CIK治疗去势抵抗性前列腺癌的疗效观察

Efficacy of CIK in the Treatment of Castration Resistant Prostate Cancer

目的研究细胞因子诱导的杀伤细胞(cytokine-induced killer cell,CIK)对去势抵抗性前列腺癌(castrate-resistant prostate cancer,CRPC)患者通过免疫治疗后的短期临床疗效。方法选择苏州大学附属第一医院泌尿科收治的CRPC患者9例,分离外周血单个核细胞体外培养,取未贴壁细胞,经IL-1、IL-2、IFN-γ、抗CD3单抗诱导培养成CIK,经静脉回输给患者。在患者治疗前进行血清前列腺癌特异性抗原(prostate specific antigen,PSA)检测,治疗结束后4周复测血清PSA,并通过对比患者的睡眠、食欲、体力、骨痛等观察指标,进行短期疗效评价。结果 CIK治疗能降低CRPC患者PSA(P<0.05),5例患者PSA出现下降,3例PSA保持稳定,1例PSA上升。对9例患者短期临床疗效评价,结果显示3例患者PR,5例患者SD,1例患者PD;2/5患者骨痛较治疗前减轻,4/9患者体力增强,3/9例患者食欲提高,5/9患者睡眠质量改善。9例CRPC患者治疗的耐受性良好。1例患者出现低热,激素治疗后好转,其余患者未有不良反应。结论 CIK治疗CRPC能激发患者的免疫应答,控制患者PSA水平,副作用少,有良好的短期临床疗效。

Objective To investigate the short-term clinical efficacy of cytokine-induced killer cell （CIK） on patients with castrated resistant prostate cancer （castrate-resistant prostate cancer CRPC） after immunotherapy. Melhods 9 cases of CRPC patients admitted to the urology department of first Hospital Affiliated to Suzhou University were selected.Isolated peripheral blood mononuclear cells gamma were cultured in vitro to extract non adherent cells. IL-1, IL-2, IFN-γ, and anti CD3 monoclonal antibody were induced to be cultured into CIK and returned to the patients via vein. Before the treatment, serum prostate cancer specific antigen （prostate specific antigen, PSA） was detected. Alter 4 weeks of treatment, the serum PSA was remeasured. By comparing the patients＇ sleep, appetite, physical strength, bone pain and other observation indexes, the short-term curative effect was evaluated. Results CIK treatment could reduce PSA （P 〈 0.05） of CRPC patients, 5 patients with PSA decreased, 3 cases of PSA remained stable, 1 case of PSA increased. The short-term clinical efficacy of 9 patients was evaluated. The results showed that 3 patients were PR, 5 patients were SD, and 1 patient were PD. 2/5 patients were relieved of bone pain before treatment, increased physical strength in 4/9 patients, increased appetite in 3/9 cases, and improved sleep quality in 5/9 patients. 9 patients with CRPC were well tolerated. 1 case of patients had low fever, after hormone treatment improved; the rest of the patients had no adverse reactions. Conelusion The treatment of CRPC by CIK can stimulate the patient＇s immune response, control the patient＇s PSA level, have less side effects and have good short-term clinical efficacy.