摘要
目的观察肝动脉栓塞化疗(transcatheter arterial chemoembolization,TACE)联合过继T细胞免疫疗法对中晚期肝癌的近期疗效,以及对外周血T淋巴细胞亚群及Treg细胞计数的影响。方法回顾分析114例中晚期原发性肝癌患者实行TACE联合过继T细胞疗法(研究组)或单一TACE治疗(对照组)的资料。研究组(56例)全部经过TACE术且术后第2天接受过继T细胞回输;对照组(58例)仅接受TACE治疗。治疗为每4周一次,最多不超过3次,观察疗程为2年。观察无进展生存期(progress free survival,PFS)和总生存期(overall survival,OS),以及治疗前后相同时间点测定T淋巴细胞亚群、Treg细胞以及AFP计数变化。结果研究组与对照组的近期疗效及AFP下降率比较,无统计学差异。研究组治疗后6个月、1年、2年的无进展生存率分别是71.4%、23.2%、5.4%;对照组分别是65.5%、31.0%、3.4%。两组中位疾病进展时间分别是8个月(95%CI,8-11个月)和5个月(95%CI,6-9个月)。研究组治疗后6个月、1年、2年的总生存率分别是89.2%、71.4%、60.7%,对照组分别是70.6%、41.4%、17.2%。两组中位生存期分别是18个月(95%CI,16-20个月)和11个月(95%CI,9-13个月)。研究组CD4+细胞比率由治疗前(51.27±4.85)%升至(54.51±5.03)%,CD8+以及Treg细胞计数分别由(40.87±3.26)%和(6.36±0.98)%下降至(37.24±3.56)%和(3.89±0.31)%,CD4+/CD8+比值增大(P<0.05);对照组治疗后与治疗前相比无统计学差异。结论中晚期肝癌患者TACE术后联合过继T细胞疗法可提高无进展生存期和总生存期,并能提高免疫能力,增强机体的抗肿瘤效应,有可能降低中晚期肝癌患者的复发率和转移率。
[ Abstract] Objective To study the different affects of TACE alone and TACE combined with adoptive T lymphocytes on the peripheral T lymphocyte subsets and Treg cells for advanced hepatocellular carcinoma（HCC）. Methods 114 patients with advanced stage HCC were recruited, 56 patients were treated with TACE followed by adoptive T lymphocytes treatment, and 58 patients were trea- ted with TACE only as a control group. Each patient was treated once a month, successive 3 times were a course of treatment. The du- ration of the observation was 2 years. The progress free survival（PFS） and overall survival（OS） , serum levels of AFP, T lymphocyte sunsets and Treg cells in peripheral blood of advanced HCC patients were found out before and after the treatments. Results The short-term responses in the 2 groups were similar. There was also no significant difference in the reduction rates of AFP between these two groups. The 6 months, 1 year, and 2 years PFS rates were 71.4% , 23.2% , 5.4% in combination group, and 65.5% , 31.0% , 3.4% in control group. The median TYP （time to progression）was 8 months （95% confidence interval CI,8-11 months） for combina- tion group and 5 months （95% confidence interval CI,6- 9 months） for control group. The proportion of 6 months, 1 year, and 2 years OS were 89.2% , 71.4% and 60.7% in combination group, while in control group they were 70.6%, 41.4% , 17.2% （P 〈 0.05 ） , respectively. The median survival time was 18 months（95% CI,16-20 months）in combination group and 11 months（95% CI,9-13 months） in control group. In the study group, the percentage of CIM ＋ increased from（ 51.27 ± 4.85 ） % to （54. 51± 5.03 ） % （ P 〈0.05 ） , CD8 ~ and Treg cells decreased from （ 40. 87± 3.26 ） % , （6.36±0.98）% to （37.24±3.56）%,（3.89 ±0.31）% （P〈 0.05 ）, respectively. The rates of CD4＋/CD8＋ increased greatly （ P 〈0.05 ）. There was no significant difference compared between be- fore and after treatment in the control group.
出处
《武警医学》
CAS
2014年第4期331-335,共5页
Medical Journal of the Chinese People's Armed Police Force
基金
秦皇岛市2012年科学技术研究与发展计划项目(编号:2012023A217)
关键词
原发性肝癌
肝动脉化疗栓塞
过继T细胞疗法
无进展生存期
总生存期
T淋巴细胞亚群
TREG细胞
hepatocellular carcinoma
transcatheter arterial ehemoembolization
adoptive T lymphocytes
progression free sur- vival
overall survival
T lymphocyte subset
Treg cells
