DC-CIK细胞免疫治疗联合化疗对卵巢癌免疫功能的影响

Effect of dendritic cell-cytokine-induced killer cells combined with chemotherapy on immunological function in patients with malignant ovarian tumor

目的 探讨细胞因子诱导的杀伤（cytokine-induced killer,CIK）细胞、树突状细胞（dendritic cells,DC）免疫治疗联合化疗对晚期卵巢癌患者外周血淋巴细胞亚群的影响,并评估其治疗效果. 方法 选取2011-09～2013-08就诊于新乡市中心医院的62例卵巢上皮性恶性肿瘤患者,其中30例患者采用DC-CIK联合化疗[紫杉醇（taxel）＋卡铂（cisplatin）]为联合治疗组;选取同期进行单纯化疗的32例患者为单纯化疗组.3周为1个周期,3周期后评价疗效.治疗结束1周后采用流式细胞仪检测外周血CD3＋、CD3＋ CD4＋、CD4＋/CD8＋、CD4＋ CD25＋T调节性T细胞、NK细胞的变化. 结果 每位患者治疗3个周期后,联合治疗组患者外周血CD3＋、CD3＋ CD4＋、CD4＋/CD8＋、NK水平明显高于单纯化疗组（P＜0.05）.联合治疗组患者的客观缓解率为85.7％,显著高于单纯化疗组的56.5％ （P ＜0.05）.联合治疗组患者的不良反应（包括骨髓抑制、肝功能损害）明显轻于单纯化疗组（P＜0.05）,联合治疗组患者治疗后体力状况评分较单纯化疗组改善明显. 结论 DC-CIK细胞免疫治疗联合化疗能提高卵巢癌患者的细胞免疫功能,且安全有效.

Objective To evaluate the curative effecacy of dentritic cell（DC）-cytokine induced killer cells（CIKs）combined with chemotherapy in treatment of ovarian carcinoma by investigating the changes of T lymphocyte subsets in peripheral blood.Methods Clinical data and the changes of lymphocyte subsets in 62 patients with ovarian carcinoma,who were admitted to Central Hospital of Xinxiang from September 2011 to August 2013,were retrospectively reviewed.Thirty patients were treated by DC-CIK combined with chemotherapy（taxel ＋ cisplatin）in combination group,while 32 patients were treated with chemotherapy alone in control group.Three weeks were designed as one course of treatment,and the curative effects were evaluated at 7 d after treatment.The immune functions （CD3 ＋,CD3＋CD4＋,CD4＋/CD8＋,CD4＋CD25＋T,NK cells）were evaluated in two groups one week after treatment.Results After three courses of treatment,the levels of CD3 ＋,CD3 ＋ CD4 ＋,CD4 ＋/CD8 ＋,NK cells in peripheral blood were statistically significantly higher in combination group than in control group （P ＜ 0.05）.The disease control rate （DCR） in combination group was higher than that in control group （85.7％ vs 56.5 ％,P ＜ 0.05）.The incidence of side effects （including bone marrow suppression,impaired liver function）was lower in combination group than in control group（P ＜ 0.05）.The physical condition and appetite of the patients in combination group were better than those in control group.Conclusion Treatment with DC-CIK cells immune therapy combined with chemotherapy can improve the immunological function in patinents with ovarian carcinoma,and it is safe and effective.