免疫治疗预防大肠癌术后肝转移  

Prevention of hepatic metastasis from colorectal cancer by immunotherapy after resection of colorectal cancer

作　　者：阚和平[1] 田伏洲[1] 周庆贤[1] 刘晓波[1] 李小军[1] 

机构地区：[1]成都军区总医院全军普外中心,四川成都610083

出　　处：《中国普通外科杂志》2001年第3期234-236,共3页China Journal of General Surgery

摘　　要：目的　探讨肿瘤浸润淋巴细胞 (TIL)、重组白细胞介素 2 (rIL 2 )和环磷酰胺经门静脉输入治疗对进展期大肠癌根治术后患者免疫功能的影响及术后肝转移的预防作用。方法　将12 4例DukesB及C期大肠癌患者于根治术后随机分为免疫治疗组和对照组。对照组 5 9例 ,术后使用氟尿嘧啶 (5 Fu)、丝裂霉素C(MMC)经静脉化疗 ;免疫治疗组 6 5例 ,术后使用TIL ,rIL 2和环磷酰胺经门静脉插管输入 ,以后的治疗与对照组相同。所有病例均随访 3年。结果　免疫治疗组术后 3年内大肠癌肝转移 8例 (12 3% ) ,而对照组为 19例 (33 2 % ) ,二者差异显著 (P <0 .0 5 )。免疫治疗后 ,患者外周血自然杀伤细胞 (NK)、白细胞介素 2 (IL 2 )活性及T细胞亚群CD3,CD4,CD4 CD8都显著上升 (P <0 .0 5 )。结论　TIL ,rIL 2联合环磷酰胺免疫治疗对提高进展期大肠癌术后患者抗肿瘤细胞免疫力 。Objective To study the preventive effect of hepatic metastasis from colorectal cancer and the immune function influence on postoperative patients with colorectal cancer treated by TIL, rIL 2 and cyclophosphamide by portal vein infusion. Methods One hundred and twenty four patients with advanced colorectal cancer (Dukes B and Dukes C stage) were randomly divided into immunotherapy group and control group. The control group were treated with 5 Fu and MMC by intravenous injection after resection of colorectal cancer. The immunotherapy group were treated with TIL, rIL 2 and cyclophosphamide by portal vein infusion after resection of the tumor, then with chemotherapy as the control group. All cases were followed up for 3 years. Results Eight cases (12.3%) had hepatic metastases from colorectal cancer in the immunotherapy group, but nineteen cases (33.2%) in the control group. There was significant difference between the two groups (P>0.05). The NK, IL 2 activity and CD3, CD4, CD4/CD8 levels in peripheral blood of the immunotherapy group increased significantly after treatment (P<0.05). Conclusions The TIL, rIL 2 and cyclophosphamide treatment after resection of colorectal cancer is effective in improving antitumorgenic immune function, and preventing hepatic metastases.

关 键 词：结直肠肿瘤/外科学 结直肠肿瘤/药物疗法 免疫疗法 肝肿瘤/继发性 肝肿瘤/预防和控制 

分 类 号：R735.340.5[医药卫生—肿瘤]