發(fā)布時(shí)間：2018-04-29 04:34

  本文選題：DC-CIK + 化療　； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：消化道腫瘤常見(jiàn)的惡性腫瘤之一是胃癌,以手術(shù)治療為主并結(jié)合傳統(tǒng)放射治療、化學(xué)治療療的綜合治療是當(dāng)前治療胃惡性腫瘤的主要方式。近些年來(lái),研究表明,樹突狀細(xì)胞(dendritic cells,DCs)和細(xì)胞因子誘導(dǎo)的殺傷細(xì)胞(cytokine induced killer cells,CIK)共培養(yǎng)后得到的DC-CIK細(xì)胞,不僅增殖能力得到很好的加強(qiáng)同時(shí)對(duì)腫瘤的殺傷作用也得到大大提升。已經(jīng)在血液系統(tǒng)腫瘤及一些實(shí)體瘤的治療中進(jìn)行了相關(guān)臨床研究。目的:分析樹突狀細(xì)胞(Dendritic cells,DCs)及細(xì)胞因子誘導(dǎo)的殺傷細(xì)胞(Cytokine induced killer,CIK)聯(lián)合化療在免疫狀態(tài)變化、近期臨床療效等方面對(duì)晚期胃癌患者的影響。同時(shí)記錄不良反應(yīng)。探索其成為臨床治療手段的可能性及安全性。方法:選取集青島大學(xué)第二臨床醫(yī)學(xué)醫(yī)學(xué)院(青島市中心醫(yī)院)的腫瘤數(shù)據(jù)庫(kù)里的2011年2月-2015年11月符合入組條件的50例晚期胃惡性腫瘤患者。其中將行DC-CIK細(xì)胞免疫治療聯(lián)合化學(xué)治療的25例晚期胃癌患者設(shè)為觀察組,并選擇同期臨床資料相近的僅行化學(xué)治療的25例晚期胃癌患者設(shè)為對(duì)照組。對(duì)照組25例,接受的治療方式僅為單純化療;觀察組25例,接受的治療方式為DC-CIK細(xì)胞免疫治療聯(lián)合化療治療。采用流式細(xì)胞術(shù)的方法分別對(duì)兩組患者治療前后T細(xì)胞亞群(CD3+、CD4+及CD8+)的比例進(jìn)行檢測(cè),采用ELISA法分別對(duì)兩組治療前后細(xì)胞因子IFN-γ、IL-12及IL-2的分泌水平進(jìn)行檢測(cè)。統(tǒng)一根據(jù)RECIST標(biāo)準(zhǔn)對(duì)兩組患者進(jìn)行臨床療效評(píng)價(jià)。所有數(shù)據(jù)采用SPSS17.0統(tǒng)計(jì)軟件錄入數(shù)據(jù)進(jìn)行分析,計(jì)量資料以“(?)±s”表示,采用t檢驗(yàn)進(jìn)行兩兩分析,認(rèn)為P0.05為差異有統(tǒng)計(jì)學(xué)意義。注意觀察兩組的不良反應(yīng)。結(jié)果:觀察組治療后外周血中T細(xì)胞亞群CD4+、CD3+T細(xì)胞比值、細(xì)胞因子IFN-γ、IL-12較治療前顯著升高(P0.05),差異有統(tǒng)計(jì)學(xué)意義。對(duì)照組治療后外周血中T細(xì)胞亞群CD8+T細(xì)胞比例較治療前升高(P0.05),差異有統(tǒng)計(jì)學(xué)意義。而細(xì)胞因子IFN-γ較治療前下降(P0.05),差異具有統(tǒng)計(jì)學(xué)意義。治療后觀察組和對(duì)照組的IL-2較治療前比較均無(wú)顯著性差異。觀察組近期臨床療效較對(duì)照組有一定的改善,但無(wú)顯著性差異(P0.05)。在行DC-CIK細(xì)胞回輸?shù)倪^(guò)程中及回輸結(jié)束后未見(jiàn)明顯不良反應(yīng)。結(jié)論:DC-CIK細(xì)胞免疫治療胃癌是有一定的近期臨床療效的,在改善患者的免疫功能方面具有一定的優(yōu)勢(shì),且安全性較好。它有望成為晚期胃惡性腫瘤一種有效的過(guò)繼免疫細(xì)胞治療方法。
[Abstract]:Gastric cancer is one of the most common malignant tumors in digestive tract tumor. In recent years, it has been shown that the co-cultured DC-CIK cells derived from dendritic cells (DC) and cytokine induced killer cells (DC-CIK) not only enhance the proliferation ability, but also enhance the cytotoxicity to tumor. Clinical studies have been conducted in the treatment of hematologic tumors and some solid tumors. Aim: to investigate the effects of dendritic cells (DC) and cytokine induced cytotoxic induced killer (Cytokine induced kill CIK) combined chemotherapy on patients with advanced gastric cancer. Adverse reactions were also recorded. To explore the possibility and safety of clinical treatment. Methods: 50 patients with advanced gastric malignancy were selected from the tumor database of the second College of Clinical Medicine of Qingdao University (Qingdao Central Hospital) from February 2011 to November 2015. Among them, 25 patients with advanced gastric cancer who received DC-CIK cell immunotherapy combined with chemotherapy were selected as observation group, and 25 patients with advanced gastric cancer who had similar clinical data were selected as control group. The control group (25 cases) received chemotherapy alone, while the observation group (25 cases) received DC-CIK cell immunotherapy combined with chemotherapy. The ratio of CD4 and CD8 of T cell subsets before and after treatment were detected by flow cytometry, and the levels of cytokine IFN- 緯 IL-12 and IL-2 were detected by ELISA method before and after treatment. Two groups of patients were evaluated according to RECIST criteria. All the data were analyzed by SPSS17.0 statistical software, and the measurement data were expressed as "+ s". T test was used to analyze the data. The result showed that the difference was statistically significant (P0.05). The adverse reactions in both groups were observed. Results: the ratio of T cell subsets CD4 and CD3 T cells and the cytokine IFN- 緯 -IL-12 in the observation group were significantly higher than those before treatment (P 0.05). The percentage of CD8 T cells in peripheral blood of the control group was significantly higher than that before treatment (P 0.05). The level of cytokine IFN- 緯 was significantly lower than that before treatment (P 0.05). There was no significant difference in IL-2 between observation group and control group after treatment. The clinical effect of the observation group was improved to some extent than that of the control group, but there was no significant difference between the two groups (P 0.05). No significant adverse reactions were observed during and after DC-CIK cell retransfusions. Conclusion: the cell immunotherapy of gastric cancer with WDC-CIK has a certain clinical effect, and has some advantages in improving the immune function of patients, and the safety is good. It is expected to be an effective adoptive immune cell therapy for advanced gastric malignancies.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R735.2

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