DC-CIK联合化疗治疗结肠癌的临床研究

The study of clinical application of DC-CIK combined with chemotherapy on colon cancer

目的:研究树突状细胞(Dendritic cells,DCs)和细胞因子诱导的杀伤细胞(Cytokine induced killer,CIK)联合化疗治疗结肠癌的临床疗效和免疫功能变化。方法:将40例入选病例随机分为单纯化疗组和联合治疗组,化疗组20例,仅行化疗[奥沙利铂(Oxaliplatin)+亚叶酸钙(CF)+5-氟尿嘧啶(5-FU)];联合组20例,给予DC-CIK联合化疗[奥沙利铂+亚叶酸钙+5-氟尿嘧啶]。比较两组患者治疗后局部复发率、生存率和毒性反应。流式细胞术检测T细胞亚群的比例、ELISA法检测细胞因子表达水平。评价DC-CIK免疫治疗的安全性。结果:联合组治疗后局部复发率低于化疗组(P<0.05),1、2年生存率高于化疗组,无明显差异(P>0.05)。化疗组治疗后外周血中CD8+比例升高,CD4+/CD8+比值下降,IL-6升高(P<0.05);而联合组治疗后外周血中CD4+、CD16+、CD56+、CD4+/CD8+比值显著升高,CD4+CD25+调节性T细胞比例显著下降,IFN-γ显著升高(P<0.05),联合组患者治疗后周围神经毒性、胃肠道反应明显轻于化疗组(P<0.05)。DC-CIK细胞回输过程中及回输后未见明显不良反应。结论:DC-CIK免疫治疗联合化疗,有可能降低术后复发和转移,提高结肠癌患者的免疫功能,减轻毒性反应,具有较高的安全性。

Objective：To evaluate the clinical effect and variation of immune function of dendritic cell-cytokine induced killers（DC-CIK） combined with chemotherapy on colon cancer.Methods：A total of 40 patients with colon cancer were randomly divided into two groups： 20 in chemotherapy group,received chemotherapy alone（Oxaliplatin ＋ CF ＋ 5-FU）.20 in combined therapy group,received DC-CIK combined with chemotherapy（Oxaliplatin ＋ CF ＋ 5-FU）.The local recurrence rates,survival rates,immune function and side effects were compared between the two groups.The percentases of T cell subsets were detected by flow cytometry,the level of cytokines was detected by enzyme-linked immuno sorbent assay（ELISA）.Moreover,the safety of DC-CIK immunization therapy was assessed.Results：The local recurrence rate was 5% in chemotherapy group and 35% in combined therapy group（P0.05）,whereas the 1,2-year survival rates of the two groups were showing no significant difference.After therapy in chemotherapy group,the percentage of CD8＋ was higher,the ration of CD4＋/CD8＋was lower and the level of IL-6 was higher（P0.05）;after therapy in combined therapy group,the percentage of CD4＋,CD16＋CD56＋,the ration of CD4＋/CD8＋were higher,the percentage of CD4＋CD25＋was lower and the level of IFN-γ was higher（P0.05）.The combined therapy group had less side effects（including gastrointestinal reaction and peripheral nerve toxicity） compared with the chemotherapy group（P0.05）.In the course of DC-CIK cells feedback,obvious adverse reaction didn＇t appear.Conclusion：DC-CIK combined with chemotherapy in treatment of colon cancer is safe and effective,and it maybe depress the tumor recurrence and metastasis,improve the patients＇ immune function,reduce adverse effects and have higher security attributes.