原发性肝癌经综合微创治疗后联合细胞因子诱导杀伤细胞灌注的近期疗效观察

Short-term Curative Efficacy of Cytokine-induced Killer Cells Combined Micro-invasive Treatments on Hepatocellular Carcinoma

背景与目的:近年来,微创治疗在原发性肝癌的临床应用中显示出良好的应用前景,而肿瘤免疫治疗也已成为肿瘤治疗研究的热点之一。本研究旨在探讨微创治疗联合细胞因子诱导的杀伤(cytokine-inducedkiller,CIK)细胞免疫治疗对防止肝癌复发的作用。方法:原发性肝癌患者85例(均为肝动脉化疗栓塞联合射频消融术后,经影像学检查显示病灶无活性且无远处转移),随机选45例为研究组,其余40例为对照组,研究组患者在微创治疗后联合CIK细胞经肝动脉回输,对照组患者不进行CIK细胞回输;CIK细胞治疗前及治疗结束后抽研究组患者外周血,采用流式细胞仪(FCM)测定T淋巴细胞亚群及NK细胞水平变化;研究组和对照组每2～3个月进行CT检查,了解肿瘤变化情况。结果:CIK细胞回输后CD3+、CD4+、CD56+(NK)效应细胞的比例和CD4+/CD8+比值显著上升,由最初的(68.6±11.0)%、(31.0±9.0)%、(15.6±7.8)%和1.1±0.5上升至(70.7±10.1)%(P<0.05)、(33.5±8.0)%(P<0.05)、(18.4±9.4)%(P<0.05)和1.3±0.6(P<0.05);CD8+和CD3+CD56+效应细胞比例下降,由回输前的(31.1±7.8)%和(6.4±3.5)%下降至回输后的(28.6±8.3)%(P<0.05)和(5.2±3.3)%(P<0.05)。研究组1年和18个月的复发率分别为8.89%和15.56%,而对照组为30.00%和40.00%(χ2值分别为4.87和6.41,P<0.05)。结论:微创治疗后联合CIK细胞免疫治疗可提高肝癌患者的免疫功能,对降低肝癌的复发率具有重要作用。

BACKGROUND ＆ OBJECTIVE： Recently, micro-invasive treatments showed well application prospective in treating primary hepatocellular carcinoma （HCC）, while tumor immunotherapy is a hot topic in tumor treatment. This study was to investigate the efficacy of cytokine- induced killer cells （CIK） combined micro-invasive treatments （transcatheter arterial chemoembolization and radiofrequency ablation） on the recurrence of HCC. METHODS. A total of 85 HCC patients without active lesions and metastasis, which were displayed by imaging examination after transcatheter arterial chemoembolization and radiofrequency ablation therapy, were divided randomly into 2 groups： 45 in study group, and 40 in control group. The patients in study group were transfused with CIK cells through hepatic artery after micro-invasive treatments, while the patients in control group were not. The levels of T lymphocyte subsets and native killer （NK） cells in peripheral blood of HCC patients before and after CIK cell transfusion were detected by flow cytometry （FCM）. Tumor condition was observed by CT scanning every 2-3 months. RESULTS： The percentages of CD3^＋, CD4^＋, and CD56^＋ effect cells and the proportion of CD4^＋/CD8^＋ were increased from （68.6±11.0）%, （31.0±9.0）%, （15.6±7.8）%, and 1.1±0.5to （70.7±10.1）% （P〈0.05）, （33.5± 8.0）% （P〈0.05）, （18.4±9.4）% （P〈0.05）, and 1.3±0.6 （P〈0.05） after CIK cell transfusion; while the percentages of CD8^＋ and CD3^＋ CD56^＋ cells were decreased from （31.1 ±7.8）% and （6.4±3.5）% to （28.6±8.3）% （P〈0.05） and （5.2±3.3）% （P〈0.05）. The 1- and 1.5-year recurrence rates were 8.89% and 15.56% in study group, and 30.00% and 40.00% in control group （χ^2 = 4.87 and 6.41, P 〈0.05）. CONCLUSION： CIK cell transfusion after micro-invasive treatments may improve the immunologic function in HCC patients, and play an important role in reducing the recurrence rate of HCC.