香菇多糖联合IL-2治疗恶性胸腔积液的前瞻性研究

Clinical study of intrapleural injection of lentinan combined with IL-2 in the treatment of malignant pleural effusion

目的 探讨香菇多糖(LNT)腔内注射同时联合应用皮下注射白介素-2(IL-2)的方法治疗恶性胸腔积液的临床疗效。方法 观察比较单纯LNT腔内注射组(A组,25例)与腔内注射LNT同时皮下注射IL-2组(B组,25例)的近期疗效、癌细胞阴转率、行为状况、外周血免疫指标变化及副反应。结果 B组的近期疗效、癌细胞阴转率、行为状况改善程度均明显优于A组(P均<0.01),B组治疗后CD3、CD4、CD4/CD8及NK细胞活性均高于治疗前(P<0.05)。而A组治疗前后免疫指标测定值变化不大。B组与A组相比,治疗前免疫指标测定差异无显著性,治疗后B组CD4、CD4/CD8及NK细胞活性均高于A组(P<0.05)。结论 LNT腔内注射同时联合应用皮下注射IL-2的方法治疗恶性胸腔积液具有较好的临床疗效,值得临床推广使用。

Objective To observe the therapeutic efficacy of intrapleural injection of lentinan combined with IL-2 in the treatment of malignant pleural effusion. Methods 50 patients with malignant pleural effusion were divided into two groups. One group received intrapleural injection of lentinan(group A, n = 25), the other group receive intrapleural injection of lentinan combined with subcutaneous injection of IL-2(group B, n = 25) .The therapeutic efficacy, the changes of tumor cells, performance and immunological criteria and the side reactions were compared between the two groups. Results The therapeutic efficacy, the negative conversion rate of tumor cells and the improvement of performance were significantly higher in group B than in group A( P < 0.01) . CD4, CD4/CD8 and the activity of NK cells showed marked elevation in group B as compared with those before treatment( P < 0.05) , but no improvement was observed in group A. Conclusion The combined treatment group has better efficacy in treating malignant pleural effusion than the monotherapy group, and has no increase in the side reactions. Hence it is suitable for the elderly and patients with poor general condition.