DC-CIK细胞免疫治疗联合化疗对老年中晚期非小细胞肺癌的临床研究

Clinical Investigation of DC-CIK Cell Immunotherapy Combined with Chemotherapy in Older Patients with Advanced Non-small Cell Lung Cancer

目的探讨树突状细胞-细胞因子诱导的自然杀伤(DC-CIK)细胞免疫治疗联合化疗治疗老年中晚期非小细胞肺癌(NSCLC)的临床疗效,以及对患者血清微小RNA-137(miR-137)和微小RNA-29a(miR-29a)的影响.方法选取2013年1月~2015年12月期间扎兰屯市中蒙医院和锦州医科大学附属第一医院收治的68例中晚期NSCLC老年患者,按照随机数字表法分为对照组和观察组,各34例.其中对照组患者单纯行紫杉醇+顺铂(TP方案)治疗,观察组在对照组化疗基础上采用DC-CIK细胞免疫治疗.采用荧光定量聚合酶链式反应(PCR)技术检测患者治疗前和治疗2个周期后血清miR-137和miR-29a表达水平变化.比较两组患者临床疗效和不良反应发生情况.结果观察组疾病控制率(DCR)和客观缓解率(ORR)均显著高于对照组(P<0.05).治疗后3个月两组卡氏体能状态评分(KPS)变化情况比较差异具有统计学意义(P<0.05);观察组KPS评分好转率显著高于对照组(P<0.05).两组患者治疗后miR-137和miR-29a表达水平较治疗前均显著下降(P<0.001);观察组治疗后miR-137和miR-29a表达水平下降程度显著大于对照组(P<0.001).两组不良反应比较差异无统计学意义(P>0.05).结论DC-CIK细胞免疫治疗联合化疗可提高老年中晚期NSCLC患者临床疗效和生活质量,下调miR-137和miR-29a表达可能是其重要机制.

Objective To investigate the clinical efficacy of dendritic cell-cytokine induced natural killer(DC-CIK)cell immunotherapy combined with chemotherapy in the treatment of advanced non-small cell lung cancer(NSCLC)in the elderly and the effect on the serum micro RNA-137(miR-137)and micro RNA-29a(miR-29a).Methods 68 older patients with advanced NSCLC from January 2013 to December 2015 were divided into the control group(34 cases)and the observation group(34 cases)according to the random number table.The control group was treated with paclitaxel plus cisplatin(TP regimen).The obser-vation group was treated with DC-CIK cell immunotherapy combined with TP regimen.Quantitative PCR was used to detect serum miR-137 and miR-29a levels before and after 2 cycles of treatment.The clinical efficacy and adverse reactions were documented.Results The disease control rate(DCR)and objective response rate(ORR)in the observation group were significantly higher than those in the control group(P<0.05).There was a significant difference in the score of karnofsky performance status(KPS)between the two groups at 3 months after treatment(P<0.05).The improvement rate of KPS score in the observation group was significantly higher than that in the control group(P<0.05).The levels of miR-137 and miR-29a after treatment in the two groups were signif-icantly lower than those before treatment(P<0.05).The levels of miR-137 and miR-29a in the observation group were signifi-cantly lower than those in the control group after treatment(P<0.05).There was no significant difference in adverse reactions be-tween the two groups(P>0.05).Conclusion DC-CIK cell immunotherapy combined with chemotherapy can improve the clinical outcome and quality of life of the elderly patients with advanced NSCLC,which may be mediated by down regulating the expression of miR-137 and miR-29a.