DC-CIK细胞治疗联合TACE及RFA治疗小肝癌的疗效  

DC-CIK cell therapy combined with transcatheter arterial chemoembolization and radiofrequency ablation for treatment of small hepatocellular carcinoma

作　　者：张泉成[1] 潘国政[2] 李国强[2] 袁庆忠[2] 徐教邦[2] 孔阳[3] 王立明[3] 

机构地区：[1]胜利石油管理局卫生管理中心,山东省东营市257034 [2]胜利油田中心医院肝胆外科,山东省东营市257034 [3]大连医科大学附属二院肝胆胰外科,辽宁省大连市116023

出　　处：《世界华人消化杂志》2014年第16期2237-2242,共6页World Chinese Journal of Digestology

基　　金：国家自然科学基金资助项目;No.81272368~~

摘　　要：目的:探讨DC-CIK细胞治疗联合肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)及射频消融(radiofrequency ablation,RFA)治疗小肝癌(small hepatic carcinoma,SHCC)的临床效果及免疫状态变化.方法:2008-03/2012-03本院收治SHCC患者85例,纳入对象分为2组,所有患者均先行TACE联合RFA治疗.其中研究组41例,术后7 d均完成6次DC-CIK细胞治疗,每次回输细胞>1×1010,检测患者在DC-CIK治疗前后外周血甲胎蛋白(alpha fetoprotein,AFP)、谷丙转氨酶(alanine aminotransferase,ALT)、谷草转氨酶(aspartate aminotransferase,AST)、T细胞及NK细胞水平变化;对照组44例,未行DC-CIK过继性免疫治疗.结果:对照组A组治疗前vs治疗后AFP均值为494.5 mg/L±51.3 mg/L vs 226.5 mg/L±39.4 mg/L,P<0.05;研究组B组治疗前vs治疗后AFP均值为486.4 mg/L±54.8 mg/L vs 168.7mg/L±49.5 mg/L,P<0.01.B组ALT、AST治疗前vs治疗后为66 U/L±6.3 U/L、68 U/L±7.7 U/L vs 31 U/L±5.9 U/L、45 U/L±3.7 U/L,P<0.05;对照组为67 U/L±7.4 U/L、63 U/L±4.5 U/L vs 65 U/L±6.2 U/L、61 U/L±5.2 U/L,P>0.05.治疗后6 mo影像学检查B组vs A组有效率分别为87.80%vs 79.54%,P<0.05.B组vs A组1、2、3年生存率分别为95.1%,71.6%,68.3%vs 90.9%,65.9%,59.1%,P<0.05.B组治疗后外周血CD3+、CD16+CD56+和CD4+/CD8+细胞比值均上升(P<0.05),CD8+效应细胞比例下降(P<0.05).结论:DC-CIK细胞治疗序贯TACE联合RFA治疗可改善SHCC患者术后肝功能,提高患者免疫水平,降低肿瘤复发,延长SHCC患者生存期.AIM： To evaluate the efficacy of dendritic and cytokine-induced killer cell therapy（DC-CIK） after transcatheter arterial chemoembolization combined with radiofrequency ablation in patients with small hepatocellular carcinoma （SHCC） and to investigate the changes in immunologic indexes in patients with SHCC. METHODS： Eighty-five patients with SHCC treated at our hospital from April 2008 to April 2012 were recruited and divided into two groups after transcatheter arterial chemoembolization（TACE） and radiofrequency ablation（RFA）： a study group and a control group. The study group（n = 41） received DC-CIK therapy 6 times 7 days after TACE and RFA, and the number of DC-CIK cells was above 1.0×1010. The control group（n = 44） only received TACE and RFA. RESULTS： AFP differed significantly between before and after treatment in both the control group（494.5 mg/L ± 51.3 mg/L vs 226.5 mg/L ± 39.4 mg/L, P ＆lt; 0.05） and the study group（486.4 mg/L ± 54.8 mg/L vs 168.7 mg/L ± 49.5 mg/L, P ＆lt; 0.01）. ALT and AST differed significantly between before and after treatment in the study group（66 U/L ± 6.3 U/L vs 31 U/L ± 5.9 U/L, 68 U/L ± 7.7 U/L vs 45 U/L ± 3.7 U/L, P ＆lt; 0.05 for both）, but showed no significant differences in the control group（67 U/L ± 7.4 U/L vs 65 U/L ± 6.2 U/L, 63 U/L ± 4.5 U/L vs 61 U/L ± 5.2 U/L, P ＆gt; 0.05 for both）. The efficacy evaluated by imaging examination in the study group was better than that in the control group（87.80% vs 79.54%, P ＆lt; 0.05）. The 1-, 2- and 3-year survival rates were significantly better in the study group than in the control group（95.1% vs 90.9%, 71.6% vs 65.9%, 68.3% vs 59.1%, P ＆lt; 0.05 for all）. The percentages of CD3＋ and CD16＋CD56＋ cells and the ratio of CD4＋/CD8＋ cells were significantly increased after DC-CIK therapy（P ＆lt; 0.05 for all）, while the percentage of CD8＋ cells was decreased in the study group（P ＆lt; 0.05）.CONCLUSION： Sequential DC-CIK therapy after TAC

关 键 词：小肝癌 肝动脉化疗栓塞 射频消融 DC-CIK细胞治疗 

分 类 号：R735.7[医药卫生—肿瘤]