过继免疫联合化疗对晚期非小细胞肺癌的疗效及免疫功能的影响  

Curative Effect of Adoptive Immunotherapy Combined with Chemotherapy for Advanced Non-small Cell Lung Cancer and Its Effect on Immune Function

作　　者：胡振红[1] 吴妍雯[1] 刘海潮[1] 张波[1] 

机构地区：[1]广州军区武汉总医院,430070

出　　处：《实用癌症杂志》2016年第9期1466-1469,共4页The Practical Journal of Cancer

摘　　要：目的探讨过继免疫联合化疗治疗非小细胞肺癌的疗效和对免疫功能的影响。方法选择NSCLC患者112例按治疗方式分为观察组和对照组。观察组42患者采用紫杉醇加奈达铂(TP方案)化疗,21 d为1个治疗周期,第1个周期治疗结束后10 d开始回输DC-CIK细胞,1次/d,输注4次为1个疗程,每次回输前给予苯海拉明20 mg肌注防止过敏反应的发生,然后再进行2个周期的化疗。对照组70例患者仅给予TP方案化疗3个周期。结果观察组患者DCR为66.7%,对照组患者DCR为52.9%,差异有统计学意义,P<0.05。观察组患者治疗后外周血CD3+、D8+、D56+细胞比值的升高有统计学意义,P<0.05,CD4+/CD8+的比值降低,与治疗前相比差异显著,P<0.05。对照组患者治疗后外周血CD3+、D8+、D56+细胞比值的降低有统计学意义,P<0.05,CD4+/CD8+的比值升高,与治疗前相比差异显著,P<0.05。观察组患者治疗后外周血IL-2、IL-12、IFN-γ和TNF-α水平升高显著,P<0.05。对照组患者治疗后外周血IL-12、IFN-γ和TNF-α降低显著,P<0.05。结论过继免疫治疗联合化疗治疗NSCLC,可提高患者的疾病控制率,改善患者的免疫功能。Objective To investigate the clinical efficacy of adoptive immunotherapy combined with chemotherapy for advanced non-small cell lung cancer and its effect on immune function. Methods 112 cases of NSCLC were divided into the ob- servation group and the control group according to the treatment method. In the observation group,42 patients were treated with paclitaxel and nedaplatin （TP Regimen） chemotherapy,21 days for one period of treatment, 10 days after the end of the first cycle of treatment, DC -CIK cells reinfusion started, 1 times/D ,4 times for a period of treatment. Before each transfusion ,20 mg intra- muscular injection of diphenhydramine hydrochloride was given to prevent the occurrence of allergic reactions, and 2 cycles of chemotherapy were performed. In the control group,70 patients were only treated with TP chemotherapy for 3 cycles. Results DCR was 66.7% in the observation group and 52.9% in the control group ,the difference was statistically significant,P 〈0.05. CD3 ＋ ,D56 ＋ and D8 ＋ cells in the peripheral blood of the observation group significantly increased after treatment ,P 〈0.05. CIM ＋/CD8 ＋ decreased significantly compared with before treatment,P 〈 0.05. CD3 ＋ , D8 ＋ , D56 ＋ cells in the peripheral blood significantly decreased in the control group, and CD4 ＋/CD8 ＋ significantly increased, P 〈 0.05. The levels of IL-2, IL-12, IFN-aand TNF-awere significantly higher in the observation group after treatment,P 〈 0.05. The levels of IL-12, IFN-aand TNF- a were significantly lower in the control group after treatment, P 〈 0.05. Conclusion Adoptive immunotberapy combined with chemotherapy in the treatment of non-small cell lung cancer can improve disease control rate and immune function of patients.

关 键 词：过继免疫 树突状细胞 细胞因子诱导的杀伤细胞 非小细胞肺癌 免疫功能 

分 类 号：R734.2[医药卫生—肿瘤]