DC-CIK联合化疗对结直肠癌根治术后肝转移患者疗效及对TRF1和TRF2表达的影响  

The effect of DC-CIK combined with chemotherapy on patients with liver metastases after radical resection of colorectal cancer and its influence on the expression of TRF1 and TRF2

作　　者：朴龙镇 金兰 李滕 胡乌云 梁雪 Piao Longzhen;Jin Lan;Li Teng;Hu Wuyun;Liang Xue(Department of Oncology,Yanbian University Hospital. Jilin Province,Yanbian 133000,China)

机构地区：[1]延边大学附属医院肿瘤科,133000

出　　处：《疑难病杂志》2021年第5期446-449,455,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：国家自然科学基金资助项目(81160270,81060166)。

摘　　要：目的观察树突状细胞—细胞因子诱导的杀伤细胞(DC-CIK)联合化疗对结直肠癌根治术后肝转移患者疗效及对端粒重复序列结合因子1(TRF1)和TRF2表达的影响。方法选取2014年1月—2015年3月延边大学附属医院肿瘤科收治晚期结直肠癌伴肝转移患者98例,随机数字表法分为对照组(49例)和观察组(49例),对照组采用XELOX方案化疗,观察组在此基础上给予DC-CIK治疗,采用实体瘤疗效评价标准比较2组疗效,比较2组治疗前后免疫功能、肝脏TRF1和TRF2表达水平,以及治疗后生活质量评分,采取Kaplan-Meier对2组生存率进行对比。结果观察组客观缓解率明显高于对照组(67.35%vs.36.73%,χ^(2)/P=13.848/0.003);治疗后,观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组,CD8^(+)水平低于对照组(t/P=5.927/0.000、3.362/0.001、3.944/0.000、1.995/0.049);治疗后,2组TRF1表达上调,且观察组高于对照组,TRF2表达水平下调,且观察组低于对照组(t/P=16.163/0.000、17.730/0.000);观察组生活质量评分中社会功能、情绪功能、认知功能、角色功能、躯体功能、总健康评分等均明显高于对照组(t/P=8.542/<0.001、13.069/<0.001、12.131/<0.001、10.943/<0.001、9.996/<0.001、10.867/<0.001),生存率亦高于对照组(χ^(2)/P=4.513/0.023)。结论DC-CIK对直肠癌根治术后肝转移患者疗效更优,可提高其免疫功能,调节肝转移病灶处TRF1和TRF2表达水平,提高患者生活质量,值得临床推广应用。Objective To observe the curative effect of dendritic cell-cytokine-induced killer cell(DC-CIK)combined chemotherapy on patients with liver metastases after radical resection of colorectal cancer and the effect on the expression of telomere repeat binding factor 1(TRF1)and TRF2.Methods From January 2014 to March 2015,98 patients with advanced colorectal cancer and liver metastases were admitted to the Department of Oncology,Yanbian University Hospital.They were randomly divided into control group(49 cases)and observation group(49 cases),and control group.The XELOX regimen was used for chemotherapy,and the observation group was given DC-CIK treatment on this basis.The efficacy evaluation criteria for solid tumors were used to compare the efficacy of the two groups.The immune function,liver TRF1 and TRF2 expression levels,and quality of life scores after treatment were compared between the two groups before and after treatment.Kaplan-Meier compared the survival rates of the two groups.Results The objective remission rate of the observation group was significantly higher than that of the control group(67.35%vs.36.73%,χ^(2)/P=13.848/0.003);after treatment,the CD3^(+),CD4^(+),CD4^(+)/CD8^(+)levels of the observation group were higher than those of the control group,and the CD8^(+)level was lower than the control group(t/P=5.927/0.000,3.362/0.001,3.944/0.000,1.995/0.049).After treatment,the expression of TRF1 in the two groups was up-regulated,and the observation group was higher than the control group,the expression of TRF2 was down-regulated,and the observation group was lower than the control group(t/P=16.163/0.000,17.730/0.000).The social function,emotional function,cognitive function,role function,physical function,and total health score of the observation group’s quality of life score were significantly higher than those of the control group(t/P=8.542/<0.001,13.069/<0.001,12.131/<0.001,10.943/<0.001,9.996/<0.001,10.867/<0.001),the survival rate was also higher than that of the control group(χ^(2)/P=4.513/0.02

关 键 词：结直肠癌 肝转移 免疫治疗 树突状细胞—细胞因子诱导的杀伤细胞 免疫功能 端粒重复序列结合因子 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]