树突状细胞-细胞因子诱导的杀伤细胞过继免疫联合化疗对胃癌根治术后患者的临床疗效分析  

Analysis of clinical efficacy of dendritic cells-cytokine induced killer cells adoptive immunotherapy combined with chemotherapy for patients with gastric cancer after radical gastrectomy

作　　者：朱晓亮[1,2] 张正聪[2] 王海平 吕鹏飞[2] 袁得峰 丁方回 汪名飞[1] 孟文勃[4] 张磊[1] 朱克祥[5] 苗龙[5] 白小平 张建军 李汛[1,3] ZHU Xiaoliang;ZHANG Zhengcong;WANG Haiping;LÜPengfei;YUAN Defeng;DING Fanghui;WANG Mingfei;MENG Wenbo;ZHANG Lei;ZHU Kexiang;MIAO Long;BAI Xiaoping;ZHANG Jianjun;LI Xun(The Fifth Department of General Surgery,The First Hospital of Lanzhou University,Lanzhou 730000,P.R.China;Department of General Surgery,Donggang District,The First Hospital of Lanzhou University,Lanzhou 730000,P.R.China;Gansu Provincial Key Laboratory of Biotherapy and Regenerative Medicine,Lanzhou 730000,P.R.China;Department of Special Minimally Invasive Surgery,The First Hospital of Lanzhou University,Lanzhou 730000,P.R.China;The Second Department of General Surgery,The First Hospital of Lanzhou University,Lanzhou 730000,P.R China)

机构地区：[1]兰州大学第一医院普外五科,兰州730000 [2]兰州大学第一医院东岗院区普外科,兰州730000 [3]甘肃省生物治疗与再生医学重点实验室,兰州730000 [4]兰州大学第一医院特需外科,兰州730000 [5]兰州大学第一医院普外二科,兰州730000

出　　处：《中国普外基础与临床杂志》2020年第7期801-807,共7页Chinese Journal of Bases and Clinics In General Surgery

基　　金：甘肃省卫生行业科研计划项目(编号:GSWSKY2017-26);甘肃省生物治疗与再生医学重点实验室开放基金课题(编号:zdsyskfkt-201704);兰大一院院内基金资助项目(编号:ldyyyn2015-16)。

摘　　要：目的探讨树突状细胞(DC)-细胞因子诱导的杀伤(CIK)细胞过继性免疫治疗联合化疗对胃癌根治术后患者的安全性及临床疗效。方法收集2014年1月至2016年1月期间在兰州大学第一医院接受DC-CIK细胞过继性免疫治疗联合XELOX或FOLFOX方案化疗的48例胃癌根治术后患者作为研究组,另外收集同期仅进行XELOX或FOLFOX方案化疗的48例胃癌根治术后患者作为对照组。评价2组患者治疗前后的免疫功能状态、毒副反应及生活质量并比较2组患者的远期疗效。结果①2组患者性别、年龄、临床分期等基线资料比较差异无统计学意义(P>0.05)。②外周静脉血中CD3^+、CD3^+CD4^+、CD3^+CD8^+、CD3^–CD56^+(NK细胞)及CD3+CD56+(NKT细胞)在研究组的治疗前后比较差异无统计学意义(P>0.05),而其在对照组治疗后较治疗前显著下降且明显低于研究组(P<0.05)。③研究组和对照组治疗后的外周静脉血中CEA、CA19-9及CA724含量均明显低于治疗前(P<0.05)且研究组在治疗后明显低于对照组(P<0.05)。④研究组的白细胞减少、血小板减少及腹泻发生率明显低于对照组(P<0.05)。⑤研究组患者治疗后在躯体功能、情绪功能、角色功能、认知功能及社会功能方面均较对照组显著改善(P<0.05)且研究组治疗后在躯体功能和情绪功能方面较治疗前改善明显(P<0.05)。⑥研究组的无进展生存时间明显优于对照组(P<0.05),而总生存时间2组间比较差异无统计学意义(P>0.05)。结论DC-CIK细胞过继性免疫治疗联合化疗能够显著改善胃癌根治术后患者免疫状态及生活质量,减轻化疗不良反应,提高远期疗效,延长无进展生存时间。Objective To investigate the safety and clinical efficacy of dendritic cell(DC)-cytokine induced killer(CIK)cell adoptive immunotherapy combined with chemotherapy in patients with gastric cancer after radical gastrectomy.Methods Forty-eight patients with gastric cancer after the radical gastrectomy receiving the DC-CIK cell adoptive immunotherapy combined with XELOX or FOLFOX chemotherapy were enrolled as a study group in the First Hospital of Lanzhou University from January 2014 to January 2016.In addition,48 patients with gastric cancer after the radical gastrectomy in the same period and only receiving XELOX or FOLFOX chemotherapy were collected as a control group.The CD3^+,CD3^+CD4^+,CD3^+CD8^+,CD3^–CD56^+(NK cell),and CD3^+CD56^+(NKT cell),toxic reaction,quality of life were evaluated in both groups before and after the treatment,and the long term effect were compared in both groups.Results①There were no significant differences in the gender,age,clinical stage,etc.between the two groups(P>0.05).②The CD3^+,CD3^+CD4^+,CD3^+CD8^+,CD3^–CD56^+,and CD3^+CD56^+cells in the peripheral blood had no significant changes between before and after treatment in the study group(P>0.05),which were decreased after the treatment in the control group as compared with before the treatment and were significantly lower than those in the study group(P<0.05).③The levels of CEA,CA19-9,and CA724 in the peripheral blood after the treatment in the study group and the control group were significantly lower than those before the treatment(P<0.05),which in the study group were significantly lower than those in the control group after the treatment(P<0.05).④The incidences of leukopenia,thrombocytopenia,and diarrhea in the study group were significantly lower than those in the control group(P<0.05).⑤Compared with before the treatment,the body function and emotional function after the treatment were significantly improved in the study group(P<0.05).And in the body function,emotion function,role function,cognitive function,and so

关 键 词：胃癌 树突状细胞 细胞因子诱导的杀伤细胞 过继性免疫治疗 化学治疗 

分 类 号：R735.2[医药卫生—肿瘤]