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目的:研究自体细胞因子诱导的杀伤(cytokine-induced killer,CIK)细胞治疗对放化疗后的中晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者免疫功能及生活质量的影响。方法:收集我院肿瘤科2012年6月至2014年3月放化疗后的中晚期NSCLC患者38例,输注自体CIK细胞同时行最佳支持治疗;选择同期放化疗后的中晚期NSCLC患者34例,仅行最佳支持治疗作为对照组。流式细胞术检测外周血T淋巴细胞亚群及调节性T细胞的表达水平,ELISA法检测外周血清中IL-2、IL-12、IFN-γ浓度,评价自体CIK细胞治疗前后患者免疫学指标的变化、体能状态的改善情况及CIK治疗的安全性。结果:(1)38例NSCLC患者治疗后外周血CD4+、CD4+/CD8+比值较治疗前及对照组治疗后有明显升高(P<0.05或P<0.01),CD8+明显下降(P<0.05),对照组无明显变化;CIK细胞治疗组治疗前后及与对照组治疗后相比,调节性T细胞(CD4+CD25+)比率明显下降(P<0.01);(2)CIK细胞治疗后较治疗前及对照组治疗后IL-12、IFN-γ的水平明显升高(P<0.01),IL-2水平较治疗前有明显升高(P<0.01),但与对照组治疗后相比变化不明显(P>0.05);(3)治疗组CIK治疗后KPS评分明显升高(P<0.05),对照组KPS评分差异无统计学意义(P>0.05);(4)CIK治疗组中无一例出现畏寒、发热等不良反应。结论:自体CIK细胞治疗可改善放化疗后中晚期NSCLC患者的免疫功能、提高其生活质量,且细胞治疗安全。
Objective: To study the effects of cytokine-induced killer (CIK) cell therapy on the immune function and quality of life of patients with advanced-stage non-small cell lung cancer (NSCLC) after radiotherapy and chemotherapy. Methods: Thirty-eight patients with advanced NSCLC after chemoradiation were collected from June 2012 to March 2014 in our department of Oncology. The patients with idiopathic CIK were treated with the best supportive therapy. The patients with advanced NSCLC after chemoradiotherapy For example, only the best supportive treatment was given as a control group. The levels of T lymphocyte subsets and regulatory T cells in peripheral blood were detected by flow cytometry. The concentrations of IL-2, IL-12 and IFN-γ in peripheral blood were measured by ELISA, and the immunological indexes of patients with CIK cells before and after treatment Changes in physical fitness and the safety of CIK treatment. Results: (1) The ratio of CD4 + and CD4 + / CD8 + in peripheral blood of 38 NSCLC patients after treatment was significantly higher than that before treatment and control group (P <0.05 or P <0.01) (P <0.01); (2) The percentage of CD4 + CD25 + regulatory T cells in CIK cell treated group before and after treatment and after treatment with control group were significantly decreased (P <0.01); (2) The levels of IL-12 and IFN-γ in the control group were significantly increased (P <0.01), while the levels of IL-2 in the control group were significantly higher than those before treatment (P <0.01), but not significantly different from those in the control group (P> 0.05). (3) The KPS score of the treatment group was significantly higher after CIK treatment (P <0.05), but there was no significant difference between the control group and the KPS score (P> 0.05). (4) Chills, fever and other adverse reactions. Conclusion: The treatment of autologous CIK cells can improve the immune function of patients with advanced-stage NSCLC after chemoradiotherapy and improve their quality of life, and the cell therapy is safe.