DC-CIK细胞联合厄洛替尼对EGFR基因突变阳性的晚期肺腺癌患者外周血T淋巴细胞亚群影响研究

Study on the effects of DC-CIK cells combined with erlotinib on peripheral blood T lymphocyte subsets in the patients with advanced lung adenocarcinoma of positive EGFR gene mutation

目的探讨DC-CIK细胞联合厄洛替尼对EGFR基因突变阳性的晚期肺腺癌患者外周血T淋巴细胞亚群的影响。方法选取我院2012年6月~2016年8月间收治的EGFR基因突变阳性的晚期肺腺癌患者42例,按随机数字表法分为两组,每组21例。对照组采用厄洛替尼治疗;实验组采用DC-CIK细胞联合厄洛替尼治疗;治疗1个月为1周期,共治疗3个周期。治疗前后分别采血检测血清T淋巴细胞亚群、CEA、CA125、IFN-γ、IL-2及VEGF等,同时对比临床疗效及安全性。结果对照组有效率[57.14%(12/21)]低于实验组[85.71%(18/21)](P<0.05);与治疗前比较,两组治疗后CD3^+、CD4^+、CD4^+/CD8^+升高,CD8^+降低,治疗后血清IL-2、IFN-γ升高,CEA、CA125降低,治疗后血清VEGFA、VEGFB、VEGFC降低(P<0.05);与对照组比较,实验组治疗后CD4^+、CD4^+/CD8^+较高,CD8^+较低,治疗后血清IL-2、IFN-γ较高,CEA、CA125较低,治疗后血清VEGFA、VEGFB、VEGFC较低(P<0.05);对照组不良反应发生率为38.10%(8/21),与实验组不良反应发生率42.86%(9/21)比较,差异无统计学意义(P>0.05)。结论 DC-CIK细胞联合厄洛替尼对EGFR基因突变阳性的晚期肺腺癌疗效确切,降低IL-2、IFN-γ等炎症因子及CEA、CA125等肿瘤标志物,提高免疫功能。

Objective To investigate the effect of DC-CIK cells combined with erlotinib on peripheral blood T lymphocyte subsets in the patients with advanced lung adenocareinoma of positive EGFR gene mutation. Methods 42 patients with advanced lung adenoearcinoma of positive EGFR gene mutations who were collected from June 2012 to August 2016 in our hospital were selected. According to the random number table method, the patients were divided into two groups, with 21 cases in each group. The control group was treated with erlotinib; the experimental group was treated with DC-CIK cells combined with erlotinib. One cycle of the treatment lasted for 1 month, with a total of 3 cycles. Blood was collected and serum levels of T lymphocyte subsets, CEA, CA125, IFN-γ IL-2 and VEGF were detected before and after treatment, and at the same time the clinical efficacy and safety were compared. Results The effective rate was 57.14% （12/21） in the control group, lower than that of 85.71%（18/21） in the experimental group（P〈0.05）; CD3^3, CD4^＋, CD4^＋/CD8^＋ were increased, and CD8＋ was decreased after the treatment in both groups compared with those before the treatment. After the treatment, the serum IL-2, IFN-~/were increased, and CEA, CA125 were decreased. After the treatment, the levels of serum VEGFA, VEGFB and VEGFC were decreased（P〈0.05）; compared with the control group, CD4~, CD4＋/CD8＋ were higher, and CD8t was lower after the treatment in the experimental group. After the treatment, serum IL-2, IFN-γ were higher, and CEA, CA125 were lower. After the treatment, the levels of serum VEGFA, VEGFB and VEGFC were lower （P〈0.05）; the incidence rate of adverse reactions in the controI group was 38.10% （8/21） and 42.86% （9/21） in the experimental group, and the difference between the two groups was not signifi- cant （P〉0.05）. Conclusion DC-CIK cells combined with erlotinib have an exact curative effect on advanced lung ade- nocareinoma of positive EGFR gene mutations, which can reduce IL-2, IFN-γ and other inflammatory factors and CEA, CA125 and other tumor markers, and improve immune function.