海南医科大学学报

目的:探讨DC-CIK细胞联合化疗治疗晚期非小细胞肺癌(NSCLC)患者免疫功能的影响及临床疗效。方法:将86例NSCLC患者随机分为观察组(43例)及对照组(43例),均行常规化疗,观察组在常规化疗的基础上联合DC-CIK细胞免疫治疗,均治疗3个疗程。对比两组治疗后外周血T细胞亚群、细胞因子水平变化,及临床治疗效果、不良反应发生情况。结果:观察组治疗后总有效率及疾病控制率略高于对照组,但组间比较无统计学差异(P>0.05);观察组治疗后CD8⁺与治疗前比较明显降低,CD3⁺、CD4⁺及CD4⁺/CD8⁺明显升高(P<0.05);观察组治疗后CD3⁺、NK含量及CD4⁺/CD8⁺高于对照组(P<0.05);观察组治疗后干扰素-γ(IFN-γ)、白介素(IL)-4、肿瘤坏死因子(TNF)-α水平及Th1/Th2均高于对照组,转化生长因子(TGF)-β水平低于对照组(P<0.05);观察组恶心呕吐、肝肾功能损伤的发生率低于对照组,中位无进展生存期(PFS)长于对照组(P<0.05),而两组间中位总生存期(OS)比较无统计学差异(P>0.05),2年生存率高于对照组(P<0.05)。结论:DC-CIK细胞联合化疗治疗可纠正晚期NSCLC患者机体免疫紊乱现象,增强机体抗肿瘤效应。

Objective:To explore the effect of DC-CIK in combined with chemotherapy on the immunological function in patients with advanced non-small cell lung cancer(NSCLC).Methods:A total of 86 patients with NSCLC who were admitted in our hospital were included in the study and randomized into the observation group and the control group with 43 cases in each group.The patients in the two groups were given routine chemotherapy.On this basis,the patients in the observation group were given DC-CIK cellular immunotherapy.The patients in the two groups were treated for 3courses.The peripheral blood T lymphocytes and cytokines after treatment in the two groups were compared.The clinical efficacy and adverse reactions in the two groups were evaluated.Results:The total effective rate and disease control rate after treatment in the observation group were slightly higher than those in the control group,but the comparison between the two groups was not statistically significant(P>0.05).CD8~+after treatment in the observation group was significantly reduced,while CD3⁺,CD4⁺,and CD4⁺/CD8~+were significantly elevated when compared with before treatment(P<0.05).CD3~+and NK contents,and CD4⁺/CD8~+after treatment in the observation group were significantly higher than those in the control group(P<0.05).IFN-γ,IL-4,TNF-αlevels,and Th1/Th2 after treatment in the observation group were significantly higher than those in the control group(P<0.05),while TGF-βlevel was significantly lower than that in the control group(P<0.05).The occurrence rate of nausea and vomiting,and liver and renal function damage in the observation group was significantly lower than that in the control group(P<0.05),but the median progression free survival(PFS)was significantly longer than that in the control group(P<0.05),while the comparison of median overall survival(OS)between the two groups was not statistically significant(P>0.05),and 2-year survival rate was significantly higher than that in the control group(P<0.05).Conclusions:DC-CIK in combined with chemotherapy can correct the immunologic disorder in patients with advanced NSCLC,and strengthen the antitumor effect.