人结肠癌主动特异性免疫治疗的初步研究  

Preliminary study of active specific immunotherapy for human colon cancer

作　　者：姚德茂[1] 陈武科[1] 潘承恩[1] 

机构地区：[1]西安交通大学医学院第一附属医院外科,陕西西安710061

出　　处：《现代肿瘤医学》2006年第10期1244-1247,共4页Journal of Modern Oncology

基　　金：陕西省科技攻关基金资助[编号:2001K10-G5(2)];陕西省自然科学基金资助(编号:2002C251)

摘　　要：目的：探讨自体肿瘤疫苗的作用机制及临床意义。方法：50例进展期结肠癌病人术后，以自体肿瘤细胞疫苗辅助主动免疫治疗。术后第4周开始免疫接种（共4次，每次间隔7～10天）；接种前3天及第4次接种后1周，采集外周血。采集血清监测血清IFN-γ IL-10水平；用PPD及自体肿瘤抗原做皮肤迟发型过敏试验（DTH），48小时后测量红斑、硬结大小（mm）；对DTH反应部位皮肤活检，用免疫组化染色，了解局部免疫活性细胞浸润；临床随访。结果：自体肿瘤细胞疫苗治疗后：血清IFN-γ水平升高，由（6．01±2．30）pg／ml升至（12．98±4．65）pg／ml；而IL-10水平由（19．80±10．15）pg／ml降至（8．92±4．60）pg／ml，差异有非常显著性（P〈0．05）；治疗前后病人对自体肿瘤抗原的特异性DTH反应明显增强（P〈0．01）；DTH反应部位，CD8^＋T细胞、CD4^＋T细胞及DC细胞浸润明显增多；病人耐受性良好，无溃疡等严重副作用发生；随访结果显示：术后辅助自体肿瘤疫苗主动特异性免疫治疗，可延长结肠癌病人的无瘤生存时间，降低复发率及死亡率。结论：自体肿瘤疫苗可激发病人特异性细胞介导的免疫反应；可改善肿瘤病人的抗瘤免疫反应；自体肿瘤疫苗主动特异性免疫治疗，对于杀灭残留癌细胞、抗转移及复发有重要作用。Objective：To explore the mechanism of active immunotherapy with autologous tumor vaccine and clinical significance. Methods： Fifty patients with advanced colon cancer were enrolled in this study. 4 weeks after operation, the patients received vaccinations of autologous tumor vaccine every 7 - 10 days for 4 times as adjuvant active immunotherapy, 3 days before and 7 days after administrations; serum IFN - γ/and IL - 10 were measured, within 48 hours after the skin tests with PPD and autologous tumor antigen, diameters of erythemas or indurations were observed, in order to assay DTH local cellular immune response, the biopsy specimens of DTH skin reactions were analyzed by immunohistoehemistry. The clinical follow - up was performed. Results： After active immunotherapy with autologous tumor vaccine. The serum IFN - γ was increased from （6.01±2.30）pg/ml to （ 12.98 ±4.65） pg/ml（P 〈 0.05 ） and the serum IL - 10 was decreased from （ 19.80 ± 10.15 ） pg/ml to （ 8.92 ± 4.60 ） pg/ml （ P 〈 0.05 ）. Specific DTH reactions to autologous tumor antigen were enhanced obviously（p 〈0.01 ）. The analysis of DTH skin reactions site biopsy specimens showed dense infictration with CD8^＋ T cells and CD4^＋ T cells, DC cells. Patients could tolerat well without serious side effects such as ulceration. The follow - up showed that the disease - free interval of 50 patients with advanced colon cancer was longer than control group. It can decrease the rate of recurrence and death with patients of advanced colon cancer. It may decrease rate death and recurrence of patients with colon cancer using adjuvant active specific immunotherapy. Conclusion. The autologous tumor vaccine can elicit specific cellular immune response. Improve the host＇s anti - tumor immune response. It may play an important role in improving life quality survival and prevention of recurrence and metastasis.

关 键 词：人结肠癌 细胞免疫 自体肿瘤疫苗 特异性反应 主动特异性免疫治疗 

分 类 号：R735.35[医药卫生—肿瘤]