树突状细胞诱导的杀伤细胞联合化疗治疗老年结直肠癌的临床研究

发布时间：2018-03-04 15:22

本文选题：结直肠癌　切入点：树突状细胞诱导的杀伤细胞　出处：《中国临床药理学杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的观察树突状细胞诱导的杀伤细胞(DC-CIK)联合化疗对老年结直肠癌患者外周血T细胞亚群及细胞因子的影响,探讨DC-CIK联合化疗对老年结直肠癌的临床疗效及作用机制。方法 68例老年结直肠癌患者随机分为对照组和试验组,每组34例。对照组第1天静脉滴注奥沙利铂100 mg·m~(-2),静脉滴注2 h,第2~6天静脉滴注亚叶酸钙200 mg·m~(-2),静脉滴注5-氟尿嘧啶500 mg·m~(-2)。试验组于化疗前2 d单采外周血单个核细胞,培养树突状细胞诱导的杀伤细胞,于第14~16天连续回输3 d,每天1次,每次1.5 h内回输完毕。2组均21 d为1个疗程,根据患者情况术后辅助化疗4~6个疗程,试验组接受2个疗程树突状细胞诱导的杀伤细胞治疗。比较2组患者治疗前后外周血T细胞亚群及血清血管内皮生长因子(VEGF)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及干扰素-γ(IFN-γ)水平,比较2组患者的临床疗效及治疗过程中出现的药物不良反应情况。结果治疗后,试验组CD3~+、CD4~+、CD4~+/CD8~+,CD4~+CD25~+分别为(59.61±5.95)%,(38.97±6.58)%,(1.28±0.07),(4.31±1.07)%;对照组CD3~+为(53.64±5.25)%,CD4~+为(34.64±6.36)%,CD4~+/CD8~+为1.10±0.06,CD4~+CD25~+为(8.17±1.19)%,差异有统计学意义(P0.05)。治疗后,对照组和试验组的VEGF分别为(216.51±26.82),(136.73±27.56)ng·L~(-1),TNF-α分别为(3.12±0.81),(4.57±0.79)μg·L~(-1),差异有统计学意义(P0.05)。试验组治疗前IFN-γ为(23.41±2.29)ng·L~(-1),治疗后为(32.63±2.58)ng·L~(-1)(P0.05)。对照组的客观缓解率为41.18%(14/34例),疾病控制率为73.53%(25/34例);试验组客观缓解率为55.88%(19/34例),疾病控制率为94.12%(32/34例),2组疾病控制率差异有统计学意义(P0.05)。2组患者的胃肠道反应和周围神经毒性的发生率差异无统计学意义(P0.05),试验组的骨髓抑制发生率低于对照组(P0.05)。结论 DC-CIK联合化疗可改善老年结直肠癌患者的免疫功能,提高患者的临床疗效,且安全性较高。
[Abstract]:Objective to observe the effect of dendritic cell-induced killer cell DC-CIK combined with chemotherapy on T cell subsets and cytokines in peripheral blood of elderly patients with colorectal cancer. To investigate the clinical efficacy and mechanism of DC-CIK combined chemotherapy in the treatment of elderly colorectal cancer. Methods Sixty-eight elderly patients with colorectal cancer were randomly divided into two groups: control group and experimental group. 34 patients in each group were treated with oxaliplatin 100 mg 路m-1 ~ (-2) intravenously on day 1, 2 h, 2 h, 200 mg 路m ~ (2 +), 5 ~ (fluorouracil) 500 mg 路m ~ (2) 路m ~ (-2), respectively. Peripheral blood mononuclear cells (PBMC) were collected only 2 days before chemotherapy in the experimental group. The cultured dendritic cell-induced killer cells were continuously infused for 3 days, once a day, within 1.5 hours each time for 21 days as a course of treatment. According to the patients' condition, the adjuvant chemotherapy was 4 ~ 6 courses after operation. The peripheral blood T cell subsets and serum levels of vascular endothelial growth factor (VEGF), interleukin-6 (IL-6), tumor necrosis factor- 伪 (TNF- 伪) and interferon- 纬 (IFN- 纬) were compared between the two groups before and after treatment. Results after treatment, the CD3- ~ + -CD4- / -CD8- / -CD8- / -CD25 ~ were 59.61 卤5.955.95 卤1.28 卤0.074.31 卤1.071.28 卤0.074.31 卤1.07in the control group and 34.64 卤6.36m CD4- / -CD8- / -0.10 卤0.06CD4- / -CD8- respectively in the control group, respectively. The difference was significant after treatment, and the difference was significant (P < 0.05). After treatment, the CD4- / -CD8- / CD8- was 1.10 卤0.06CD4- / -CD4- / CD8- was 8.17 卤1.190.The difference was significant after treatment. The VEGF of control group and trial group were 216.51 卤26.82 ng 路L ~ (-1) and 32.63 卤2.58 ng 路L ~ (-1) ng 路L ~ (-1) respectively. The objective remission rate of control group was 41.18 卤0.81 卤0.79 渭 g 路L ~ (-1) 渭 g 路L ~ (-1), the difference was statistically significant (P0.055.The IFN- 纬 was 23.41 卤2.29 ng 路L ~ (-1)) before treatment and 32.63 卤2.58 ng 路L ~ (-1) P 0.05 after treatment. The objective remission rate of control group was 41.18 卤1434 cases, and the disease control rate was 73.25 34 cases. There was no significant difference in the incidence of gastrointestinal reaction and peripheral neurotoxicity between the two groups (P 0.05, P 0.05). The incidence of bone marrow suppression in the trial group was lower than that in the control group (P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05%). Conclusion DC-CIK combined with chemotherapy can improve the immune function of elderly patients with colorectal cancer. Improve the clinical efficacy of patients, and high safety.
【作者单位】：郑州大学附属肿瘤医院内科综合病区;郑州大学附属肿瘤医院生物免疫治疗科;郑州大学附属肿瘤医院消化内科;
【分类号】：R735.3

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