摘要
目的观察树突状细胞诱导的杀伤细胞(DC-CIK)联合化疗对老年结直肠癌患者外周血T细胞亚群及细胞因子的影响,探讨DC-CIK联合化疗对老年结直肠癌的临床疗效及作用机制。方法 68例老年结直肠癌患者随机分为对照组和试验组,每组34例。对照组第1天静脉滴注奥沙利铂100 mg·m^(-2),静脉滴注2 h,第2~6天静脉滴注亚叶酸钙200 mg·m^(-2),静脉滴注5-氟尿嘧啶500 mg·m^(-2)。试验组于化疗前2 d单采外周血单个核细胞,培养树突状细胞诱导的杀伤细胞,于第14~16天连续回输3 d,每天1次,每次1.5 h内回输完毕。2组均21 d为1个疗程,根据患者情况术后辅助化疗4~6个疗程,试验组接受2个疗程树突状细胞诱导的杀伤细胞治疗。比较2组患者治疗前后外周血T细胞亚群及血清血管内皮生长因子(VEGF)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及干扰素-γ(IFN-γ)水平,比较2组患者的临床疗效及治疗过程中出现的药物不良反应情况。结果治疗后,试验组CD3^+、CD4^+、CD4^+/CD8^+,CD4^+CD25^+分别为(59.61±5.95)%,(38.97±6.58)%,(1.28±0.07),(4.31±1.07)%;对照组CD3^+为(53.64±5.25)%,CD4^+为(34.64±6.36)%,CD4^+/CD8^+为1.10±0.06,CD4^+CD25^+为(8.17±1.19)%,差异有统计学意义(P<0.05)。治疗后,对照组和试验组的VEGF分别为(216.51±26.82),(136.73±27.56)ng·L^(-1),TNF-α分别为(3.12±0.81),(4.57±0.79)μg·L^(-1),差异有统计学意义(P<0.05)。试验组治疗前IFN-γ为(23.41±2.29)ng·L^(-1),治疗后为(32.63±2.58)ng·L^(-1)(P<0.05)。对照组的客观缓解率为41.18%(14/34例),疾病控制率为73.53%(25/34例);试验组客观缓解率为55.88%(19/34例),疾病控制率为94.12%(32/34例),2组疾病控制率差异有统计学意义(P<0.05)。2组患者的胃肠道反应和周围神经毒性的发生率差异无统计学意义(P>0.05),试验组的骨髓抑制发生率低于对照组(P<0.05)。结论 DC-CIK联合化疗可改善老年结直肠癌患者的免疫功能,提高患者的临�
Objective To observe the clinical effect of dendritic cells induced killer cells（ DC-CIK） combined with chemotherapy on T cell subsets and cytokines in peripheral blood of elderly patients with colorectal cancer. Methods Sixty-eight elderly patients with colorectal cancer were randomly divided into control group and treatment group,34 patients in each group. Patients in control group were given oxaliplatin 100 mg · m（-2）,intravenous drip for 2 h on first day ＋ intravenous dripleucovorin 200 mg·m（-2）＋ 5-fluorouracil 500 mg·m（-2）on 2-6 d. Treatment group was treated with DC-CIK cell therapy on the basis of control group on 14-16 d,qd. The course was 21 d,and treated for 4-6 courses. The DC-CIK cell therapy was lasted for 2 courses. The peripheral blood T lymphocyte subsets and serum vascular endothelial growth factor（ VEGF）,interleukin-6（ IL-6）,tumor necrosis factor-α（ TNF-α） and interferon-γ（ IFN-γ） levels of the two groups before and after treatment were compared. The clinical efficacy and adverse drug reactions in two groups were compared. Results The proportion of CD3＋,CD4＋,CD4＋/ CD8＋,CD4＋CD25＋in treatment group were（ 59. 61 ± 5. 95） %,（ 38. 97 ± 6. 58） %,（ 1. 28 ± 0. 07）,（ 4. 31 ± 1. 07） %,had significant difference with those in control group, which were（ 53. 64 ± 5. 25） %,（ 34. 64 ± 6. 36） %,1. 10 ± 0. 06,（ 8. 17 ± 1. 19） %（ P〈0. 05）. After treatment,the VEGF,TNF-α in treatment group were（ 136. 73 ± 27. 56）ng·L（-1）,（ 4. 57 ± 0. 79） μg · L（-1）, had significant difference with those in control group, which were（ 216. 51 ± 26. 82） ng·L（-1）,（ 3. 12 ± 0. 81） μg·L（-1）（ P 0. 05）. The IFN-γ in treatment group before and after treatment were（ 23. 41 ± 2. 29）,（ 32. 63 ± 2. 58） ng · L（-1）（ P〈0. 05）. The objective response rate and disease control rate in control group were 41. 18%（ 14 /34） and 73. 53%（ 25 /34）,and were 55. 88%（ 19 /34） and 94.
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2017年第1期10-13,共4页
The Chinese Journal of Clinical Pharmacology
