免疫治疗方案对甲状腺癌术后患者的疗效及免疫功能的影响

The impact of immune therapy on the post-operative efficacy and immune function in thyroid cancer patients

目的探讨树突状细胞-细胞因子诱导杀伤细胞(DC-CIK)生物免疫疗法对甲状腺癌患者的疗效及术后免疫功能的影响。方法 2013年6月至2015年7月将84例甲状腺癌患者随机分为对照组(n=42)及观察组(n=42),两组均行甲状腺肿瘤切除术。对照组术后行CMF[环磷酰胺(CTX)+甲氨蝶呤(MTX)+氟尿嘧啶(5-FU)]化疗方案辅助治疗,观察组术后应用DC-CIK治疗。对比分析两组患者治疗效果、术后免疫功能、炎症因子及血管内皮细胞因子(VEGF)水平的变化。结果观察组近期总有效率85.71%高于对照组的59.52%,组间比较有统计学差异(P<0.05)。观察组治疗后CD4+Th17细胞比率低于对照组,Th17/Treg、CD4^+CD^+25 Treg细胞的比率则高于对照组(P<0.05)。观察组患者术后白细胞介素-1,6(IL-1,6)、肿瘤细胞坏死因子-α(TNF-α)及VEGF水平显著低于对照组(P<0.05)。结论 DC-CIK生物免疫疗法能有效改善甲状腺癌患者术后免疫功能,降低患者炎症因子水平,提高患者治疗效果。

Objective To investigate the influence of dendritic cell-cytokine induced killer cells（DC-CIK） biological immunotherapy on the post operative effect and immune function in the thyroid cancer patients.Methods Eighty-four cases of thyroid cancer were randomly divided into control group（n = 42） and observation group（n=42） from June 2013 to July 2015.Two groups were underwented with thyroid tumor resection,postoperative group CMF [cyclophosphamide（CTX）＋methotrexate（MTX）＋fluorouracil（5-FU） ] chemotherapy adjuvant therapy,postoperative observation group were treatmented with DC-CIK.The therapeutic effect,after immunization function,changes in inflammatory cytokines and vascular endothelial growth factor（VEGF） of two groups were compared.Results The recent overall response rate of observation group（85.71%） were higher than that of control group（59.52%）（P〈0.05）.The levels of CD4^＋Th17 cell ratio of observation group was lower than that of the control group after treatment.The levels of Th17/Treg,CD4^＋CD^＋25 Treg cells ratio of observation group were higher than those of control group（P〈0.05）.The levels of interleukin-1,6（IL-1,6）,tumor necrosis factor-α（TNF-α） and VEGF of observation group were significantly lower than those of the control group（P〈0.05）.Conclusion DC-CIK immune therapy can effectively improve the immune function of postoperative patients with thyroid cancer,reduce inflammatory factors in patients,improve patient outcomes.