扩增活化的自体淋巴细胞过继性细胞免疫治疗小细胞肺癌  

Adoptive immunotherapy of expanded activated autologous lymphocytes(EAAL) for small cell lung cancer: A retrospective clinical observation

作　　者：张国庆[1] 孙胜杰[1] 李瑾昱[1] 胡毅[1] 燕翔[1] 王刚[2] 吴亮亮[2] 焦顺昌[1] 

机构地区：[1]中国人民解放军总医院肿瘤内一科,北京100853 [2]中国人民解放军总医院肿瘤中心实验室,北京100853

出　　处：《临床药物治疗杂志》2016年第1期21-27,共7页Clinical Medication Journal

基　　金：军队"十二五"课题计划基金(JZ90356328)

摘　　要：目的:研初步探讨扩增活化的自体淋巴细胞(expanded activated autologous lymphocytes,EAAL)过继性细胞免疫治疗在小细胞肺癌(small cell lung cancer,SCLC)的疗效。方法:在层流实验室体系下,由SCLC患者外周血单个核淋巴细胞体外诱导扩增EAAL细胞,应用流式细胞术检测其细胞表型。然后回顾性分析2008年5月~2010年10月在本院接受过EAAL免疫治疗以及未接受过EAAL免疫治疗的各16例SCLC患者的临床资料,分析比较EAAL治疗组和对照组总生存期(OS)的差异。结果:经过体外培养和扩增,EAAL细胞表型与培养前外周血淋巴细胞相比,CD_3^+、CD_3^+CD_8^+、CD_(45)RO^+、CD_(25)^+、CD_(29)^+以及CD_3^+CD_(16)^+/CD_(56)^+细胞的比例明显增加(P<0.05)。EAAL治疗组和对照组的OS分别为17.4个月和10.0个月,两者差异无统计学意义(P=0.060,HR=0.487,95%CI 0.228~1.037)。EAAL治疗组1~3年生存率分别为81.25%、25.0%和18.75%,而对照组1~3年生存率则分别为43.75%、6.25%和0%,两者差异也无统计学意义(P>0.05)。COX多因素回归分析结果显示EAAL细胞免疫治疗是SCLC患者总生存时间延长的独立预后风险因素之一。亚组分析结果显示女性及化疗≤6周期SCLC患者的OS经EAAL免疫治疗后得到了延长(P<0.05)。结论:EAAL过继性细胞免疫治疗可能能够延长SCLC患者的OS。Objective：To investigate the efficacy of expanded activated autologous lymphocytes（EAAL） on small cell lung cancer（SCLC）.Methods：Thirty-two SCLC patients＇ peripheral blood mononuclear cells（PBMCs） were separated,induced and amplified in laminar flow cell culture laboratory system.After EAAL was generated,the phenotypes were detected by flow cytometry.Clinical data of 16 SCLC patients with EAAL immunotherapy and another 16 SCLC patients without EAAL immunotherapy admitted to Chinese PLA General Hospital from May 2008 to October 2010 were retrospectively analyzed.Results：After induced and amplified in vitro,the percentage of CD_3~＋,CD_3~＋CD_8~＋,CD_（45）RO~＋,CD_（28）~＋,CD_（29）~＋,CD_8~＋CD_（28）~＋ and CD_3~＋CD_（16）~＋/CD_（56）~＋ cells increased significantly（P〈0.05）.The OS of the immunotherapy group was longer than that of the control group,however the difference was of no statistical significance（P=0.060,HR=0.487,95%CI 0.228~1.037）.1-3-year survival rates of the immunotherapy group（81.25%,25.0%and 18.75%,respectively） seemed better than those of the control group（43.75%,6.25%and 0%,respectively） but the differences were also of no statistical significance（P〉0.05）.Results of COX multivariate regression analysis showed that the number of chemotherapy cycle and application of EAAL immunotherapy were independent prognostic factors for SCLC patients.The OS in subgroups of female and chemotherapy ≤6cycles was prolonged after EAAL immunotherapy（P〈0.05）.Conclusion：EAAL adoptive immunotherapy might prolong the OS in SCLC patients.

关 键 词：过继性免疫治疗 小细胞肺癌 扩增活化的自体淋巴细胞 流式细胞术 回顾性临床观察 

分 类 号：R743[医药卫生—神经病学与精神病学]