自体CIK细胞胸腔灌注联合静脉回输对恶性胸腔积液的近期疗效

Short-term effect of intraperitoneal combined with intravenous injection of autologous CIK cells on malignant pleural effusion

目的 评价自体CIK细胞胸腔灌注联合静脉回输治疗恶性胸腔积液（MPE）的疗效.方法 选取武汉市长江航运总医院确诊的MPE患者86例,抽取外周血50 ml分离单个核细胞,培养CIK细胞12 ～ 14 d,CD3＋ CD56＋细胞≥50％,CD3＋ CD8＋细胞≥30％,细胞活性＞95％,胸腔注入CIK细胞1＆#215;109个,1次/d,连续灌注3d,当天静脉输注C1K细胞数3＆#215;109个,每周1个疗程,连续4个疗程,B超监测胸水量级变化,流式细胞仪检测CD3＋、CD4 ＋/CD8＋和CD3＋ CD56＋的表型,CEA、CA125、CA199试剂盒检测肿瘤标志物,并观察以上指标治疗前后的变化及KPS评分的变化.结果 CIK治疗后总有效率为83.72％（72/86）;CD3＋、CD4 ＋/CD8＋和CD3＋ CD56＋表达均较治疗前升高,且差异有统计学意义（CD3＋：t=-8.41,P＜0.01;CD4＋/CD8＋：t=-6.09,P＜0.01;CD3＋CD56＋：t=-13.50,P＜0.01）;肿瘤标志物CEA、CA125、CA199表达均较治疗前下降,且差异有统计学意义（CEA：t =6.71,P＜0.01;CA125：t =3.87,P＜0.01;CA199：t=3.47,P＜0.01）;治疗后生活质量改善率为80.23％（69/86）.结论 自体CIK细胞胸腔灌注联合静脉回输治疗MPE疗效确切,有极大的研究和推广价值.

Objective To evaluate the effect of intraperitoneal combined with intravenous injection of autologous CIK ceils combined with intravenous transfusion-term on malignant pleural effusion（MPE）. Methods 86 cases of MPE in our hos- pital were enrolled in this study. 50ml peripheral blood was prepared to separate the mononuclear cells and the cultured CIK cells were induced by cytokines for 12 -14 days; CD3 ＋ CD56 ＋ cells ≥50% ,.CD3 ＋ CD8 ＋ cells ≥30%, cell viability 〉95% ,1 × 10^9 CIK cells were transfused through chest tube,once a day for 3 days;on the same day,3× 109 CIK cells were injected intravenously. A course was of a week and the treatment was last for four consecutive courses. The change of pleural fluid was monitored by ultrasound, the immune phenotype of CD3 ＋ , CD4＋/CD8 ＋ , and CD3 ＋ CD56 ＋was detected by flow cytometry,the tumor markers were detected with CEA,CA125 and CA199 kits. The changes in the above indica- tors and KPS score before and after treatment were compared. Results The total effective rate of CIK combination therapy to MPE was 83.72% （72/86） ; the CD3 ＋ , CD4 ＋/CD8 ＋ and CD3 ＋ CD56 ＋ expression increased after the treatment, here was significant difference（ CD3 ＋ ：t = - 8.41 ,P 〈 0.01 ; CD4 ＋/CD8＋： t = - 6.09,P 〈 0.01 ; CD3 ＋ CD56 ＋：t = - 13.50, P 〈 0.01 ） ; the expression of CEA, CA125, CA199 deceased, and there was significant difference （ CEA： t = 6.71, P 〈 0.01 ;CA125 ：t =3.87 ,P 〈0.01 ; CA199 ：t = 3.47,P 〈0.01 ） ;the improvement rate about quality of life was 80.23% （69/86） after the treatment. Conclusion The intraperitoneal combined with intravenous injection of autologous CIK cells was effectively in the treatment of malignant pleural effusion, it is of great value in research and clinical application.