CIK细胞联合化疗治疗非小细胞肺癌的疗效及对外周血T淋巴细胞和Treg细胞水平的影响
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摘要
目的探讨细胞因子诱导的杀伤(CIK)细胞联合化疗治疗非小细胞肺癌(NSCLC)的疗效及对外周血T淋巴细胞及调节性T细胞(Treg)水平的影响。方法采用随机数字表法将90例NSCLC患者随机分为观察组和对照组,每组45例。对照组患者采用多西紫杉醇和顺铂化疗,观察组患者在对照组的基础上给予CIK细胞免疫治疗。比较两组患者的临床疗效及治疗前后两组患者的外周血T淋巴细胞和Treg细胞水平。结果观察组患者的总有效率为37.8%,高于对照组的17.8%,差异有统计学意义(P﹤0.05)。治疗后,两组患者的CD_3~+、CD_3~+CD_4~+水平及CD_4~+/CD_8~+均较本组治疗前升高,且观察组患者的CD_3~+、CD_3~+CD_4~+水平及CD_4~+/CD_8~+均高于对照组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者的CD_4~+CD_(25)~+水平及CD_4~+CD_(25)~+/CD_4~+均较治疗前降低,且观察组患者的CD_4~+CD_(25)~+/CD_4~+低于对照组,差异均有统计学意义(PP﹤0.05)。结论 CIK细胞联合化疗能够提高NSCLC的治疗效果,改善患者的免疫功能,为NSCLC的治疗提供新的方案。
Objective To explore the clinical effects of cytokine-induced killer(CIK) cells combined with chemotherapy in the treatment of non-small cell lung cancer(NSCLC), and the effects on T lymphocytes and regulatory T cell(Treg) in peripheral blood. Method A total of 90 patients diagnosed with NSCLC were included in the study and randomly assigned into two groups as study group and control group according to a random number table, with 45 cases in each, respectively. The control group was given chemotherapy of docetaxel plus cisplatin, while patients in study group were administered with CIK cell immunotherapy in addition to the regimen given in control group. The clinical efficacy,levels of peripheral blood T lymphocytes and Treg before and after treatment were compared between the two groups.Result The overall response rate(ORR) in study group was 37.8%, which was higher than that of the control group at17.8%, and the difference was statistically significant(P<0.05). After treatment, the levels of CD_3~+, CD_3~+CD_4~+ and CD_4~+/CD_8~+ were increased in both groups, and those in study group were higher compared to control group, indicating statistically significance(P<0.05). After treatment, the levels of CD_4~+CD_(25)~+ and CD_4~+CD_(25)~+/CD_4~+ were decreased in both groups,and the CD_4~+CD_(25)~+/CD_4~+ was lower in study group than that in control group(P<0.05). Conclusion CIK cells combined with chemotherapy could further improve the therapeutic effect of conventional chemotherapy in the treatment of NSCLC patients, improving patient's immune function, and it may be a new regimen for treatment of NSCLC.
Objective To explore the clinical effects of cytokine-induced killer(CIK) cells combined with chemotherapy in the treatment of non-small cell lung cancer(NSCLC), and the effects on T lymphocytes and regulatory T cell(Treg) in peripheral blood. Method A total of 90 patients diagnosed with NSCLC were included in the study and randomly assigned into two groups as study group and control group according to a random number table, with 45 cases in each, respectively. The control group was given chemotherapy of docetaxel plus cisplatin, while patients in study group were administered with CIK cell immunotherapy in addition to the regimen given in control group. The clinical efficacy,levels of peripheral blood T lymphocytes and Treg before and after treatment were compared between the two groups.Result The overall response rate(ORR) in study group was 37.8%, which was higher than that of the control group at17.8%, and the difference was statistically significant(P<0.05). After treatment, the levels of CD_3~+, CD_3~+CD_4~+ and CD_4~+/CD_8~+ were increased in both groups, and those in study group were higher compared to control group, indicating statistically significance(P<0.05). After treatment, the levels of CD_4~+CD_(25)~+ and CD_4~+CD_(25)~+/CD_4~+ were decreased in both groups,and the CD_4~+CD_(25)~+/CD_4~+ was lower in study group than that in control group(P<0.05). Conclusion CIK cells combined with chemotherapy could further improve the therapeutic effect of conventional chemotherapy in the treatment of NSCLC patients, improving patient's immune function, and it may be a new regimen for treatment of NSCLC.
引文
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[12]程春来.化疗联合DC-CIK方案治疗非小细胞肺癌的疗效分析[J].实用癌症杂志, 2015, 30(5):759-761.
[13]廉政君,黄建国.晚期非小细胞肺癌预后相关因素分析[J].现代肿瘤医学, 2014, 22(1):95-97.
[14]石光英,马晓媛,谢敬东.不同阶段原发性胆汁性肝硬化患者经不同剂量熊去氧胆酸治疗后外周血T淋巴细胞亚群及细胞因子的变化[J].临床肝胆病杂志, 2015, 31(9):1447-1451.
[15] Dammeijer F, Lievense LA, Veerman GD, et al. Efficacy of tumor vaccines and cellular immunotherapies in nonsmall-cell lung cancer:a systematic review and meta-analysis[J]. J Clin Oncol, 2016, 34(26):3204-3212.
[16] Zhang L, Yang X, Sun Z, et al. Dendritic cell vaccine and cytokine-induced killer cell therapy for the treatment of advanced non-small cell lung cancer[J]. Oncol Lett, 2016,11(4):2605-2610.
[17]王嘉,曲秀娟,张敬东,等.肠癌患者外周血T淋巴细胞亚群数量及临床意义[J].中国医科大学学报, 2014, 43(4):289-292.
[18] Pircher A, Gamerith G, Amann A, et al. Neoadjuvant chemo-immunotherapy modifies CD4(+)CD25(+)regulatory T cells(Treg)in non-small cell lung cancer(NSCLC)patients[J]. Lung Cancer, 2014, 85(1):81-87.
[19] Wang S, Wang Z. Efficacy and safety of dendritic cells cocultured with cytokine-induced killer cells immunotherapy for non-small-cell lung cancer[J]. Int Immunopharmacol, 2015, 28(1):22-28.
[2] Velcheti V, Schalper KA, Carvajal DE, et al. Programmed death ligand-1 expression in non-small cell lung cancer[J].Lab Invest, 2014, 94(1):107-116.
[3]赵华,贾咏梅. DC-CIK免疫治疗联合常规化疗对非小细胞肺癌患者血清学及外周血免疫功能指标的影响[J].海南医学院学报, 2015, 21(7):967-970.
[4]林称意.埃罗替尼靶向治疗对非小细胞肺癌患者免疫功能及临床疗效的影响[J].海南医学院学报, 2015, 21(4):547-549.
[5] Reck M, Kaiser R, Mellemgaard A, et al. Docetaxel plus nintedanib versus docetaxel plus placebo in patients with previously treated non-small-cell lung cancer(LUME-Lung1):a phase 3, doubleblind, randomised controlled trial[J].Lancet Oncol, 2014, 15(2):143-155.
[6]何丽杰. DC-CIK生物治疗对肺癌患者Pro-GRP和T淋巴细胞水平的影响[D].天津:天津医科大学, 2017.
[7]鲍云华,李俭杰.介绍新的实体瘤治疗反应评价标准(RECIST)[J].中国肺癌杂志, 2005, 8(1):77-78.
[8] Shaw AT, Kim DW, Mehra R, et al. Ceritinib in ALK-rearranged non-small-cell lung cancer[J]. N Engl J Med, 2014,370(13):1189-1197.
[9] Chen Z, Fillmore CM, Hammerman PS, et al. Non-smallcell lung cancers:a heterogeneous set of diseases[J]. Nat Rev Cancer, 2014, 14(8):535-546.
[10]郭卫东.探析DC-CIK联合化疗治疗晚期非小细胞肺癌的临床效果[J].中华肿瘤防治杂志, 2016, 23(5):335-336.
[11]蔡俊霞,谭洁,王彬,等. DC-CIK治疗43例晚期非小细胞肺癌的近期疗效观察[J].现代肿瘤医学, 2014, 22(1):67-70.
[12]程春来.化疗联合DC-CIK方案治疗非小细胞肺癌的疗效分析[J].实用癌症杂志, 2015, 30(5):759-761.
[13]廉政君,黄建国.晚期非小细胞肺癌预后相关因素分析[J].现代肿瘤医学, 2014, 22(1):95-97.
[14]石光英,马晓媛,谢敬东.不同阶段原发性胆汁性肝硬化患者经不同剂量熊去氧胆酸治疗后外周血T淋巴细胞亚群及细胞因子的变化[J].临床肝胆病杂志, 2015, 31(9):1447-1451.
[15] Dammeijer F, Lievense LA, Veerman GD, et al. Efficacy of tumor vaccines and cellular immunotherapies in nonsmall-cell lung cancer:a systematic review and meta-analysis[J]. J Clin Oncol, 2016, 34(26):3204-3212.
[16] Zhang L, Yang X, Sun Z, et al. Dendritic cell vaccine and cytokine-induced killer cell therapy for the treatment of advanced non-small cell lung cancer[J]. Oncol Lett, 2016,11(4):2605-2610.
[17]王嘉,曲秀娟,张敬东,等.肠癌患者外周血T淋巴细胞亚群数量及临床意义[J].中国医科大学学报, 2014, 43(4):289-292.
[18] Pircher A, Gamerith G, Amann A, et al. Neoadjuvant chemo-immunotherapy modifies CD4(+)CD25(+)regulatory T cells(Treg)in non-small cell lung cancer(NSCLC)patients[J]. Lung Cancer, 2014, 85(1):81-87.
[19] Wang S, Wang Z. Efficacy and safety of dendritic cells cocultured with cytokine-induced killer cells immunotherapy for non-small-cell lung cancer[J]. Int Immunopharmacol, 2015, 28(1):22-28.