肿瘤浸润淋巴细胞及重组白细胞介素2治疗原发性肝细胞癌

Tumor infiltrating lymphocytes and rIL 2 for treating hepatocellular carcinoma

目的探讨联合应用肿瘤浸润性淋巴细胞（ｔｕｍｏｒｉｎｆｉｔｒａｔｉｎｇｌｙｍｐｈｏｃｙｔｅｓ，ＴＩＬ）和重组白细胞介素２（ｒＩＬ２）治疗对原发性肝细胞癌（ｐｒｉｍａｒｙｈｅｐａｔｏｃｅｌｕｌａｒｃａｒｃｉｎｏｍａ，ＰＨＣＣ）术后患者细胞免疫功能的影响和其临床疗效。方法对１６例ＰＨＣＣ术后患者进行了ＴＩＬ和ｒＩＬ２治疗，１２例从肝动脉插管输入，４例从门静脉插管输入。结果ＴＩＬ治疗后１６例患者外周血白细胞介素２（ＩＬ２），Ｔ细胞亚群及比率均有不同程度上升；肿瘤坏死因子（ＴＮＦ），白细胞介素６（ＩＬ６）多有不同程度下降。随访６～２４个月，１４例肝癌根治性切除术患者，肿瘤无复发迹象，１例肝癌根治切除术患者ＴＮＦ上升了８ＩＵ，该患者治疗８个月后死于肝功能衰竭；１例肝癌姑息性切除，残癌无水酒精注射病人，ＴＩＬ治疗１８个月后肿瘤直径扩大２ｃｍ。结论ＴＩＬ治疗对提高ＰＨＣＣ术后患者抗肿瘤细胞免疫功能，防止肿瘤复发，抑制残瘤生长，延长患者生存期具有一定作用。

Objective To study the clinical effect and influence on the cellular immune function of postoperative patients with primary hepatocellular carcinoma (PHCC) of combined use of tumor infiltrating lymphocytes (TILs) and rIL 2. Methods From December 1994 to April 1977, 16 cases of postoperative PHCC patients were managed with TILs and rIL 2. Respectively, TILs and rIL 2 were infused from hepatic artery in 12 cases, other 4 cases infused from portal vein. Results The IL 2, NK activity, T subsets, CD + 4/CD + 8 level in peripheral blood were increased in all of the patients, while the IL 6, TNF level were decreased in most of the patients. All patients were followed up for 6～24 months after this management; 14 cases who underwent radical tumor resection had no recurrance; one case, who had palliative tumor resection, had enlargement 2cm in diameter of the tumor 18 months after the treatment. One patient who underwent radical tumor resecion with TNF level increasing 8IU, died of hepatic function failure 8 months after the treatment. Conclusions Practice of combination of TILs and rIL 2 has a fair definite effect for treating postoperative patients with PHCC, such as improving the living quality, preventing the tumor recurance, restraining the remnant tumor growth and prolonging the life span of patients.