DC-CIK细胞联合全身静脉化疗治疗晚期结直肠癌伴弥漫性肝转移的研究  

Study on DC-CIK cells combined with intravenous chemotherapy for advanced colorectal cancer with diffuse hepatic metastasis

作　　者：李威威[1] 张海萍[1] 吴敏[1] 

机构地区：[1]湖北省天门市第一人民医院,湖北天门431700

出　　处：《现代中西医结合杂志》2016年第18期1942-1945,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：湖北省自然科学基金项目(2012KFC143)

摘　　要：目的观察DC-CIK细胞联合全身静脉化疗治疗晚期结直肠癌伴弥漫性肝转移的疗效。方法选取晚期结直肠癌伴弥漫性肝转移患者77例,依据治疗方式的不同将患者分为2组,对照组38例行FOLFOX化疗,21 d为1个周期,6个周期为1个疗程;联合组39例行FOLFOX化疗联合DC-CIK细胞治疗,DC-CIK细胞治疗每月1次,至患者死亡或放弃治疗。检测2组治疗前后T细胞亚群(CD3^+、CD4^+、CD8^+)、Th1细胞因子(IFN-γ、TNF-α、IL-2)、血清肿瘤标记物(CEA、CA242、CA199)水平,统计2组近期疗效、不良反应情况,门诊复查及电话随访记录患者生存情况,随访截止时间2015年8月31日。结果治疗后联合组CD3^+、CD8^+水平及IFN-γ、TNF-α、IL-2水平均显著高于治疗前(P均<0.05),而CD4^+水平无显著变化(P>0.05);对照组CD3^+、CD4^+、CD8^+水平及IFN-γ、TNF-α、IL-2水平均显著低于治疗前(P均<0.05);联合组CD3^+、CD8^+水平及IFN-γ、TNF-α、IL-2水平均显著高于对照组(P均<0.05),2组CD4^+水平比较差异无统计学意义(P>0.05)。治疗后2组CEA水平较治疗前均明显降低(P均<0.05),且联合组明显低于对照组(P<0.05);2组CA199、CA242水平与治疗前比较差异无统计学意义(P均>0.05)。2组有效率比较差异无统计学意义(P>0.05);联合组疾病控制率明显高于对照组(P<0.05),不良反应发生率明显低于对照组(P均<0.05)。联合组生存时间最短116 d,最长者超过16个月,中位生存时间8.5个月;对照组生存时间最短29 d,最长者超过12个月,中位生存时间6个月。Log-rank检验显示,联合组生存率显著高于对照组(P<0.05)。结论 DC-CIK细胞联合全身静脉化疗是治疗晚期结直肠癌伴弥漫性肝转移较为有效的方案,可明显提高疾病控制率,降低不良反应发生率,延长生存期。Objective It is to observe the curative effect of DC- CIK cells combined with intravenous chemotherapy for advanced colorectal cancer with diffuse hepatic metastasis. Methods 77 cases of advanced colorectal cancer with diffuse liver metastases were divided into two groups according to the treatment of different ways. 38 cases in control group were treated with line FOLFOX chemotherapy,21 days for a cycle,6 cycles for a course of treatment. 39 cases in combined group were treated with line FOLFOX chemotherapy combined with DC- CIK cell treatment,DC- CIK cells treatment for once a month until the patient died or gave up treatment. The levels of T cell subsets（ CD3~＋,CD4~＋,CD8~＋）,intracellular Th1 cytokines（ IFN- γ,TNF- α,IL- 2）,and serum tumor markers（ CEA,CA242,CA199） were detected and recorded in two groups before and after treatment. The short-term efficacy and adverse reactions of the two groups were summarized,the patient＇s survival situation were recorded by outpatient review and telephone follow up. The follow-up deadline was 2015 /8 /31. Results After treatment,the levels of CD3~＋,CD8~＋,IFN- γ,TNF- α and IL- 2 in combined group were significantly higher than before treatment（ all P 0. 05）,but the level of CD4~＋had no obvious change（ P 0. 05）; the levels of CD3~＋,CD4~＋,CD8~＋,IFN- γ,TNF- α,IL- 2 were significantly lower than before treatment（ all P 0. 05）; the levels of CD3~＋,CD8~＋,IFN- γ,TNF- α and IL- 2 in combined group were significantly higher than those in control group（ all P 0. 05）,but there was no significant difference in CD4~＋between the both groups（ P 0. 05）. The levels of CEA in two groups were significantly lower than before treatment（ all P 0. 05）,and there was significant difference between the both groups（ P 0. 05）;there was no significant difference in CA199 and CA242 of both groups before and after treatment（ all P 0. 05）. There was no significant difference in efficiency between the 2 groups（ P 0. 05）,the con

关 键 词：晚期结直肠癌 DC-CIK细胞 全身静脉化疗 弥漫性肝转移 

分 类 号：R735.3[医药卫生—肿瘤]