CIK细胞免疫治疗在原发性肝癌中的应用及对免疫活性细胞的影响  

Autologous cytokine-induced killer cells in immunological treatment of hepatocellular carcinoma and their effect on immunological effector cells: a clinical study

作　　者：宋娟[1] 钱程[1] 

机构地区：[1]第三军医大学西南医院病理学研究所西南癌症中心,重庆400038

出　　处：《第三军医大学学报》2015年第23期2386-2390,共5页Journal of Third Military Medical University

摘　　要：目的探讨CIK细胞续灌输入治疗对原发性肝癌患者免疫功能的影响,研究其防止肝癌术后复发的有效性。方法取重庆市西南医院2012年9月至2014年9月收治的资料齐全的原发性肝癌患者共54例。随机将所有患者分为治疗组与对照组。治疗组27例患者,接受CIK细胞续灌输入治疗;对照组27例,接受常规治疗。另取同时期我院体检中心的健康体检者16例为健康组。治疗组患者术后接受CIK细胞续灌输入治疗2个疗程,对照组患者术后仅接受常规支持治疗。对所有患者进行随访。在CIK细胞回输前后用流式细胞仪测定受试者外周血的T细胞亚群和树突状细胞亚群的比例变化,并分别统计治疗组与对照组患者治疗1年后的复发率,进行对比分析。结果研究结果显示健康组患者相比,原发性肝癌患者的外周血CD8+/CD4+及DC1/DC2比值均有降低,差异有统计学意义(P<0.05)。接受CIK细胞治疗后,患者外周血CD8+占外周血单个核细胞百分比较治疗前升高,DC1/DC2亦升高,差异均有统计学意义(P<0.05)。治疗组复发率低于对照组(11.1%vs 33.3%,P<0.05),治疗组死亡率亦低于对照组,但差异无统计学意义(11.1%vs 18.5%,P>0.05)。治疗组无明显不良反应。结论原发性肝癌患者自身免疫环境发生变化,CIK细胞在提高患者免疫功能,降低肝癌复发率方面有一定效果。Objective To determine the effect of continuous infusion of autologous cytokine-induced killer cells （CIK） on the immunological function in the patients with primary hepatocellular carcinoma, and investigate the efficiency in the prevention of tumor recurrence after surgery. Methods Full clinical data of 54 cases of primary hepatocellular carcinoma in Southwest Hospital from September 2012 to September 2014 were collected in the study. They were divided into 2 groups, treatment group （receiving CIK treatment after operation for 2 courses, n = 27 ） and control group （ receiving conventional therapy, n = 27）. Sixteen healthy individuals taking physical examination meanwhile served as normal control. All cases were followed up, and flow cytometry was used to detect the percentages of T lymphocyte subsets and dendritic cell subsets before andafter continuous infusion. The recurrence was compared between the treatment group and control group in 1 year after treatment. Results Peripheral blood CD8 ＋/CD4 ＋ and DC1/DC2 were significantly lower in the patients with primary hepatocellular carcinoma before CIK treatment than the normal control （ P 〈 0.05 ）. After continuous infusion, the CD8 ＋ percentage and DC1/DC2 ratio were significantly increased in the treatment group than before （ P 〈 0.05 ）. The treatment group had obviously lower recurrence than the control group （ 11.1% vs 33.3% , P 〈 0.05 ）, and lower mortality though without statistical difference （ 11.1% vs 18.5%, P 〉 0.05）. No obvious adverse reaction was observed in the treatment group. Conclusion The immune functions of primary hepatocellular carcinoma patients are declined. CIK infusion improves their immune functions and decrease cancer recurrence.

关 键 词：CIK细胞 原发性肝癌 免疫功能 复发率 

分 类 号：R392.12[医药卫生—免疫学] R730.51[医药卫生—基础医学]