经皮穿刺氩氦刀冷冻消融联合自然杀伤细胞治疗肾癌的安全性和近期临床疗效  

Percutaneous argon-helium cryoablation combined with natural killer cells in the treatment of kidney cancer:Safety and short-term clinical efficacy

作　　者：曾健滢 何丽华 马洋洋 梁冰 刘树鹏 牛立志 Zeng Jianying;He Lihua;Ma Yangyang;Liang Bing;Liu Shupeng;Niu Lizhi(Affiliated Fuda Cancer Hospital,Jinan University,Guangdong Guangzhou 510665,China)

机构地区：[1]暨南大学附属复大肿瘤医院,广东广州510665

出　　处：《现代肿瘤医学》2020年第7期1161-1165,共5页Journal of Modern Oncology

基　　金：广州市天河区科技计划项目(编号:201604KW025)。

摘　　要：目的:明确自然杀伤细胞对冷冻消融治疗不可切除肾癌是否具有协同作用,观察两者联合治疗的安全性和近期临床疗效。方法:2016年6月至2018年6月筛选我院入院接收经皮冷冻不可切除肾癌患者,最终入组40人,随机分为冷冻联合NK治疗组(n=20)和单一冷冻治疗组(n=20)。冷冻+NK组先行经皮冷冻治疗,13~15天时回输NK细胞,共三个疗程。比较两组的免疫指标、肿瘤最大径及CT值。结果:围手术期及随访期间无一例死亡,经皮冷冻术成功率为100%,冷冻+NK组淋巴细胞计数及淋巴细胞功能与对照组相比,差异有统计学意义(P<0.05)。术后三个月冷冻+NK组与对照组获得CR、PR、SD、PD分别为42.1%、36.8%、21.1%、0.0%和25.0%、40.0%、30.0%、5.0%。肿瘤缓解率(RR)分别为78.9%和65.0%。两组CT值相比,差异无统计学意义(P>0.05)。根据CTCAE 4.0评分,术后90 d内术后不良反应均为I级或II级。两组相比,差异无统计学意义(P>0.05)。结论:自然杀伤细胞联合冷冻消融治疗不可切除肾癌术后可有效提高患者免疫功能,提高治疗疗效且安全性较好。Objective:To clarify whether natural killer cells(NK cells) have synergistic effects on cryoablation for unresectable renal cell carcinoma(RCC),the safety and short-term clinical efficacy of the combined therapy were observed.Methods:From June 2016 to June 2018,40 patients with unresectable renal cell carcinoma received percutaneous cryotherapy were randomly divided into cryotherapy combined with NK treatment group(Cryo+NK group,n=20) and single cryotherapy group(Cryo group,n=20).In the Cryo+NK group,NK cells were transfused in 13~15 days after percutaneous cryoablation.Immune indexes,maximum diameter of tumors and CT values were compared between the two groups.Results:There was no death during perioperative period and follow-up period.The success rate of percutaneous cryosurgery was 100%.There was significant difference in lymphocyte count and lymphocyte function between Cryo+NK group and Cryo group(P<0.05).In three months after treatment,the CR,PR,SD and PD were 42.1%,36.8%,21.1%,0.0% and 25.0%,40.0%,30.0% and 5.0% respectively in the Cryo+NK group and the Cryo group.The tumor remission rate(RR) was 78.9% and 65.0% respectively.There was no significant difference in CT values between the two groups(P>0.05).According to CTCAE 4.0 score,all the adverse reactions within 90 days after operation were grade I or grade II.There was no significant difference between the two groups(P>0.05).Conclusion:Natural killer cells combined with cryoablation can effectively improve the immune function of patients with unresectable renal cell carcinoma,and improve the therapeutic effect and has high safety.

关 键 词：肾肿瘤 消融 自然杀伤细胞 

分 类 号：R737.11[医药卫生—肿瘤]