动脉化疗栓塞联合CIK细胞过继免疫治疗对中晚期肝癌患者免疫功能的影响  

Influence of transcatheter arterial chemoembolization combined with cytokine-induced killer cell on the immune function in patients with advanced primary hepatocellular carcinoma

作　　者：杨茂[1] 郭志[1] 司同国[1] 邢文阁[1] 刘方[1] 李保国[1] 于海鹏[1] 

机构地区：[1]天津医科大学附属天津肿瘤医院肿瘤介入治疗科天津市肿瘤防治重点实验室,300060

出　　处：《介入放射学杂志》2011年第2期116-119,共4页Journal of Interventional Radiology

基　　金：国家科技支撑计划课题资助项目(编号:2007BAI05B06)

摘　　要：目的分析肝动脉化疗栓塞(TACE)联合细胞因子诱导的杀伤细胞(CIK)过继免疫治疗对中晚期肝癌患者外周血T淋巴细胞亚群及NK细胞的影响及临床意义。方法回顾天津肿瘤医院136例中晚期原发性肝癌患者(均为TACE术后,经影像学检查显示无远处转移)资料,依据治疗方式分为两组:TACE联合CIK治疗67例为研究组,单纯TACE治疗69例为对照组。分别于治疗前、治疗后相同时间点取外周血,测定AFP、T淋巴细胞亚群及NK细胞计数变化;术后1个月采用增强CT、MRI或PET-CT评价肿瘤坏死程度。结果研究组与对照组近期疗效及AFP下降率比较,差异无统计学意义(P>0.05)。对照组治疗前后比较,CD3+、CD4+、NK细胞比率及CD4+/CD8+分别由(50.26±6.37)%、(53.20±9.29)%、(21.03±8.58)%、1.58±0.43下降至(48.95±8.83)%(P>0.05)、(50.09±9.99)%(P<0.01)、(19.63±8.42)%(P>0.05)、1.44±0.52(P<0.01),CD8+、Treg细胞比率分别由(35.70±8.71)%、(6.55±1.47)%上升至(38.04±10.50)%(P<0.05)、(6.76±1.67)%(P>0.05)。研究组治疗前后比较,CD3+、CD4+、NK细胞比率及CD4+/CD8+分别由(50.51±12.37)%、(52.48±15.55)%、(20.67±10.92)%、1.76±0.90上升至(53.62±11.37)%(P<0.01)、(55.62±14.63)%(P<0.05)、(23.23±10.37)%(P<0.01)、1.94±0.84(P<0.01),CD8+、Treg细胞比率分别由(35.61±12.90)%、(6.57±4.88)%下降至(32.68±10.56)%(P<0.05)、(4.77±1.99)%(P<0.01)。结论 TACE术后联合CIK细胞过继性免疫治疗可以改善患者免疫状态,提高机体的抗肿瘤免疫效应,有可能降低中晚期HCC患者TACE术后的复发和转移机会。Objective To investigate the influence of TACE and autologous cytokine-induced killer（CIK） cells on the peripheral T lymphocyte subsets and native killer cell in patients with advanced primary hepatocellular carcinoma（HCC）.Methods A total of 136 patients with unresectable HCC were divided into study group（n = 67,patients were treated with CIK cell therapy after TACE）,and control group（n = 69,patients were treated with TACE only）.The serum levels of AFP,T lymphocyte subsets and native killer（NK） cell in peripheral blood of HCC patients were determined before and after the treatment.Tumor condition was observed by CT,MRI or PET-CT one month after the treatment.Results No significant difference in serum AFP level decrease and therapeutic effectiveness existed between two groups（P 0.05）.In the control group,the percentages of CD3＋,CD4＋,NK cells and the proportion of CD4＋/CD8＋ decreased from（50.26 ± 6.37）%,（53.20 ± 9.29）%,（21.03 ± 8.58）%,1.58 ± 0.43 to（48.95 ± 8.83）%（P 0.05）,（50.09 ± 9.99）%（P 0.01）,（19.63 ± 8.42）%（P 0.05）,1.44 ± 0.52（P 0.01） respectively,while CD8＋ and Treg cells increased from（35.70 ± 8.71）%,（6.55 ± 1.47）% to（38.04 ± 10.50）%（P 0.05）,（6.76 ± 1.67）%（P 0.05） respectively.In the study group,the percentages of CD3＋,CD4＋,NK cells and the proportion of CD4＋/CD8＋ increased from（50.51 ± 12.37）%,（52.48 ± 15.55）%,（20.67 ± 10.92）%,1.76 ± 0.90 respectively to（53.62 ± 11.37）%（P 0.01）,（55.62±14.63）%（P 0.05）,（23.23 ± 10.37）%（P 0.01）,1.94 ± 0.84（P 0.01） respectively,while CD8＋ and Treg cells decreased from（35.61 ± 12.90）%,（6.57 ± 4.88）% to（32.68 ± 10.56）%（P 0.05）,（4.77 ± 1.99）%（P 0.01） respectively.Conclusion Autologous CIK cells transfusion after TACE can efficiently improve the immunological status in HCC patients,moreover,it may provide a potent means to reduce the recurrence rate of HCC.

关 键 词：原发性肝细胞癌 细胞因子诱导杀伤细胞 T淋巴细胞亚群 NK细胞 CD4+CD25+调节T细胞(Treg细胞) 

分 类 号：R735.7[医药卫生—肿瘤]