动脉栓塞联合CIK细胞对中晚期肾癌患者免疫功能的影响  

Effects of Transcatheter Renal Arterial Embolization(TRAE) Combined with Cytokine induced Killer Cell on Immune Function in Patients with Advanced Renal Cellular Carcinoma

作　　者：杨茂[1] 郭志[1] 司同国[1] 邢文阁[1] 刘方[1] 邢纪中[1] 

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

出　　处：《临床放射学杂志》2011年第3期398-401,共4页Journal of Clinical Radiology

基　　金：国家十一五科技支撑计划(编号:2007BAI05B06)

摘　　要：目的分析肾动脉栓塞(transcatheter renal arterial embolization,TRAE)联合细胞因子诱导的杀伤细胞(cy-tokine-induced killer cell,CIK cell)过继免疫治疗对中晚期肾癌患者外周血CD4+CD25+调节性T细胞(regulatory Tcell,Treg)细胞比例、细胞免疫功能的影响及临床意义。资料与方法 65例中晚期肾癌患者(均为TRAE术后,经影像学检查显示无远处转移),以入院先后顺序随机分为两组:TRAE联合CIK治疗30例为研究组,单纯TRAE治疗35例为对照组,研究组患者在TRAE术后1周静脉补充CIK细胞治疗。分别于治疗前1周、治疗后3个月取外周血,流式细胞仪检测T淋巴细胞亚群及NK细胞比例变化;术后采用增强CT、MRI或PET-CT评价肿瘤坏死程度。结果研究组与对照组客观有效率相比,差异无统计学意义(P>0.05)。研究组Treg细胞比例由(5.75±1.85)%下降至(4.55±1.76)%,二者差异具有统计学意义(P<0.01);CD3+、CD4+、NK细胞比例及CD4+/CD8+分别由(52.24±12.56)%、(46.33±16.26)%、(17.72±6.89)%、1.25±0.66上升至(62.22±10.58)%(P<0.01)、(53.00±14.17)%(P<0.05)、(21.59±8.08)%(P<0.01)、1.57±0.70(P<0.01),CD8+由(43.95±13.78)%下降至(38.23±10.74)%(P<0.05)。对照组治疗前后Treg细胞比例及CD8+比例略有下降,CD3+、CD4+、NK细胞比例及CD4+/CD8+略有增加,但差异无统计学意义(P>0.05)。研究组中位生存期为18个月,明显高于对照组的12个月,二者差异具有统计学意义(P<0.05)。相关性分析显示:治疗后Treg细胞比例下降程度与生存期呈正相关关系(P<0.01)。结论 TRAE联合CIK细胞过继性免疫治疗中晚期肾癌能改善患者细胞免疫抑制状态,提高机体的抗肿瘤免疫效应,延长患者生存期。Objective To investigate the influence of TRAE and autologous cytokine induced killer（CIK） cells on the differentiation of regulatory CD4CD25＋T cell（Treg）,immune function and their implication in patients with advanced renal cell carcinoma（RCC）.Materials and Methods A total of 65 patient with RCC were divided into resarch group（30 patients treaed with CIK cell thrapy after TRAE）and control group（35 patients treated only with TRAE）.The levels of T lymphocyte subsets and native killer（NK） cell in peripheral blood of RCC patients before and after treatment were detected.Tumor condition was observed by CT,MRI or PET-CT 1 month after treatment.Results The therapeutic efficacy between two gtoups had no significant difference（P0.05）.In the resarch group,the percentages of Treg cells decreased from（5.75±1.85）% to（4.55±1.76）%（P0.01）CD3＋,CD4＋,NK cells and the proportion of CD4＋/CD8＋ increased from（52.24±12.56）%,（46.33±16.26）%,（17.72±6.89）%,1.25±0.66 to（62.22±10.58）%（P0.01）,（53.00±14.17）%（P0.05）,（21.59±8.08） %（P0.01）,1.57±0.70（P0.01）,while CD8＋ cells decreased from（43.95±13.78）% to（38.23±10.74）%（P0.05）.In the control group,the percentages of Treg,CD3＋,CD4＋,NK cells and the proportion of CD4＋/CD8＋ had no significant changes（P0.05）.The median survival of patients were 18 months vs.12 months（P0.05）.The decreasing extent of Treg is correlated with life time（P0.01）.Conclu-sion TRAE combined with autologous CIK cells transfusion should efficiently improve the immunological status in RCC patients,consequently prolonging the patients′survival.

关 键 词：肾细胞癌 细胞因子诱导杀伤细胞(CIK细胞) T淋巴细胞亚群 CD4+CD25+调节T细胞(Treg细胞) 

分 类 号：R737.11[医药卫生—肿瘤]