本文選題：結(jié)直腸癌　切入點(diǎn)：樹突狀細(xì)胞誘導(dǎo)的殺傷細(xì)胞　出處：《中國(guó)臨床藥理學(xué)雜志》2017年01期 　論文類型：期刊論文

【摘要】：目的觀察樹突狀細(xì)胞誘導(dǎo)的殺傷細(xì)胞(DC-CIK)聯(lián)合化療對(duì)老年結(jié)直腸癌患者外周血T細(xì)胞亞群及細(xì)胞因子的影響,探討DC-CIK聯(lián)合化療對(duì)老年結(jié)直腸癌的臨床療效及作用機(jī)制。方法 68例老年結(jié)直腸癌患者隨機(jī)分為對(duì)照組和試驗(yàn)組,每組34例。對(duì)照組第1天靜脈滴注奧沙利鉑100 mg·m~(-2),靜脈滴注2 h,第2~6天靜脈滴注亞葉酸鈣200 mg·m~(-2),靜脈滴注5-氟尿嘧啶500 mg·m~(-2)。試驗(yàn)組于化療前2 d單采外周血單個(gè)核細(xì)胞,培養(yǎng)樹突狀細(xì)胞誘導(dǎo)的殺傷細(xì)胞,于第14~16天連續(xù)回輸3 d,每天1次,每次1.5 h內(nèi)回輸完畢。2組均21 d為1個(gè)療程,根據(jù)患者情況術(shù)后輔助化療4~6個(gè)療程,試驗(yàn)組接受2個(gè)療程樹突狀細(xì)胞誘導(dǎo)的殺傷細(xì)胞治療。比較2組患者治療前后外周血T細(xì)胞亞群及血清血管內(nèi)皮生長(zhǎng)因子(VEGF)、白細(xì)胞介素-6(IL-6)、腫瘤壞死因子-α(TNF-α)及干擾素-γ(IFN-γ)水平,比較2組患者的臨床療效及治療過程中出現(xiàn)的藥物不良反應(yīng)情況。結(jié)果治療后,試驗(yàn)組CD3~+、CD4~+、CD4~+/CD8~+,CD4~+CD25~+分別為(59.61±5.95)%,(38.97±6.58)%,(1.28±0.07),(4.31±1.07)%;對(duì)照組CD3~+為(53.64±5.25)%,CD4~+為(34.64±6.36)%,CD4~+/CD8~+為1.10±0.06,CD4~+CD25~+為(8.17±1.19)%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后,對(duì)照組和試驗(yàn)組的VEGF分別為(216.51±26.82),(136.73±27.56)ng·L~(-1),TNF-α分別為(3.12±0.81),(4.57±0.79)μg·L~(-1),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。試驗(yàn)組治療前IFN-γ為(23.41±2.29)ng·L~(-1),治療后為(32.63±2.58)ng·L~(-1)(P0.05)。對(duì)照組的客觀緩解率為41.18%(14/34例),疾病控制率為73.53%(25/34例);試驗(yàn)組客觀緩解率為55.88%(19/34例),疾病控制率為94.12%(32/34例),2組疾病控制率差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2組患者的胃腸道反應(yīng)和周圍神經(jīng)毒性的發(fā)生率差異無統(tǒng)計(jì)學(xué)意義(P0.05),試驗(yàn)組的骨髓抑制發(fā)生率低于對(duì)照組(P0.05)。結(jié)論 DC-CIK聯(lián)合化療可改善老年結(jié)直腸癌患者的免疫功能,提高患者的臨床療效,且安全性較高。
[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- 偽 (TNF- 偽) and interferon- 緯 (IFN- 緯) were compared between the two groups before and after treatment. Results after treatment, the CD3- ~ + -CD4- / -CD8- / -CD8- / -CD25 ~ were 59.61 鹵5.955.95 鹵1.28 鹵0.074.31 鹵1.071.28 鹵0.074.31 鹵1.07in the control group and 34.64 鹵6.36m CD4- / -CD8- / -0.10 鹵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 鹵0.06CD4- / -CD4- / CD8- was 8.17 鹵1.190.The difference was significant after treatment. The VEGF of control group and trial group were 216.51 鹵26.82 ng 路L ~ (-1) and 32.63 鹵2.58 ng 路L ~ (-1) ng 路L ~ (-1) respectively. The objective remission rate of control group was 41.18 鹵0.81 鹵0.79 渭 g 路L ~ (-1) 渭 g 路L ~ (-1), the difference was statistically significant (P0.055.The IFN- 緯 was 23.41 鹵2.29 ng 路L ~ (-1)) before treatment and 32.63 鹵2.58 ng 路L ~ (-1) P 0.05 after treatment. The objective remission rate of control group was 41.18 鹵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.
【作者單位】： 鄭州大學(xué)附屬腫瘤醫(yī)院內(nèi)科綜合病區(qū);鄭州大學(xué)附屬腫瘤醫(yī)院生物免疫治療科;鄭州大學(xué)附屬腫瘤醫(yī)院消化內(nèi)科;
【分類號(hào)】：R735.3

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