自体树突状细胞疫苗联合细胞因子诱导的杀伤细胞治疗胆系肿瘤的临床疗效观察  

Autologous dendritic cells vaccine combined with cytokine-induced killer cells in treatment of biliary tract cancer:a clinical observation of efficacy

作　　者：寇晓霞[1] 杨喜晶[1] 黄耀[1] 袁振刚[1] 钱其军[1] 

机构地区：[1]第二军医大学东方肝胆外科医院生物治疗科,上海200438

出　　处：《第二军医大学学报》2015年第8期897-900,共4页Academic Journal of Second Military Medical University

基　　金：第二军医大学青年启动基金课题(2012QN18)~~

摘　　要：目的观察自体树突状细胞（DC）疫苗联合细胞因子诱导的杀伤细胞（CIK细胞）治疗胆系肿瘤的临床疗效。方法采集患者外周血单个核细胞,采用多种肿瘤抗原刺激后进行扩增和培养,收获成熟DC制成疫苗进行皮内注射,同时联合自体CIK细胞静脉回输,观察85例胆系肿瘤患者治疗前后的临床疗效、免疫功能、不良反应及生存时间。结果 85例胆系肿瘤患者经自体DC-CIK细胞治疗后,临床症状较前明显改善（P〈0.05）;临床疗效显著,完全缓解2例（2.3%）、部分缓解14例（16.5%）、疾病稳定54例（63.5%）及疾病进展15例（17.6%）;免疫功能提高,治疗后淋巴细胞亚群中CD3＋、CD3＋CD4＋、CD3＋CD8＋、CD3＋CD56＋及CD4＋/CD8＋比值升高,而调节性T细胞降低（P〈0.05）。至随访结束,58例患者死亡,2例失访,25例存活,中位生存期为16.5个月（95%CI：12.1-20.9个月）。结论自体DC-CIK细胞治疗是胆系肿瘤患者一种安全有效的治疗方法,不良反应少,但相关结论仍有待进一步大样本随机对照研究证实。Objective To observe the clinical efficacy of autologous dendritic cells（DCs）vaccine combined with cytokineinduced killer（CIK）cells for treatment of patients with biliary tract cancer.Methods Peripheral blood mononuclear cells（PBMCs）were collected from the patients with biliary tract cancer and were stimulated with multiple tumor-associated antigens（TAA）for amplification and culture.Mature DCs were harvested and made into vaccine for intradermal administration,and at the same time the patients were given autologous CIK cells via vein transfusion.The clinical efficacy,immune function,side effect,and overall survival of 85 patients with biliary tract cancer were observed before and after treatment.Results The clinical symptoms were improved significantly in the 85 patients after autologous DC-CIK therapy（P0.05）.The clinical efficacy was remarkable：with 2cases（2.3%）having complete remission,14（16.5%）with partial remission,54（63.5%）with stable disease and 15（17.6%）with progressive disease.The immune function was improved after combined treatment;CD3＋,CD3＋CD4＋,CD3＋CD8＋,CD3＋CD56＋and CD4＋/CD8＋ratio were elevated in the lymhocyte subpopulation,but the regulatory T cells were reduced（P0.05）.At the end of the follow-up,58 patients died,2patients were lost in follow-up,and 25 patients survived,with the median overall survival time being 16.5months（95%CI：12.1-20.9 months）.Conclusion Autologous DC-CIK therapy is a safe and effective treatment for patients with biliary tract cancer,with less side effect,but the relevant conclusion still needs to be confirmed by larger sample randomized controlled studies.

关 键 词：树突状细胞疫苗 细胞因子诱导的杀伤细胞 胆道肿瘤 药物疗法 过继性细胞免疫治疗 

分 类 号：R735.8[医药卫生—肿瘤]