树突细胞-细胞因子诱导的杀伤细胞免疫治疗晚期结直肠癌32例临床观察

Observation of DC -CIK immune therapy in the treatment of patients with advanced colorectal cancer

目的：探讨树突细胞-细胞因子诱导的杀伤细胞（DC-CIK）免疫治疗晚期结直肠癌患者的临床疗效及安全性。方法选择32例晚期结直肠癌患者作为研究对象，所有患者患者均采用树突细胞（DC）联合细胞因子诱导杀伤细胞（CIK）治疗，每疗程间隔3个月，治疗3个疗程，疗程结束后评价实体瘤近期疗效，治疗前后进行 KPS 评分，空腹抽血检测血清 AFP，CEA，CA125，CA199及外周血 T 细胞亚群，记录不良反应发生情况。结果32例患者，CR 1例，PR 10例，SD 15例，PD 6例，DCR 为81．25％；KPS 较治疗前评分提高20分的18例（56．25％）；免疫指标好转25例（78．13％），变差7例（22．87％）。治疗后 AFP 和 CEA 分别为（123．15±45．26）ng／mL 和（15．48±7．34）ng／mL，较治疗前明显降低（t ＝4．043、4．152，均 P ＜0．05）；治疗后CD ＋3、CD ＋4、CD ＋8、CD ＋4／CD ＋8分别为（63．51±2．35）％、（36．27±2．96）％、（29．32±3．01）％、（1．41±1．02），较治疗前明显明显升高（t ＝3．952、3．945、3．434、3．522，均 P ＜0．05）。结论 DC-CIK 细胞免疫治疗晚期结直肠癌的效果确切，能有效增强晚期直肠癌患者的免疫水平，缓解病情，改善症状，毒副作用轻微。

Objective To investigate the efficacy and safety of DC -CIK immune therapy in the treatment of patients with advanced colorectal cancer.Methods 32 patients with advanced colorectal cancer in our hospital were selected as study subjects.All patients had been treated by dendritic cells （DC）combined with cytokine -induced killer cells （CIK）treatment for 3 courses,each treatment interval was 3 months.After the treatment,the effects on solid tumors were evaluated,KPS scores were assessed,the fasting blood samples were exsanguinated for detecting AFP,CEA,CA125,CA199 and peripheral blood T cell subsets,the adverse reactions were recorded.Results Of 32 patients,there were CR in 1 patient,PR in 10 patients,SD in 15 patients,PD in 6 patients.There were 18 cases （56.25%）whose KPS increased after treatment;immune index improved in 25 cases （78.13%）,deteriorated in 7 cases （22.87%）.After treatment,the AFP and CEA levels were （123.15 ±45.26 ）ng/mL and （15.48 ± 7.34）ng/mL,which were lower than before treatment （t =4.043,4.152,all P 〈0.05 ）.After treatment,the CD ＋3 ,CD ＋4 ,CD ＋8 ,CD ＋4 /CD ＋8 were （63.51 ±2.35 ）%,（36.27 ±2.96 ）%,（29.32 ±3.01 ）%,（1.41 ± 1.02）respectively,which were significantly higher than before treatment（t =3.952,3.945,3.434,3.522,all P 〈0.05）.Conclusion The DC -CIK cell immune therapy has exact effect in the treatment of patients with advanced colorectal cancer,can effectively enhance the immune level,remission of disease,improve symptoms,and has mild side effects.