放疗联合DC—CIK治疗对Ⅲ／Ⅳ期非小细胞肺癌患者免疫功能和生存的影响

Effect of radiotherapy combined DC-CIK treatment on immune function and survival of patients with non-small cell lung cancer of stageⅢ/Ⅳ

目的探讨放疗联合树突状细胞（DC）与细胞因子诱导杀伤细胞（CIK）治疗对Ⅲ／Ⅳ期非小细胞肺癌患者免疫功能和生存的影响。方法选取2010年12月至2013年12月收治的Ⅲ／Ⅳ期非小细胞肺癌患者76例，将其随机分为对照组和观察组，对照组采用放疗方案，观察组采用DC-CIK细胞联合放疗方案进行治疗。疗程结束后，流式检测治疗前后患者外周血CD3^＋、CD4^＋、CD8^＋、CD16^＋、CD56^＋、CD4^＋、D25^＋细胞比例和CD4^＋／CD8^＋比值。比较两组患者治疗前后的机体免疫功能变化；采用酶联免疫法检测治疗前后两组患者外周血Th1Th2细胞因子水平的变化；比较两组患者治疗后的累计生存率。结果治疗后观察组淋巴细胞水平改善明显优于对照组，差异有统计学意义（P〈0．05）；治疗后观察组外周血血清Th1胞因子（白细胞介素-2、γ-扰素）水平显著高于治疗前及对照组治疗后（P〈0．05），Th2细胞因子（白细胞介素-4、白细胞介素-10）水平显著低于治疗前及对照组治疗后（P〈0．05）；对照组1、2、3年累计生存率分别为81．6％（31例）、68．4％（26例）和57．9％（22例）；观察组1、2、3年的累计生存率分别为92．1％（35例）、81．6％（31例）和71．1％（27例），两组比较差异有统计学意义（P〈0．05）。结论放疗联合DC—CIK治疗方案能够有效调节Ⅲ／Ⅳ期非小细胞肺癌患者体内淋巴细胞比例及Th1／Th2平衡，显著改善机体免疫功能，提高生存率。

Objective To investigate the effect of radiotherapy combined DC-CIK treatment on immune function and survival of patients with non-small cell lung cancer of stage Ⅲ/Ⅳ. Methods Seventy-six patients with non-small cell lung cancer of stage Ⅲ/Ⅳ from December 2010 to December 2013 were randomly divided into control group and observation group. Patients in the control group were treated by radiotherapy only, and patients in the observation group were treated by DC-CIK cells combined with radiotherapy. CD4^ ＋ , CD8^＋ ,CD16^＋、 CD56^＋ , CD4 ^＋ CD25^＋ cell percentage and CD8^＋/CD4 ^＋ ratios were evaluated by FCM before and after treatment. Th1/Th2 eytokine levels were analyzed using ELISA method before and after treatment. The cumulative survival rate was estimated in the two groups. Results The level of lympbocytes in the observation group after treatment was significantly improved than that before treatment and in the control group （P 〈 0. 05）. IL-2 and IFN-γ levels in the observation group increased significantly compared with before treatment and the control group （ P 〈 0. 05 ）. IL-4 and IL-10 levels in the observation group decreased significantly compared with before treatment and in the control group （P 〈 0. 05 ）. 1, 2 and 3 years cumulative recurrence rate were 81.6% （31 cases） , 68.4% （26 cases） and 57.9% （22 cases） in the control group, while 92. 1% （35 cases）, 81.6% （31 cases） and 71.1% （27 cases） in the observation group. There was significantly difference in cumulative recurrence rates between the two groups （P 〈 0. 05）. Conclusions Radiotherapy combined with DC-CIK treatment can effectively regulate ratio of patients with non-small cell lung cancer of stage Ⅲ/Ⅳ as well as Thl/Th2 balance, improving immune function and survival rate. lymphocyte significantly