DC-CIK联合放化疗对小细胞肺癌患者免疫功能的影响

The effect of DC-CIK combined with chemoradiotherapy on the immune function of SCLC patients

目的探讨细胞因子诱导的杀伤细胞(CIK)、树突状细胞(DC)免疫治疗联合放化疗对小细胞肺癌患者外周血淋巴细胞亚群的影响及疗效。方法收集60例小细胞肺癌患者资料,其中32例患者采用DC-CIK联合放化疗(化疗方案为依托泊苷+顺铂/依托泊苷+卡铂/伊立替康+顺铂,放疗方案为适形调强放疗技术)为联合治疗组;28例进行放化疗的患者为对照组。治疗结束2周后采用流式细胞仪检测外周血CD3+、CD3+CD4+、CD3+CD8+、NK细胞、Treg细胞及相关因子IFN-γ、IL-2、IL-10、TGF-β1的变化,并评价疗效。结果联合治疗组IFN-γ治疗后较治疗前升高,IL-10、TGF-β1较治疗前降低(P﹤0.05);联合治疗组患者外周血CD3+CD8+、CD3+CD4+、NK细胞治疗后水平高于对照组(P﹤0.05);而Treg细胞、IL-10、TGF-β1治疗后水平低于对照组(P﹤0.05)。对照组患者外周血CD3+、CD3+CD4+、CD3+CD8+、NK细胞治疗后较治疗前下降,差异有统计学意义(P﹤0.05);细胞因子在治疗前后无变化。虽然联合组疾病控制率较对照组高,但差异无统计学意义(87.50%vs 71.43%,P﹥0.05)。结论自体DC-CIK治疗可以改善小细胞肺癌联合放化疗患者的细胞免疫功能,是否能改善生存需进一步研究。

Objective To evaluate the effect of dendritic cell （DC）-cytokine induced killer cells （CIK） combined with chemoradiotherapy in T-lymphocyte subsets of small cell lung cancer （SCLC） patients. Method 60 patients with SCLC were included in this study, in which 32 patients who were treated by DC-CIK＋chemoradiotherapy （etoposide/irinotecan＋cisplatin/carboplatin; conformal modulating radiotherapy） were stratified as the study group; another 28 patients were treated with chemoradiotherapy alone during the same period, which was the control group. Flow cytometry was applied to detect the changes of CD3＋, CD3＋CD4＋, CD3＋CD8＋, NK cell, Treg cell and related cytokines of IFN-γ, IL-2, IL-10, TGF-β1 in peripheral blood. Result The IFN-γlevel was increased （P〈0.05）, while IL-10 and TGF-β1 levels were sig-nificantly decreased after treatment in study group （P〈0.05）;the levels of CD3＋CD8＋, CD3＋CD4＋, and NK were higher in study group than that of control group after treatment （P〈0.05）;furthermore, the levels of Treg cell and IL-10, TGF-β1 were significantly lower in study group as compared with control group （P〈0.05）; in the control group, the levels of CD3＋, CD3＋CD4＋, CD3＋CD8＋, and NK cells were significantly decreased after treatment （P〈0.05）, while the cytokines remained stable. The study group had a higher though insignificant disease control rate as compared with control group （87.50%vs 71.43%, P〉0.05）. Conclusion Treatment with autologous DC-CIK therapy combined with chemoradiothera-py improve the immune function of patients with small cell lung cancer, while further study is needed to determine the po-tential survival benefits.