摘要
目的 :将癌性胸腹水的有效成分回收 ,制备成自体蛋白和TIL ,施用于患者本身 ,用于晚期恶性肿瘤合并胸腹水患者的治疗。方法 :闭式引流的胸腹水经体外分离 ,将可溶性蛋白制备成自体蛋白予以静脉回输作为营养支持及改变胶体渗透压 ,以抑制胸腹水的生成 ;同时将淋巴细胞分离 ,体外经IL - 2激活培养 ,作为肿瘤浸润的淋巴细胞 (TIL)腔内给予 ,进行局部的过继免疫治疗。所有病例均取自本院收治的恶性肿瘤并发胸腹水的患者共32例 ,其中腹水 2 6例 ,胸水 6例 ;单纯自体蛋白质回输 14例 ,其中 6例二次回输 ,1例三次回输 ;单纯TIL回输 7例 ,自体蛋白 +TIL回输 11例。结果 :1)单纯自体蛋白、单纯TIL及自体蛋白与TIL综合利用 ,用于恶性肿瘤胸腹水患者的治疗 ,三者的有效率分别为 5 0 % (7/ 14) ,5 7 1% (4/ 7) ,6 3 6 % (7/ 11) ,其中自体蛋白与TIL共用的治疗效果最好 ,但无统计学差异。 2 )胸水与腹水比较 ,胸水的治疗效果非常显著 ,CR率为 6 6 7% (4/ 6 ) ,有效率为 10 0 %(6 / 6 ) ,与腹水比较有显著差异。但由于病例数少 ,无统计学意义 (P =0 0 6 7)。结论 :癌性胸腹水自体蛋白与TIL的综合利用 ,既避免了异体蛋白和异体LAK的过敏反应 ,又为晚期癌肿患者提供了一种有效的治疗手段。
Patients with terminal malignant tumors are often accompanied by hydrothorax and ascites At present, closed drainage of pleural/abdominal cavity,intracavitary chemotherapy, biological response modifiers (BRM), heterogenous LAK and TIL are among the most popular treatments Considering that there is a large amount of protein as well as a large number of lymphocytes in fluid from hydrothorax and ascites, we took pains to make use of these useful components First of all, the drained fluid from hydrothorax or ascites was put under separation process and then the autoprotein was isolated from soluble protein and was reinfused intravenously This would meet the nutritional requirement and improve the colloid osmotic pressure, which inhibited the production of hydrothorax and ascites Meanwhile, the isolated lymphocytes were utilized as local adoptive immunotherapy, given intracavitarily as TIL We studied 32 patients with malignant tumors accompanied by hydrothorax and ascites Among them , 26 were having hydrothorax and 6 ascites Fourteen cases were reinfused with simple autoprotein, 6 of them were given a second reinfusion and 1 of them was given a third,seven were reinfused with simple TIL, 11 were reinfused with both autoprotein and TIL The results according to WHO therapeutic index showed that the therapeutic efficiency rates were 50%(7/14) for simple autoprotein, 57 1%(4/7) for simple TIL and 63 6%(7/1) for the combination of autoprotein and TIL The combination of autoprotein and TIL also showed the highest CR rate of 66 7%(4/6) and a PR rate of 100%(6/6) The combined utilization of autoprotein and TIL prepared from the isolated useful components of carcinomatous hydrothorax and ascites can avoid the allergic reaction to heterogenous protein or heterogenous LAK and it may be an efficacious treatment for patients with advanced cancer
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
1999年第12期893-895,共3页
Chinese Journal of Clinical Oncology
基金
天津市卫生局科研基金
关键词
恶性肿瘤
胸腹水
自体蛋白
Malignant tumor Hydrothorax and ascites Autoprotein
