自体树突状细胞瘤苗诱导的杀伤细胞过继免疫在老年性大肠癌姑息治疗的临床研究  

Clinical Research of Adoptive Immunotherapy with Killer Cells Induced Byautologousdendritic Cells Vaccine in Palliative Care of Elder Patients with Colorectal Carcinoma

作　　者：岳伦莉[1] 代洪玉[1] 李萍[1] 江莉[1] 刘建昆[2] 匡红[1] 李硕[1] 钟国成[1] 

机构地区：[1]解放军第452医院肿瘤科,四川成都610021 [2]成都军区昆明总医院消化科,云南昆明650032

出　　处：《四川医学》2016年第11期1228-1232,共5页Sichuan Medical Journal

摘　　要：目的探讨自身肿瘤抗原（Ag）致敏的树突状细胞（DC）联合细胞因子诱导的杀伤细胞（CIK）的过继免疫在老年性大肠癌（CRC）姑息治疗的临床疗效。方法选择110例诊断明确的老年性晚期CRC患者（不再适宜行手术或放化疗）,随机分为2组：对照组55例,接受内科对症治疗;免疫组55例,除接受内科对症治疗外,还给予Ag致敏的DC-CIK过继免疫治疗,观察两组患者的临床疗效和安全性。结果治疗后免疫组患者外周血淋巴细胞Ag NOR的IS值、CD56阳性率、血清IL-12含量、PS评分、VAS评分、CEA含量均比对照组改善,差异有统计学意义（P〈0.05）。治疗后,免疫组患者的半年疗效、1年生存率、2年生存率及MST均优于对照组,差异有统计学意义（P〈0.05）。1例免疫组PR患者在6次免疫治疗后病灶明显缩小。有6例患者在第1次细胞回输后出现短暂发热和寒颤（体温38-39℃）,其中1位患者体温自行恢复,其余患者给予地塞米松和降温药后症状消失,后续细胞治疗未再发生。结论 Ag-DC-CIK过继免疫对晚期老年CRC患者有良好的姑息治疗价值。Objective To explore the clinical effect of adoptive immunotherapy combined dendritic cells（ DC） sensitized byautologous tumor antigen（ Ag） with cytokine-induced killer cell in palliative care of elder patients with colorectal carcinoma（ CRC）.Methods 110 cases of elder patients with CRC who were diagnosed definitely（ no longer suitable for surgery,radiation or chemotherapy） wereselected and randomly divided into two groups： 55 cases in control group,accepted symptomatic treatment of internal medicine; while 55 patients in immune group,accepted symptomatic treatment of internal medicine and adoptive immunotherapy with Ag-sensitized DC-CIK.The clinical efficacy and safety of the two groups were observed.Results the IS value of Ag NOR on lymphocytes in peripheral blood,positive rate of CD56,content of IL-12 in serum,PS score,VAS score and the CEA content of the immune group were all better than the control group after treatment,and the difference was statistically significant（ P〈 0. 05）.After treatment,the curative effect of six months,the survival rate of 1 year,the survival rate of 2 years and MST of the immune group were all better than the control group,and the difference was statistically significant（ P 0. 05）. There was one patient with PR in immune group whose lesion shrank significantly after 6 immune treatments. There were six patients who developed transient fever and chills（ temperature 38 - 39℃） after the first cells infusion,of which 1 patientsalleviated spontaneously,and the rest of the patients＇ symptoms disappeared after dexamethasone and cooling medicine was given,and it did not happen again in subsequent cell therapy. Conclusion Ag- DC-CIK adoptiveimmunotherapy has significant clinical value inpalliative care of elderly patients with CRC in late stage.

关 键 词：结直肠癌 姑息治疗 过继免疫治疗 树突状细胞 细胞因子诱导杀伤细胞 

分 类 号：R735.34[医药卫生—肿瘤]