异体CIK联合血浆置换干预晚期原发性肝癌的临床研究  

Clinical study of allogeneic CIK combined with plasma exchange in the treatment of advanced primary liver cancer

作　　者：侯俊杰[1] 杨影[1] 李孝男[1] 倪志强[1] 周颖[1] 江显卓 谭岩[1] 方艳秋[1] 

机构地区：[1]吉林省人民医院医学诊治实验中心,吉林长春130021

出　　处：《中国实验诊断学》2017年第1期50-53,共4页Chinese Journal of Laboratory Diagnosis

基　　金：吉林省科技厅项目(20140520037JH;20140519018JH;20140414043GH);吉林省人社厅省人才开发资金(2016年度)及吉林省科技厅重点实验室项目(20122113)资助

摘　　要：目的研究异体CIK联合血浆置换临床治疗肝癌的效应和机制。方法分离健康人外周血单个核细胞(PBMC),加入细胞因子诱导成CIK细胞,体外培养扩增。病例均给予内科综合支持治疗情况下,随机分为异体CIK细胞治疗组和异体CIK+血浆置换治疗组。应用ELISA法比较二组治疗前后血浆中IFN-γ、IL-4、IL-10、TGF-β、VEGF的浓度变化;流式细胞术检测二组治疗前后患者外周血中CD3+和CD4+细胞比例、CD4+/CD8+比值、CD8+细胞比例;比较二组患者的生存质量、无进展生存期(PFS)、总生存期(OS)。结果二组异体CIK的抗肿瘤免疫效应均上调,异体CIK+血浆置换治疗组免疫上调显著,与同时下调IL-4、IL-10和TGF-β、VEGF的血浆浓度有关(P<0.05);流式细胞术检测发现,治疗后的患者外周血中CD3+、CD4+细胞比例和CD4+/CD8+比值明显上升,CD8+细胞比例下降,以异体CIK+血浆置换治疗组更为显著(P<0.05);PFS长于单纯异体CIK细胞治疗组(P<0.05),OS无延长(P>0.05);生活质量显著优于异体CIK细胞治疗组(P<0.01)。结论通过应用异体CIK细胞过继免疫治疗+血浆置换方案,可抑制和清除免疫抑制性细胞和免疫抑制因子,上调CIK细胞免疫效应及数量,可抑制原发性肝癌进展,改善患者生活质量。Objective To study the effect and mechanism of allogeneic CIK combined with plasmapheresis in the treatment of liver cancer.Methods Peripheral blood mononuclear cells（PBMC）were isolated from healthy volunteers and cultured in vitro by culturing the cells into cytokine-induced（CIK）cells.All cases were randomly assigned to allogeneic CIK cell treatment group and allogeneic CIK＋ plasma replacement therapy group.The levels of IFN-γ,IL-4,IL-10,TGF-βand VEGF in plasma were measured by ELISA.The percentage of CD3^＋ and CD4^＋ cells in the peripheral blood of the two groups before and after treatment were detected by flow cytometry.CD4^＋ /CD8^＋ ratio and CD8^＋ cell ratio,and the quality of life and overall survival of the two groups were compared.Results The anti-tumor immunity effect of allogeneic CIK was up-regulated,and the up-regulation of IL-4,IL-10,TGF-βand VEGF was related to the up-regulation of CIK ＋ plasma replacement therapy group（P〈0.05）;The percentage of CD3^＋ ,CD4^＋ and CD4^＋ /CD8^＋ in peripheral blood in CIK＋ plasma replacement group were significantly higher than those in allogeneic CIK group（P〈0.05）,and the percentage of CD8^＋ cells decreased significantly after treatment（P〈0.05）,PFS has been prolonged（P〈0.05）and no OS prolongation（P〈0.05）,and quality of life was significantly better than that of allogeneic CIK cells treated group（P〈0.01）.Conclusion Adoptive CIK cell adoptive immunotherapy ～＋ plasma exchange program can inhibit and remove immunosuppressive cells and immunosuppressive factors,increase the immune effect and quantity of CIK cells,inhibit the progression of primary liver cancer and improve the quality of life of patients.

关 键 词：CIK 肝癌 血浆置换 细胞因子 

分 类 号：R735.7[医药卫生—肿瘤]