恶性肿瘤免疫治疗后淋巴细胞表型及临床疗效的研究

The relationship between lymphocyte phenotype and clinical efficacy in patients receiving immunotherapy combined with chemoradiotherapy

目的:研究免疫治疗和放、化疗对恶性肿瘤患者淋巴细胞表型的影响及其临床疗效的关系。方法:42例晚期肿瘤患者中22例以放、化疗同时输注经共刺激的正常人外周血淋巴细胞(PBLs)进行免疫治疗,每周2次,8次为1疗程。另20例患者作为对照组,仅接受放、化疗。治疗前后用流式细胞仪检测淋巴细胞表型并观察临床症状。结果:放、化疗和免疫综合治疗组患者中15例(68.18％)的淋巴细胞表型明显改善,CD3^+、CD4^+治疗后明显升高,与治疗前比较P<0.05,CD95^+升高,P<0.02,PS评分改善P<0.01;与20例对照组相比,治疗前各项无显著差异,治疗后CD4^+升高,P<0.05,PS评分改善P<0.05;放、化疗联合免疫治疗组病人中有7例(31.82％)的淋巴细胞表型改善不明显,与治疗前及对照组比较,均无显著差异,但PS评分改善,P<0.02;对照组淋巴细胞表型与临床症状改变均不明显。结论:免疫治疗与放化疗联合治疗,可能有利于减轻放化疗的副作用,提高疗效,改善生活质量。

Objective: To observe the relationship between lymphocyte phenotype and clinical efficacy in cancer patients receiving immunotherapy combined with chemoradiotherapy. Methods: 42 patients were enrolled into the study. Among these patients, 22 received costimulated normal peripheral blood lymphocytes ( PBLs) as well as chemoradiotherapy, and 20 patients received chemoradiotherapy only as control group. Immunotherapy was administrated biweekly, totally 8 times. Results; Among 22 patients receiving immmunotherapy, 15(68. 18%) had lymphocyte phenotype change that was in accordance with symptom improvement, including elevation of CD3+ , CD4+ (P <0.05) , CD95 (P <0. 02) ; Among 22 patients receiving immmunotherapy, 7 (32. 18% ) had lymphocyte phenotype change that was in accordance with symptom improvement, but was not significant statistically. Control group had no symptom improvement without any change of lymphocyte phenotype. Conclusion; Immunotherapy combined with chemoradiotherapy could relieve the toxicity of chemoradiotherapy, enhance curative effect and improve life quality.