DC-CIK联合靶向治疗肾透明细胞癌的临床意义

Effect of DC-CIK Combined with Targeted Therapy on Renal Cell Carcinoma Patients and Its Clinical Significance

目的:考察靶向治疗、靶向治疗联合树突状细胞(DC)和杀伤细胞(CIK)免疫疗法治疗肾癌患者2个疗程后外周血淋巴细胞亚群比率差异,探讨不同治疗方法治疗肾癌的疗效差异及外周血淋巴细胞亚群比率与其预后的关系。方法:回顾性分析我院于2011年1月—2015年7月收治的确诊为肾透明细胞癌的48例患者,将其分为靶向治疗组(ST)和DC-CIK联合靶向治疗组(DC-CIK&ST)组;通过流式细胞术检测两组患者的治疗前、治疗2个疗程后外周血中CD3^(+)T、CD19^(+)B、CD3-CD56^(+)NK、CD3^(+)CD56^(+)NK-T、CD4^(+)、CD8^(+)、CD8^(+)CD28^(+)、CD8^(+)CD28^(-)、CD4^(+)CD25^(+)Treg占淋巴细胞百分比,依据结果结合临床评估统计分析两种治疗方法的差异,并尝试分析淋巴细胞亚群与患者预后的关系。结果:经治疗后,两组患者的中位无进展生存期分别为ST组5.3个月和DC-CIK&ST组7.8个月,具显著性差异(P<0.05);两组患者的中位总生存期分别为ST组18.3个月和DC-CIK&ST组22.1个月,具显著性差异(P<0.05);两组患者的CD3^(+)CD56^(+)NK-T细胞与CD4^(+)CD25^(+)Treg细胞的比率,在治疗前后的差值于两组间具显著性差异(P<0.05)。结论:DC-CIK联合靶向治疗或可通过显著影响患者CD3^(+)CD56^(+)NK-T细胞与CD4^(+)CD25^(+)Treg细胞的比率而改善患者的预后。

Objective:Investigate the difference in efficacy between two groups of patients with renal cell carcinoma treated with targeted therapy,targeted therapy combined with DC-CIK.To explore the difference in peripheral blood lymphocyte subset ratio between different therapies,and the relationship with the prognosis of patients with renal cell carcinoma.Methods:48 patients diagnosed as renal clear cell carcinoma from January 2011 to July 2015 in our hospital oncology was divided into ST group and DC-CIK&ST group according to the patient’s wishes;CD3^(+)T,CD19^(+)B,CD3-CD56^(+)NK,CD3^(+)CD56^(+)NK-T,CD4^(+),CD8^(+),CD8^(+)CD28^(+),CD8^(+)CD28^(-),CD4^(+)CD25^(+)Treg accounted for the percentage of lymphocytes in peripheral blood before treatment and after 2 courses of treatment were detected by flow cytometry,and the differences between the two treatment methods were analyzed based on the results and clinical evaluation.Trying to analyze the relationship between lymphocyte subsets and patient prognosis.Results:After treatment,the median progression-free survival of the ST group was 5.3 months and the DC-CIK&ST group was 7.8 months,with significant differences(P<0.05);median overall survival was 18.3 months in the ST group and the DC-CIK&ST group was 22.1 months,with significant difference(P<0.05).There was a significant difference in the proportion of CD3^(+)CD56^(+)NK-T cells and CD4^(+)CD25^(+)Treg cells before and after treatment between the two groups(P<0.05).Conclusion:DC-CIK combined with targeted therapy may improve the prognosis of patients by significantly affecting the proportion of CD3^(+)CD56^(+)NK-T cells and CD4^(+)CD25^(+)Treg cells before and after treatment.