自体肿瘤抗原致敏的树突状细胞联合细胞因子诱导的杀伤细胞治疗晚期肾癌的疗效观察

发布时间：2018-11-28 16:53

【摘要】：目的探讨负载自体肿瘤抗原的树突状细胞(DC)联合细胞因子诱导的杀伤细胞(CIK细胞)在晚期肾癌治疗中的临床疗效,并监测患者的免疫状态及不良反应。方法回顾分析2011-01/2013-12期间在我科治疗的82例晚期肾癌患者,单采其外周血单个核细胞(PBMC),其中贴壁细胞经体外诱导产生DC,并负载自体肿瘤细胞裂解物(Ag)制备Ag-DC;T淋巴细胞经体外诱导产生CIK细胞,将Ag-DC与CIK细胞共培养制备Ag-DC-CIK瘤苗,检测DC表面分子的表达及IL-12的分泌,监测CIK细胞增殖情况,并将Ag-DC-CIK分次回输给其中41名患者,以41例单纯的CIK细胞治疗作为对照,治疗2疗程后,检测患者外周血细胞因子水平及T细胞亚群变化,结合影像学等检查综合评价疗效,同时观察不良反应。结果负载肿瘤细胞冻融抗原的DC,高表达CD11c、CD83、CD86、HLA-DR表面分子,IL-12的分泌显著增加。Ag-DC与CIK细胞共培养后,可明显刺激CIK细胞的增殖,同时CD3+CD8+细胞及CD3+CD56+细胞的含量明显增加,此外,Ag-DC-CIK瘤苗的临床疗效明显高于单纯CIK细胞治疗组,2组均未发生严重的不良反应。结论晚期肾癌PBMC来源的DC负载自身肿瘤细胞冻融抗原能提高晚期肾癌患者的免疫状态。
[Abstract]:Objective to investigate the clinical efficacy of dendritic cells (DC) loaded with autologous tumor antigen and cytokine induced killer cells (CIK cells) in the treatment of advanced renal cell carcinoma (RCC), and to monitor the immune status and adverse reactions of the patients. Methods A retrospective analysis of 82 patients with advanced renal cell carcinoma treated in our department during 2011-01 / 2013-12 was performed. (PBMC), of peripheral blood mononuclear cells (PBMC) was isolated from 82 patients whose adherent cells were induced to produce DC, in vitro. Preparation of Ag-DC; by loading autologous tumor cell lysate (Ag) T lymphocytes were induced to produce CIK cells in vitro. Ag-DC and CIK cells were co-cultured to prepare Ag-DC-CIK tumor vaccine. The expression of DC surface molecules and the secretion of IL-12 were detected, and the proliferation of CIK cells was monitored. Ag-DC-CIK was given back to 41 of them, and 41 patients were treated with CIK cells as control. After 2 courses of treatment, the levels of cytokines and T cell subsets in peripheral blood were measured. Combined with imaging examination and other comprehensive evaluation of the efficacy of adverse reactions at the same time. Results DC, loaded with freeze-thaw antigen of tumor cells expressed highly CD11c,CD83,CD86,HLA-DR surface molecules, and the secretion of IL-12 increased significantly. The proliferation of CIK cells was stimulated by co-culture of Ag-DC and CIK cells. At the same time, the content of CD3 CD8 cells and CD3 CD56 cells increased significantly. In addition, the clinical efficacy of Ag-DC-CIK vaccine was significantly higher than that of CIK cells alone, and no serious adverse reactions occurred in both groups. Conclusion PBMC derived DC loaded with freeze-thawed antigens can improve the immune status of patients with advanced renal cell carcinoma.
【作者单位】：苏州大学附属第二医院肿瘤科;
【基金】：苏州市科技计划项目(SYS201129)
【分类号】：R737.11

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