冷冻消融联合索拉非尼和IL-2对晚期转移性肾癌患者免疫功能的影响  

Effects of cryoablation combined with sorafenib and interleukin-2 on immune function of patients with advanced metastatic renal cell carcinoma

作　　者：程海峰[1] 赵振民 杨庆民 平玉杰[1] 丁瑞[1] 文红壮[1] 李博科 王磊[1] CHENG Haifeng;ZHAO Zhenmin;YANG Qingmin(Department of Urinary Surgery,Central Hospital of Handan City,Hebei,Handan 056001,China)

机构地区：[1]河北省邯郸市中心医院泌尿外一科,056001 [2]河北省邯郸市第七医院外科 [3]河北省曲周县医院外科

出　　处：《河北医药》2018年第5期677-680,共4页Hebei Medical Journal

摘　　要：目的观察冷冻消融联合索拉非尼和白介素(IL-2)对晚期转移性肾癌患者免疫功能的影响。方法选取收治的晚期转移性肾癌患者90例,随机分为对照组和观察组,每组45例。对照组给予口服索拉非尼和静脉滴注IL-2治疗。治疗组先行局麻下冷冻消融治疗,2周后给予索拉菲尼和IL-2治疗。疗程均为4周。采用微粒子酶免疫分析法检测2组治疗前后外周血甲胎蛋白(AFP)、H亚基铁蛋白(HF)、癌胚抗原(CEA)、CA199变化。采用流式细胞术检测2组治疗前后外周血T淋巴细胞亚群(CD_3^+、CD_4^+、CD_8^+、CD_4^+/CD_8^+、CD_(19)^+、CD_(16)^+_(56)^+)、NK细胞、Treg细胞比例。采用免疫散射比浊法检测外周血Ig A、Ig G、Ig M水平。结果对照组治疗前后AFP、HF、CEA、CA199、CD_3^+、CD_4^+、CD_8^+、CD_4^+/CD_8^+、CD_(19)^+、CD_(16)^+_(56)^+、NK细胞、Treg细胞比例、Ig A、Ig G、Ig M比较差异无统计学意义(P>0.05);观察组治疗后CD_3^+、CD_4^+、CD_4^+/CD_8^+、CD_(19)^+、CD_(16)^+_(56)^+、NK细胞比例、Ig A、Ig G、Ig M较治疗前显著升高,AFP、HF、CEA、CA199、CD_8^+、Treg细胞比例较治疗前显著降低,差异有统计学意义(P<0.05)。结论冷冻消融联合索拉非尼和IL-2治疗能够明显改善晚期转移性肾癌免疫功能,提高机体抗肿瘤免疫。Objective To observe the effects of cryoablation combined with sorafenib and interleukin-2(IL-2)on immune function of patients with advanced metastatic renal cell carcinoma.Methods A total of 90 patients with advanced metastatic renal cell carcinoma who were admitted and treated in our hospital from October 2013 to October 2016 were enrolled in the study.These patients were randomly divided into observation group(n=45)and control group(n=45).The patients in control group were treated by oral sorafenib tosylate tablets and intravenous drip with recombinant human interleukin-2,however,the patients in observation group were treated firstly by cryoablation under local anesthesia for two weeks,then these patients were treated by oral sorafenib tosylate tablets and intravenous drip with recombinant human interleukin-2,with a treatment course of 4 weeks for both groups.The serum levels of alpha-fetoprotein(AFP),H-subunit ferritin(HF),carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA199)before and after treatment were measured by MEIA,and the proportions of T lymphocytes(CD+3,CD+4,CD+8,CD+4/CD+8,CD+19,CD+16+56),NK cells and Treg cells were detected by flow cytometry.Moreover the serum levels of IgA,IgG and IgM were measured by immunoturbidimetry.Results There were no significant differences in the levels of AFP,HF,CEA,CA199,CD+3,CD+4,CD+8,CD+4/CD+8,CD+19,CD+16+56,NK cells and Treg cells,IgA,IgG,IgM in control group before and after treatment(P>0.05).As compared with those before treatment,the proportions of CD+3,CD+4,CD+4/CD+8,CD+19,CD+16+56 and levels of NK cells and IgA,IgG,IgM were significantly increased in observation group after treatment,however,the levels of AFP,HF,CEA,CA199 and the proportions of CD+8 and Treg cells were significantly decreased in observation group after treatment(P<0.05).Conclusion The cryoablation combined with sorafenib and interleukin-2 in treatment of advanced metastatic renal cell carcinoma can significantly improve the mmune function of patients and strengthen the anti-tumor i

关 键 词：冷冻消融 索拉非尼 注射用重组人白细胞介素-2 晚期转移性肾癌 免疫功能 T淋巴细胞 

分 类 号：R692.7[医药卫生—泌尿科学]