Exosomes致敏的树突状细胞在中晚期大肠癌的临床应用研究

Clinical application study of dendritic cells sensitized by Exosomes in the treatment of advanced colorectal cancer

目的评估Exosomes致敏的树突状细胞对中晚期大肠癌的临床疗效。方法105例中晚期大肠癌患者随机分为免疫联合化疗组（n=65）和单纯化疗组（n=50）,观察两组患者的外周血T淋巴细胞亚群含量、有效率、1年生存率、中位生存时间及毒副反应。结果治疗前两组T淋巴细胞亚群含量比较无显著性差异,免疫联合化疗组治疗后与治疗前比较,CD3^＋、CD4^＋及CD8^＋明显增高（P〈0.05）,且优于单纯化疗组（P〈0.05）;联合治疗组与单纯化疗组有效率分别为56.9%和38.0%（P〈0.05）,1年生存率分别为66.7%和52.1%（P〈0.05）,中位生存时间分别为15.6个月和12.3个月（P〈0.05）,两组毒副反应无统计学意义（P〉0.05）。结论Exosomes致敏的树突状细胞回输联合化疗对中晚期大肠癌有较好的疗效,可提高免疫功能,延长生存期。

Objective To evaluate the effect of dendritic cells（DC） sensitized by Exosomes in the treatment of advanced colorectal cancer. Methods One hundred and five patients with advanced colorectal cancer were ran- domly divided into combination treatment group （ chemotherapy ＋ DC sensitized by Exosomes ） （ n = 65） and chemotherapy group（ n = 50） for observation of the T cell subsets in peripheral blood, response rate, one year survival rate, median survival time and toxicity. Results CD3^＋ ,CD4^＋ and CD8^＋ in combination treatment group after treatment were improved（P 〈 0.05 ）, which was also superior to chemotherapy group （ P 〈 0.05 ）. Response rates were 56.9% in combination treatment group and 38.0% in chemotherapy group（P〈0.05）. One year survival rate and median survival time were 66.7 % and 15.6 months, respectively, in patients allocated to combination treatment group compared with 52.1% and 12.3 months, respectively, in patients allocated to chemotherapy group（ P〈 0.05 for both comparisons）. There was no significant difference in toxicity between both groups（ P 〉 0.05 ）. Conclusion Dendritic cells sensitized by Exosomes combined chemotherapy is well effective and tolerated in the treatment of advanced colorectal cancer, improve immunity function and prolong survival period.