胃癌根治术后LAK细胞及rIL-2腹腔灌注的临床疗效

Clinical effect of LAK cell and rIL-2 intraperitoneal perfusion on gastrectomy patients

目的探讨胃癌根治术后使用淋巴因子激活杀伤(LAK)细胞及重组白细胞介素-2(rIL-2)腹腔灌注的疗效。方法选取2016年12月-2019年12月天台县人民医院收治的行胃癌根治术治疗的患者87例,按随机数表法分为对照组(行常规化疗,n=42)与研究组(行LAK细胞过继免疫疗法及rIL-2腹腔灌注治疗,n=45)。术后采集腹腔引流液行真菌培养,对比分析两组患者腹膜转移发生情况,评价相关指标;比较治疗前后两组外周T细胞亚群变化;统计不良反应发生率和感染率。结果研究组真菌感染率、腹膜转移发生率、治疗后血管内皮生长因子(VEGF)、骨桥蛋白(OPN)、基质金属蛋白酶-9(MMP-9)均低于对照组,差异有统计学意义(P<0.05);研究组治疗后CD3^(+)、CD4^(+)高于对照组,CD8^(+)、自然杀伤(NK)细胞及切口感染、肺部感染、尿路感染发生率低于对照组,差异有统计学意义(P<0.05)。结论胃癌根治术治疗后预防腹膜转移治疗期间开展LAK细胞过继免疫疗法及rIL-2腹腔灌注效果显著,能够有效控制肿瘤复发,增强患者机体免疫功能,减少不良反应和感染的发生。

OBJECTIVE To explore the effect of intraperitoneal infusion of lymphokine activated killer(LAK)cells and recombinant interleukin-2(rIL-2)on treatment of the patients undergoing radical gastrectomy for gastric cancer.METHODS Totally 87 patients who underwent radical gastrectomy for gastric cancer in Tiantai People’s Hospital from Dec 2016 to Dec 2019 were enrolled in the study and randomly divided into the control group with 42 cases and the study group with 45 cases.The control group was treated with conventional chemotherapy,and the study group was treated with LAK cell adoptive immunotherapy and intraperitoneal perfusion of rIL-2.The peritoneal drainage fluid specimens were collected for fungal culture after the surgeries,the incidence of peritoneal metastasis was observed and compared between the two groups of patients,the related indexes were evaluated,the levels of peripheral blood T lymphocyte subsets were compared between the two groups before and after the treatment,and the incidence rates of adverse reactions and infection were statistically analyzed.RESULTS The incidence rates of fungal infection and peritoneal metastasis of the study group were significantly lower than those of the control group,and the levels of vascular endothelial growth factor(VEGF),osteopontin(OPN)and matrix metalloproteinase-9(MMP-9)of the study group were significantly lower than those of the control group after the treatment.The levels of CD3^(+)and CD4^(+)of the study group were significantly higher than those of the control group after the treatment;the CD8+level,natural killer(NK)cell level,and incidence rates of incision infection,pulmonary infection and urinary tract infection were significantly lower in the study group than in the control group.CONCLUSION LAK cell adoptive immunotherapy and rIL-2 intraperitoneal perfusion can achieve significantly effect on prevention of recurrence of tumor,boost the immune function and reduce the incidence of adverse reactions and infection in the patients undergoing radical gastrectomy for gastric cancer.