【摘要】：目的：卵巢癌是最常見的婦科惡性腫瘤，其發(fā)病率和死亡率居婦科惡性腫瘤之首，5年生存率僅為30%~40%。過繼細胞免疫治療越來越成為卵巢癌治療的重要武器，本研究通過觀察DC-CIK(dendriticcell-cytokineinducedkillercell)過繼細胞免疫治療對卵巢癌患者外周血淋巴細胞亞群及相關細胞因子的變化，評價DC-CIK細胞免疫治療對卵巢癌臨床療效。 方法： 選取2010年3月至2013年3月在吉林大學第二醫(yī)院腫瘤生物治療中心治療的22例卵巢癌患者，有明確的組織病理學檢查。取外周血分離單個核細胞(PBMC)，在體外誘導出DC和CIK細胞，分別行7個周期的DC-CIK細胞免疫治療，采用流式細胞術和酶聯(lián)免疫法檢測接受DC-CIK免疫治療不同周期后，，其外周血中淋巴細胞亞群（包括T淋巴細胞亞群（CD3+）、輔助性T細胞亞群（CD3+/CD4+）、殺傷性T細胞亞群（CD3+/CD8+）、NKT細胞亞群（CD3+/CD16+56+）等）的變化，及相關因子白介素-2、腫瘤壞死因子-α、干擾素-γ的表達水平。同時對變態(tài)反應、血液系統(tǒng)、心血管系統(tǒng)、肝臟、腎臟、胃腸道、全身癥狀等進行監(jiān)測，并進行安全性評價。利用SPSS13.0軟件包進行數(shù)據(jù)的分析和處理。 結(jié)果： 1.與治療前相比，4周期及7個周期DC-CIK細胞免疫治療組患者外周血T淋巴細胞亞群無顯著變化，即T淋巴細胞亞群（CD3+）、輔助性T細胞亞群（CD3+/CD4+）、殺傷性T細胞亞群（CD3+/CD8+）、NKT細胞亞群（CD3+/CD16+56+）等與治療前相比略有升高，但無顯著統(tǒng)計學差異（P0.05）。 2.4周期治療后，患者外周血白介素-2、腫瘤壞死因子-α、干擾素-γ水平較治療前提高，但差異并不顯著（P0.05），而當7個周期治療后，IL-2、TNF-α、IFN-γ水平較治療前明顯提高且具有統(tǒng)計學差異（P0.05）； 3.DC-CIK過繼性細胞免疫治療后，患者軀體功能、情緒方面較治療前改善明顯。 4.患者顯示出良好的耐受性，共計154周期的治療中，不良反應發(fā)生率較低，發(fā)熱，蕁麻疹，心慌，肝臟損害均為一過性。 結(jié)論： 1.DC-CIK細胞免疫治療可以明顯提高卵巢癌患者免疫狀態(tài)，提高機體抗腫瘤能力，機體免疫力提升，生活質(zhì)量顯著提高。 2.臨床應用無明顯不良反應,是卵巢癌患者重要的輔助治療手段。
[Abstract]:Objective: ovarian cancer is the most common gynecologic malignant tumor, its morbidity and mortality are the first among gynecological malignancies, and the 5-year survival rate is only 30%. Adoptive cellular immunotherapy has become an important weapon in ovarian cancer treatment. The changes of lymphocyte subsets and related cytokines in peripheral blood of patients with ovarian cancer were observed by DC-CIK (dendriticcell-cytokineinducedkillercell) adoptive cellular immunotherapy. To evaluate the clinical effect of DC-CIK cell immunotherapy on ovarian cancer. Methods: from March 2010 to March 2013, 22 patients with ovarian cancer treated in tumor biotherapy center of the second Hospital of Jilin University were examined by histopathological examination. DC and CIK cells were induced from peripheral blood mononuclear cells (PBMC),) in vitro and were treated with 7 cycles of DC-CIK cell immunotherapy respectively. Flow cytometry and enzyme-linked immunosorbent assay (Elisa) were used to detect the different cycles of DC-CIK immunotherapy. The changes of lymphocyte subsets (including T lymphocyte subsets (CD3), helper T cell subsets (CD3 / CD4), CD3 / CD8), NKT cell subsets (CD3 / CD16 56) in peripheral blood. The expression level of Interleukin-2, tumor necrosis factor-偽 and interferon-緯. Allergy, blood system, cardiovascular system, liver, kidney, gastrointestinal tract, systemic symptoms were monitored and safety was evaluated. SPSS13.0 software package is used to analyze and process the data. Results: 1. There were no significant changes in peripheral blood T lymphocyte subsets (CD3), helper T cell subsets (CD3 / CD4) in patients with 4 cycles and 7 cycles of DC-CIK cell immunotherapy compared with those before treatment. The lethal T cell subsets (CD3 / CD8), NKT cell subsets) (CD3 / CD16 56) were slightly higher than those before treatment, but there was no significant difference (P0.05). The levels of interleukin-2, tumor necrosis factor- 偽 and interferon- 緯 in peripheral blood were increased after 2. 4 cycles treatment, but the difference was not significant (P0.05). However, after 7 cycles of treatment, the levels of IL-2,TNF- 偽, TNF- 偽 and IFN- 緯 in peripheral blood of the patients were significantly higher than those before treatment (P0.05). The level of IFN- 緯 was significantly higher than that before treatment (P0.05). After adoptive cellular immunotherapy with 3.DC-CIK, the somatic function and mood of the patients improved significantly. 4. In 154 cycles of treatment, the incidence of adverse reactions was low, fever, urticaria, palpitation, and liver damage were transient. Conclusion: 1.DC-CIK cell immunotherapy can significantly improve the immune status of patients with ovarian cancer, improve the ability of anti-tumor, enhance the immunity of the body, and improve the quality of life. 2. There is no obvious adverse reaction in clinical application and it is an important adjuvant therapy for ovarian cancer patients.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R737.31

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