DC-CIK联合TACE治疗原发性肝癌的疗效分析  

DC-CIK immunotherapy combined with TACE for primary hepatic carcinoma

作　　者：朱理辉[1,2] 霍继荣[2] 张琍[1] 李国庆[1] 廖文秋[1] 

机构地区：[1]南华大学附属第二医院消化内科,湖南衡阳421001 [2]中南大学湘雅二医院消化内科,湖南长沙410011

出　　处：《实用肿瘤杂志》2016年第2期174-179,共6页Journal of Practical Oncology

摘　　要：目的探讨树突状细胞联合细胞因子诱导的杀伤细胞(dendritic cell-cytokine induced killer cell,DCCIK)过继性免疫治疗联合肝动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)治疗原发性肝癌的临床疗效及安全性分析。方法 105例原发性肝癌患者分成两组,TACE组58例,DC-CIK联合TACE组47例。TACE组行≥1次TACE,DC-CIK联合TACE组在TACE的间歇期给予≥1次的DC-CIK治疗,分析2种方法在中位生存期、肝功能及甲胎蛋白定量、安全性等方面的差异及对影响疗效的相关因素进行分析。结果 DC-CIK联合TACE组的中位生存期高于TACE组(18月vs 12月),差异有统计学意义﹙P<0.05﹚。单因素分析得出患者巴塞罗那临床肝癌分组方案(Barcelona clinic liver cancer,BCLC)、Child-Pugh分级、门静脉癌栓和是否联合应用DC-CIK治疗是影响肝癌患者总的中位生存期的因素(P<0.05)。多因素分析得出BCLC分期、Child-Pugh分级、甲胎蛋白(alpha feto protein,AFP)定量是影响DC-CIK联合TACE组总生存期的危险因素。治疗后3月观察两组的AFP均下降,肝功能好转,DC-CIK联合TACE组更明显,差异有统计学意义﹙均P<0.05﹚。DC-CIK治疗后只有2例次发热,1例次皮疹,经对症处理后患者无不适感。结论 DC-CIK联合TACE治疗原发性肝癌能延长中位生存期,改善肝功能,降低AFP,且安全可靠;术前分析BCLC分期、Child-Pugh分级、AFP定量等因素对预测疗效有指导意义。Objective To evaluate the clinical efficacy and safety of dendritic cell-cytokine induced killer cell（ DCCIK） immunotherapy combined with transcatheter arterial chemoembolization（ TACE） for primary hepatic carcinoma.Methods One-hundred-and-five patients with primary hepatic carcinoma were assigned to receive TACE（ n = 58） or TACE combined with DC-CIK immunotherapy（ n = 47）. The median survival time,liver function,AFP level and treatment related adverse events were compared between two groups. Results The median survival time in the TACE combined with DC-CIK group was higher than that in TACE group（18 months vs 12 months,P〈0. 05）. Single factor analysis showed that Barcelona-clinic-liver-cancer（ BCLC） staging,Child-Pugh classification,portal venous tumor emboli and the combined usage of DC-CIK therapy were related factors of survival time in both groups（ P〈0. 05）. Multiple factor analysis identified that BCLC staging,Child-Pugh classification and AFP were independent risk factors of overall survival time in TACE combined with DC-CIK group. Three months after the treatment,the AFP levels were decreased and liver function was improved in both group,the changes were more marked in TACE combined with DC-CIK therapy group（ P〈0. 05）. Two cases experienced fever and one had allergic reactions during DC-CIK therapy,and the symptoms were remitted after treatment. Conclusion DC-CIK immunotherapy combined with TACE can prolong median survival time,improve liver function and reduce AFP levels for patients with primary hepatic carcinoma,with little adverse effects.

关 键 词：肝肿瘤/治疗 肝动脉/外科学 化学栓塞 治疗性/方法 免疫疗法 过继 杀伤细胞 淋巴因子激活/免疫学 树突细胞/免疫学 治疗结果 

分 类 号：R735.7[医药卫生—肿瘤] R730.5[医药卫生—临床医学]