细胞因子激活的杀伤细胞治疗晚期肺癌的研究

Study of cytokine-induced killer cells for treatment of advanced lung cancer

目的探讨细胞因子激活的杀伤细胞(CIK)过继性免疫治疗对晚期肺癌患者近期免疫指标及生活质量(QOL)的影响,并观察CIK细胞治疗的安全性。方法 41例晚期肺癌的患者,体外在富细胞因子——干扰素-γ(IFN-γ)及白细胞介素-2(IL-2)的环境下,经1周左右的时间培养、增殖CIK细胞,细胞数量达到(2～5)×109后分次回输给患者。分别于CIK细胞回输前1 d及回输结束后4周抽取患者的外周血,行T细胞亚群及NK细胞活性的检测,同时分别于CIK细胞回输前1 d及回输结束后至下一疗程前评价患者的Karnofsky(KPS)状态。该组患者治疗前后的免疫指标及KPS状态进行自身对比。结果 41例晚期肺癌患者行CIK细胞治疗后的CD3+CD4+百分率上升(P<0.05),CD3+CD8+百分率下降(P<0.05),CD3+CD4+/CD3+CD8+值上升(P<0.05),NK细胞百分率升高(P<0.05)。该组患者CIK细胞治疗后KPS评分提高率为75.6%。41例肺癌行CIK细胞治疗后,1例患者出现超过39℃的高热,1例患者出现皮疹,余患者未见明显副作用出现。结论 CIK细胞治疗能改善晚期肺癌患者近期细胞免疫功能,提高患者生活质量,且安全可靠,值得临床进一步的研究。

Objective To investigate influence of adoptive immunotherapy with cytokine-induced killer（CIK） cells for advanced lung cancer on the immediate immune index and quality of life（QOL）,and to observe the safety of cellular immunotherapy of CIK.Methods In vitro,we cultivated and reproduced CIK cells of 41 patients with advanced lung cancer respectively for about one week under IL-2/IFN-γ induced stimuli,then transfused them back into the patients when the number of cells in creases to（2～5）×109.Peripheral blood of the patients was taken one day before and 4 weeks after the autologous transfusion respectively for T cell subsets test and NK Cell Viability Assay,and the Karnofsky Performance Status（KPS） of the patients was simultaneously evaluated one day before the transfusion and post-transfusion till next course of treatment.Self-comparison was conducted of the immune index and KPS pre-and post-transfusion.Results The percentage of CD3＋CD4＋increased（P0.05）,while CD3＋CD8＋decreased（P0.05）,the ratio of CD3＋CD4＋/CD3＋CD8＋increased（P〈0.05）,the percentage of NK cell increased（P0.05）and the KPS scores of the 41 patients increased75.6% after autologous CIK therapy.Over-39℃ high fever occared in one patient and one case of eruption.There were no obvious side-effects observed in others.Conclusion CIK cellular therapy can ameliorate immediate immune function and improve QOL of patients with advanced lung cancer.It is safe and worth further clinical study.