521.
[12]申妮,张永利,王志尚,等.新辅助化疗对直肠癌患者肿瘤标志物与疾病复发转移指标的影响[J].实用癌症杂志,2018,33(1):96-98.
[13]刘永增.腹腔镜联合纤维结肠镜手术对早期结肠癌患者血清Th1/Th2指标及机体免疫功能的影响[J].临床合理用药杂志,2017,10(14):115-116.
[14]胡孝祯,高鹏.腹腔镜联合结肠镜行结肠癌根治术对结肠癌患者Th1、Th2细胞因子的影响[J].实用癌症杂志,2018,33(1):23-26.
[15]Wang LH,Wang LL,Zhang J,et al.Th1/Th2 and Treg/Th17 cell balance in peripheral blood of patients with ovarian cancer[J].Nan Fang Yi Ke Da Xue Xue Bao,2017,37(8):1066-1070.
[16]周大勇,霍占伟,黄海进,等.腹腔镜联合纤维结肠镜手术对早期结肠癌患者Th1/Th2状态的影响[J].医学综述,2016,22(10):2051-2053.