肿瘤患者树突状细胞联合细胞因子诱导杀伤细胞免疫治疗后血清免疫学变化及临床意义

Serological changes and clinical significance in cancer patients after dendritic cells and cytokine in-duced killer cells immunotherapy

目的探讨肿瘤患者免疫治疗后外周血淋巴细胞亚群及细胞因子水平变化及其临床意义。方法收集80例树突状细胞联合细胞因子诱导杀伤细胞（DC．CIK）免疫治疗的肿瘤患者，采用流式细胞术（FACS）和流式液相多重蛋白定量技术（CBA）分别检测肿瘤患者外周血中细胞免疫治疗后淋巴细胞亚群及细胞因子的表达水平。结果免疫治疗后外周血抑制性T细胞（Ts）较治疗前显著下降（16．42±13．62比13．154-10．19），细胞毒性T细胞（CTL）较治疗前显著升高（11．56±9．10比12．27±9．45，P〈0．01），调节性T细胞（Treg）治疗前后差异无统计学意义（P〉0．05）。外周血中CD3^＋、CD3^＋CD4^＋、CD3^＋CD8^＋细胞显著高于治疗前，分别为（71．00±10．00比75．00±12．50、38．50±14．75比40．00±12．75、27．50±13．00比29．00±12．75，P〈0．01）。治疗后肿瘤患者血清干扰素-1（IFN-1）、白细胞介素-2（IL-2）及辅助性T细胞（Thl）／Th2比值明显升高，分别为（5．81±0．31比6．01±0．47、8．10±0．52比8．19±0．44、0．86±0．04比0．89±0．06，P〈0．05）。DC-CIK治疗后3个月影像学复查，根据免疫相关反应的标准（IRRC）评价，客观缓解率为12．50％，疾病控制率为61．25％。结论DC-CIK治疗后，患者外周血中某些淋巴细胞亚群和细胞因子可反映机体抗肿瘤免疫功能的改善。

Objective To explore the level of lymphocyte subsets and cytokines in peripheral blood of cancer patients after immunotherapy, and the clinical significance. Methods We collected 80 cases of cancer patients, who accepted dendritic ceils and cytokine induced killer cells （DC -CIK） immunotherapy. fluorescence- activated cell sorter （FACS） and cytometric beads array were employed to detect the expres- sion of lymphocyte subsets and cytokines in peripheral blood before and after immunotherapy. Results Pa- tients showed increased percentage of cytotoxicity T lymphocyte （CTL） （ 11.56 ±9. 10 vs. 12. 27±9. 45 ） and lower levels of Ts （ 16.42 ± 13.62 vs. 13. 15 ± 10. 19 ） in peripheral blood after DC - CIK immuno- therapy （P 〈 0. 01 ）. After treatment, the percentages of CD3^＋ , CD3 ^＋ CD4^＋ , and CD3 ^＋ CD8^＋ cells in peripheral blood were significantly higher than those before treatment （71.00 ± 10. 00 vs. 75.00 ± 12. 50, 38. 50± 14. 75 vs. 40.00± 12. 75, and 27.50 ± 13.00 vs. 29.00 ± 12. 75 ,P 〈 0. 01 ）. The levels of in- terleukin （IL） - 2, interferon （IFN） - γand helper T cells （ Thl ）/Th2 after treatment were significantly higher than those before treatment （5.81 ±0.31 vs. 6.01 ±0.47, 8.10 ±0.52 vs. 8.19 ±0.44, and 0. 86± 0. 04 vs. 0. 89 ±0. 06, P 〈 0. 05 ）. According to the immune - related response criteria （ IRRC ） , the effective rate was 12. 50%, and disease control rate was 61.25%. Conclusion The levels of lympho- cyte subsets and cytokines in peripheral blood may reflect the body＇ s anti - tumor immune function im- provement after the DC - CIK immunotherapy.