CIK细胞输注联合TACE治疗延缓原发性肝癌患者门静脉癌栓的形成

Effects of cytokine-induced killer cell infusion after transcatheter arterial chemoembolization in treatment of patients with primary liver cancer on preventing portal vein tumor thrombus

目的探讨细胞因子诱导的杀伤细胞（CIK）输注联合经动脉插管化疗栓塞术（TACE）治疗原发性肝癌患者延缓门静脉癌栓形成的可能性。方法选择2010年1月～2014年12月我院收治的原发性肝癌患者44例，22例接受TACE联合CIK细胞输注治疗，另22例只接受TACE治疗。采用Ficoll两步分离法分离外周血单个核细胞，经IFN—γ、抗CD3单克隆抗体和IL-2诱导，使用流式细胞仪检测细胞CD抗原表达鉴定CIK细胞培养成功，常规行TACE治疗，在TACE治疗半月后输注CIK细胞悬液3次，细胞总数为1．0×10^9。治疗前后行腹部CT检查，确定门静脉栓子形成情况。结果治疗后1m、3m和6m，联合组患者门静脉癌栓发生率分别为4．5％、13．6％和27．2％，而TACE组则分别为9．0％、45．5％和63．6％（P〈0．05）；在治疗3月时，联合组肿瘤大小为（4．77±1．27）cm，显著低于TACE组[（5．54±1．14）cm，P〈0．05]；在治疗3月时，联合组血清甲胎蛋白水平为（83．14±31．91）ng／ml，也显著低于TACE组[（139．24±98．76）ng／ml，P〈0．05]；两组肺部、颅脑和骨骼等远处转移发生率无显著性差异（P〉0．05）。结论CIK细胞输注联合TACE可明显减缓原发性肝癌患者门静脉栓子形成的时间，改善肝功能，同时能有效控制肿瘤的生长及扩散。

Objective To investigate the effects of cytokine induced killer ceils （CIK） combined with transcatheter arterial chemoembolization（TACE） for patients with primary liver cancer（PLC）. Methods A total of 44 patients with PLC were enrolled in 105th hospital between January 2010 and December 2014. 22 patients received combination CIK infusion and TACE,and 22 were treated with TACE alone. The peripheral blood mononuelear cells were obtained by Ficoll separation, and the CIKs were induced by with interferon-γ anti-CD3 monoclonal antibodies and interleukin-2 incubation. The ceils were determined by FACs detection. About 1.0×10^9 of CIKs were transfused after routine TACE,and abdominal CT scan was done for assessment of occurrence of portal vein tumor thrombus （PVTT）. Results The incidence of PVTT in CIK and TACE combination group 1 m, 3 m and 6 m after the discontinuation of the therapy were 4.5%,13.6% and 27.2% ,while those in TACE group were 9.0%, 45.5% and 63.6%, respectively （P〈0.05）;the size of tumor mass in combination group at 3 m was （4.77 ± 1.27 ）cm, much Smaller than [（5.54 ±1.14）cm,P〈0.05] in TACE-treated patients; serum alpha-fetoprotein in combination group at 3 m was （83.14±31.91） ng/ml,mucb lower than [（139.24±98.76） ng/ml,P〈0.05] in TACE group;the remote metastasis, such as lungs, brain, bone, etc, in both groups were not significantly different （P〉 0.05）. Conclusion Combination of CIK and TACE treatment can prevent patients with PLC developing PVTT occurrence, and maybe improve the life of quality of patients with PLC.