DC-CIK细胞免疫治疗晚期结直肠癌患者的远期疗效及其影响因素分析

目的:探讨树突状细胞(DC)联合细胞因子诱导的杀伤(CIK)细胞免疫治疗晚期结直肠癌(CRC)患者的远期疗效及其影响因素分析。方法:收集我院2011年1月至2014年1月收治的112例晚期结直肠癌患者,依据是否接受DC-CIK细胞免疫治疗将患者分为对照组(n=47)和观察组(n=65),分别给予一般化疗方案治疗和化疗联合DC-CIK细胞免疫方案治疗,比较两组患者治疗前后血清肿瘤标志物癌胚抗原(CEA)、淋巴细胞亚群,治疗有效率(RR)、疾病控制率(DCR)、无进展生存期(PFS)和安全性改变,并分析影响疗效的危险因素。结果:两组治疗后CEA水平均显著低于治疗前(P0.05),治疗后对照组CD3+T细胞、CD4+T细胞、CD8+T细胞和NK细胞均显著减少(P0.05),观察组治疗后CD3+T细胞和CD8+T细胞数量显著高于治疗前和同期对照组(均P0.05);对照组RR、DCR和PFS分别为44.68%、65.96%、6.5个月,观察组治疗对应指标分别为46.15%、86.15%、9个月,观察组DCR和FPS均显著高于对照组(P0.05);多因素分析发现TNM分期达到Ⅳ级(P=0.023)和年龄超过60岁(P=0.006)是影响疗效的独立危险因素。结论:DC-CIK细胞免疫治疗晚期结直肠癌安全可靠,能显著改善患者免疫功能控制肿瘤进展,延长生存期,提高生存质量,值得临床推广。

Long-termEffect of DC-CIK Cells Immunology Therapy in Patients with Advanced Colorectal Cancer

Objective:To investigate the long-term effect of dendritic cells (DC) and cytokine induced killer (CIK) cells immunology therapy of patients with advanced colorectal cancer and its influence factors.Methods:A total of 112 patients with advanced colorectal cancer (CRC), who were admitted to First People''s Hospital of Kashgar region from January 2011 to January 2014, were collected and divided into control group (n=47) and observation group (n=65) by whether or not accepted DC-CIK cells treatment.The control group was given general chemotherapy and the observation group, chemotherapy combined with DC-CIK cells. The carcinoembryonic antigen(CEA), lymphocyte subsets, response rate, disease control rate, progression free survival and security change of the patients in the two groups before and after treatment were compared; and the risk factors of influencing effect were analyzed.Results:The levels of CEA in the two groups after treatment were significantly lower than before treatment (P<0.05). The CD3+T cells, CD4+T cells, CD8+T cells and NK cells significantly decreased in the control group after treatment (P<0.05). The number of CD3+T cells and CD8+T cells in the observation group after treatment was significantly higher than before treatment and control group (p<0.05). The RR, DCR and PFS of the control group were 44.68%, 65.96% and 6.5 months, the corresponding indicators of the observation group were 46.15%, 86.15%and 9 months; the FPS and DCR of the observation group were significantly higher than those of the control group(P<0. 05). Multivariate analysis showed that grade IV of TNMstage (P=0.023) and aged over 60 (P=0.006) were independent risk factors of influencing effect.Conclusion:DC-CIK cells immunology therapy is reliable in the treatment of patients with advanced CRC. It can improve the immune function of patients with tumor progression, prolong the survival time and improve the quality of life, which is worthy of clinical application.