恶性黑色素瘤主动特异性免疫治疗的临床研究  

Clinical study of the treatment of malignant melanoma with active specific immunotherapy

作　　者：常东民[1] 张勇[1] 陈德强[1] 朱琨[1] 李康[1] 党诚学[1] 

机构地区：[1]西安交通大学医学院第一附属医院肿瘤外科,西安710061

出　　处：《陕西医学杂志》2010年第2期214-216,共3页Shaanxi Medical Journal

摘　　要：目的:探讨冷冻后瘤苗回植联合免疫佐剂及生物制剂在恶性黑色素瘤患者免疫生物治疗中的临床意义。方法:对45例经前哨淋巴结活检证实不伴有区域淋巴结转移的临床I期肢端恶性黑色素瘤患者分别采用冷冻后瘤苗回植联合免疫佐剂及生物制剂治疗(观察组)(28例)与常规手术切除联合生物制剂治疗(对照组)(17例),观察两组治疗前后免疫功能变化,并评价3年总生存期及无瘤生存期。结果:主动特异性免疫治疗中位生存时间29个月,手术联合生物制剂治疗中位生存时间18个月(P<0.05)。治疗后主动特异性免疫治疗CD4,CD4/CD8较手术联合生物制剂治疗明显升高(P均<0.05)。主动特异性免疫治疗3年总生存期(91.3%)及无瘤生存期(87.5%);高于手术联合生物制剂治疗的71.3%及54.7%(P均<0.05)。结论:冷冻后瘤苗回植联合免疫佐剂及生物制剂的主动特异性免疫治疗在临床I期恶性黑色素瘤患者中可提高患者免疫功能,较手术联合生物制剂治疗明显延长患者生存时间。Objective： To observe the effect of active specific immunotherapy with auto-tumour vaccine replantation and corynbacterium paruum in the treatment of malignant melanoma. Methods ：From 2004 to 2005, there were 45 patients with clinical stage I extremity melanoma without regional lymph node metastasis divided into two groups. The treatment group （28 patients） were treated with auto-turnout vaccine replantation and corynbacterium paruum. The comparison group （17 patients）were treated with INFaand IL-2 after surgery. Immunity level and the 3 year OS and DFS between the two groups were compared. Results：The median survival time was 29 months in the treatment group and 18 months in the comparison group respectively （P〈0. 05）. The CD4, CD4/CD8 ratio of the T cell subgroup in treatment group have the different degree of significantly increase compared with not only its initial but also the comparison group （both P〈0. 05）. The three years OS in the treatment group was 91.3% and 71.3% in the comparison group（P〈0.05）. The three years DFS in the treatment group was 87.5 % and 54.7 % in the comparison group（P〈0.05）. Conclusion ：The autotumour vaccine replantation can enhance the immune activity of the organism and extend the life span of patlents

关 键 词：黑色素瘤/治疗 免疫疗法 主动 佐剂 免疫 

分 类 号：R739.5[医药卫生—肿瘤]