负载抗原的DC疫苗联合多种T细胞治疗非小细胞肺癌的近期疗效与不良反应  

Efficacy and adverse reactions of antigen-loaded dendritic cell vaccine in combination with various T cells on nonsmall-cell lung cancer

作　　者：王作志[1] 解尚云[2] 刘庆云[1] 魏长宏[1] 卞晓山[1] 

机构地区：[1]武警山东总队医院肿瘤科,济南250014 [2]武警山东总队医院生物诊疗中心,济南250014

出　　处：《武警医学》2015年第3期276-279,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的评估采用负载抗原的DC疫苗联合多种细胞因子诱导的杀伤细胞(CIK)、γδ受体的T细胞(γδT)和自然杀伤细胞(NK)治疗非小细胞肺癌的近期疗效与不良反应。方法经机采后分离出单个核细胞(peripheral blood mononuclear cell,PBMC),体外经相应的细胞因子诱导产生DC、γδT、CIK和NK细胞。所有患者接受一疗程治疗,即静脉输注或皮内注射4次DC疫苗,静脉输注γδT、CIK各3次,静脉输注NK细胞2次,共12次治疗。通过影像学检查及外周血T淋巴细胞亚群改变评估疗效和免疫学反应。结果 22例有可评价病灶的患者中9例部分缓解(PR),11例疾病稳定(SD),2例进展(PD);2例没有可评价病灶中1例PD,1例未见疾病进展。与治疗前比较,治疗2个月后CD3+、CD4+、CD56+有较大升高,差异有统计学意义(P<0.01)。结论负载抗原的DC疫苗联合多种T细胞治疗非小细胞肺癌有一定的近期临床疗效,能诱导出特异的抗非小细胞肺癌免疫反应。Objective To evaluate the clinical efficacy and adverse reaction of antigen-loaded dendritic cells（ DC） vaccine in combination with cytokine-induced killer cells（CIK）, gamma delta receptors of T cells（γδT）and natural killer cells（NK）on 24 pa-tients with lung cancer.Methods Mononuclear cells isolated by blood apheresis were induced into productions of DC,γδT, CIK and NK cells by corresponding cytokines in vitro.All patients received a course of treatment including intravenous infusion and intradermal injection of DC vaccine for four times, intravenous infusion ofγδT, CIK each 3 times and intravenous infusion of NK cells twice, a to-tal of 12 times.Clinical and immunologic responses were evaluated by imaging examination,T lymphocytes subset changes, respective-ly.Results 22 patients were enrolled in this study.During 5-24 months follow-up（ median,10 months） ,partial remission（ PR） in 9 cases,stability of disease（SD） in 11 cases,and progression of disease（PD） in 2 cases was identified with measurable diseases pro-gress.After 2 months treatment,the levels of CD3 ＋、CD4 ＋、CD56 ＋increased very significantly（P〈0.001）.No severe adverse events were observed except 2 patients with mild fever and 1 patient had muscular soreness.Conclusions Antigen-pulsed DCs in combina-tion with various T cells shows short-term efficacy on lung cancer through inducing specific antitumor immunity.

关 键 词：非小细胞肺癌 树突细胞 自然杀伤细胞 肿瘤裂解物 

分 类 号：R734.2[医药卫生—肿瘤]