摘要
目的:评价肺癌患者自体外周血单个核细胞(MNC)培养细胞因子诱导的杀伤(CIK)细胞质量,并分析其对肺癌患者转移复发、生存期的影响。方法:选取310例肺癌患者,均行手术+化疗,系统治疗后按是否给予CIK细胞治疗分为CIK细胞(治疗组210例)和未给予CIK细胞治疗(常规组100例),其中CIK细胞治疗组中按CIK细胞的培养质量分为高质量组(124例)和低质量组(86例),给予CIK细胞输注治疗的患者,每年进行4次治疗。采用流式细胞仪对高、低质量组CIK细胞评价MNC纯度、CD3转化率及活化率、CD8转化率及活化率以及CIK细胞百分率及绝对值,然后分析治疗后肺癌患者的转移复发、生存时间的差别,并与常规组进行比较。结果:CIK细胞培养体系中高、低质量组MNC纯度分别为(78.8±9.85)%和(52.3±6.86)%,CD3转化率分别为(89.2±4.08)%和(73.9±5.10)%,CD3活化率分别为(47.1±3.93)%和(31.9±5.74)%,CD8转化率为(66.6±3.93)%和(46.1±6.45)%,CD8活化率为(49.7±5.21)%和(35.1±6.22)%,CIK细胞百分率分别为(30.5±5.80)%和(15.3±4.60)%,CIK绝对值为(3.40±1.65)×109和(0.64±0.19)×109,高质量组均高于低质量组,P=0.000。总的CIK细胞治疗组患者出现转移、复发的中位时间为41.0(34.8～47.2)个月,常规治疗组为32.0(27.9～36.1)个月,差异有统计学意义,P=0.008;CIK细胞治疗组生存期为43.0(38.7～47.3)个月,常规组为36.0(33.3～38.6)个月,差异有统计学意义,P=0.023。其中,高、低质量组出现转移、复发的中位时间分别为42.0(31.9～52.1)和36.0(23.4～42.6)个月,差异有统计学意义,P=0.023;高、低质量组生存期分别为48.0(41.8～54.2)个月,低质量组为38.0(31.2～44.8)个月,差异有统计学意义,P=0.023。高质量组与常规治疗组比较差异有统计学意义,P值分别为0.001和0.02;低质量组与常规治疗组比较差异无统计学意义,P值分别为0.387和0.620。结论:CIK细胞免疫治疗能够提高手术、化疗后肺癌患者的无进展生存期和总生存率,高质量的CIK细胞能明显延长患者出现转移复发的时间和生存时间,为肺癌患者提供了一种安全有效的术后辅助治疗手段。
OBJECTIVE.. To evaluate the quality of CIK cells induced by autologous peripheral blood mononuclear cells （MNC） of long cancer patients,and analyze the influence on metastasis,recurrence and survival of patients with lung cancer. METHODS.. Totally 310 cases patients with lung cancer were selected. Patients were divided into three groups af- ter treatmend of surgery and chemotherapy：CIK cell infusion therapy group （each year for four times, n= 210）, conven- tional treatment group （never do CIK cell infusion therapy,n： 100）. In CIK cell infusion therapy group,according to of the quality cultured CIK in autologous peripheral blood mononuclear cells （MNC）, the patients were divided into two sub- groups.. High quality group （n= 24）, and the low quality group （n= 86）. The evaluation targets of CIK cells in culture were MNC purity,CD3 percentage and activation rate,CD8 percentage,and activation rate,CIK cells percentage and abso- lute value was evaluated by the flow cytometric （FCM）. RESULTS.. In the high and low quality groups,the MNC purity was （78.8±9.85）% and （52.3±6.86）%. TheCD3 conversion rate was （89.2＋4.08）% and （73.9±5.10）%. The CD3 activation rate was （47.1±3.93）% and （31.9±5.74）%. The percentage of CD8 was （66.6±3.93）% and （46.1± 6.45）%. The CD8 activation was （49.7±5.21）% and （35. 1±6. 22）%. The percentage of CIK cell was （30. 5± 5.80）% and （15. 3±4. 60）%. The absolute value of CIK cell was （3.40±1. 65）×109 and （0. 64±0. 19） ×109（P=0. 000）. The median recurrence time of CIK cell infusion therapy group was 41.0 （34. 8-47.2） months,while that of con- ventional treatment group was 32. 0 （27. 9- 36. 1）months （P = 0. 008）. The survival time of CIK cell infusion therapy group was 43.0（38. 7--47. 3） months,while that of conventional treatment group was 36. 0（33. 3-38. 6）months （P=0. 023）. The median recurrence time of high and low quality groups were 36. 0 （23.4- 42.6）months and 42. 0 （31.9- 52. 1 ）months （P = 0. 023）, while the survival time were 48.0（41.8-54.2） months and 38. 0 （31.2-44. 8） months （P=0. 023）. There was significant difference between high quality group and conventional treatment group （P= 0. 001 ;P= 0. 02）, and there was significant differ- enee between low quality group and conventional treatment group （P= 0. 387;P= 0. 620）. CONCLUSIONS： CIK cellular immune therapy can improve the survival time and survival rate of lung cancer patients treated with chemotherapy and operation. High quality CIK cells can prolong the median recurrence time and survival time.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2013年第10期778-781,785,共5页
Chinese Journal of Cancer Prevention and Treatment
关键词
CIK细胞
肺癌
培养质量
长期疗效
生存率
CIK cells, lung cancer, training quality, long-term efficacy, survival
