恶性肿瘤术后DC联合CIK治疗的临床观察

Effects of DC and CIK on postoperative patients with malignant humors

目的:研究树突状细胞(DC)和细胞因子活化的杀伤细胞(CIK)联合治疗对各种恶性肿瘤术后预防复发和进一步治疗的临床疗效及不良反应,阐明细胞免疫治疗作为肿瘤术后化疗的替代方案的可行性。方法:15例恶性肿瘤术后患者中,13例经CT检查无肿瘤复发,1例肝脏肿瘤转移,1例肝脏有囊肿。患者采用IL-210×105U/d静脉滴入5d。96h后采集患者外周血6～8L,(3～6)×109核细胞。细胞贴壁分离,在含有DC、IL-4、GM-CSF和相应肺癌抗原的无血清培养液培养8d,经静脉注入(32±15.3)×107DC细胞。未贴壁的悬浮细胞加入含有细胞因子培养液培养,诱导生成CIK细胞,皮下注射,1次/周,共注射3次〔(87±35.6)×108CIK细胞〕。周期结束后1个月复查,每隔3个月复查1次。结果:经DC+CIK治疗后,15例中有14例无肿瘤复发或病情加重,其中1例出现肿瘤原位复发并病情加重,但15例患者均存活。临床症状显示,13例患者自感临床症状有明显改善。不良反应观察显示,13例出现1～2次发热,体温37.5～40.2℃。结论:DC+CIK治疗有预防肿瘤复发的疗效,且效率高、不良反应小,是一种有效的肿瘤术后预防性治疗方案。

OBJECTIVE： To evaluate the clinical efficacy and side effect of dendritic cells （DCs） combined with cytokine-indueed killer（CIK） cells in the prevention of postoperative recurrence and further treatment of various malignant humors, and investigate the feasibility of cellular immunotherapy as the alternative proposal of tumor postoperative chemotherapy. METHODS： Out of 15 postoperative patients with malignant tumor, 13 cases of no recurrence by CT, 1 case of hepatic metastasis and 1 case of hepatic cyst were identified. These patients were treated with IL 2 （10^6 U） for 5 days, and （3-6）× 10^9 periphral blood mononuclear cells were isolated from these patients after 96 hours. The attached cells were cultured with DC serumree medium, IL-4, GMC-SF and corresponding lung cancer antigen for 8 days and injected into patients through the vein [（32± 15. 3）× 10^7 DCs]. The suspension cells were cultured with CIK culture solution were transferred into CIK cells and the patients received intradermal CIKs administration weekly for at least 3 times [（87±35.6） × 10^8 CIK cells]. The patients were followed up at the end of the first and every 3 months after treatment. RESULTS： After treatment with DCs and CIK cells, 14 cases of no postoperative recur rence or aggravation, 1 case of recurrence in situ and progressive disease were identified in the 15 patients who were survived. Clinical symptoms were significantly improved in 13 patients. Thirteen patients had a fever （37.5- 40. 2 ℃） 1 - 2 times during treatment. CONCLUSIONS： The treatment with DC and CIK has higher effective and has less side effects in prevent of tumor recurrence. It is a feasible method to be prophylactic treatment in tumor postoperative course.