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目的:对比幽门螺杆菌(Helicobacter pylori,Hp)感染阴性和阳性的晚期胃癌患者接受自体树突状细胞联合细胞因子诱导的杀伤(dendritic cells-cytokine induced killer,DC-CIK)细胞维持治疗的疗效差异。方法:收集2010年6月至2012年6月中国人民解放军第174医院肿瘤中心收治的72例晚期胃癌患者,年龄29~90岁,中位年龄56岁,通过胃镜检查进行胃癌确诊并检测Hp,分为Hp阳性组(45例)及Hp阴性组(27例),在接受手术或/和放化疗后,接受2疗程自体DC-CIK维持治疗,比较两组外周血培养的DC分化成熟情况及临床疗效差异。结果:两组DC成熟过程形态变化无差异;Hp阳性组DC表面分子CD83、CD86表达显著高于Hp阴性组(P<0.01),两组间HIA-DR表达无明显差异(P>0.05)。Hp阳性组治疗后生活质量评分(KPS)、外周血T细胞亚群(CD3+、CD4+、CD8+)比例较治疗前显著提高(P<0.05),肿瘤标志物(CEA、CA199、CA724)表达较治疗前下降(P<0.05)。Hp阴性组治疗后肿瘤标志物表达、外周血T淋巴细胞比例较治疗前显著降低(P<0.05),KPS评分较治疗前无明显变化(P>0.05)。Hp阳性组治疗后KPS评分、CEA和CA199表达以及CD3+和CD4+T细胞数量等的改善均优于Hp阴性组(P<0.05),但瘤体稳定率、CA724、CD8+T细胞比例无显著差异(P>0.05)。共随访2年,阳性组患者中位生存期为12.64个月,长于阴性组的11.42个月(P<0.05)。结论:携带Hp抗原信息的DC疫苗协同CIK治疗能够提高Hp感染的晚期胃癌患者的自身免疫功能,达到稳定瘤体、改善生活质量、延长生存期的目的。
Objective: To compare the curative effects of autologous dendritic cells with dendritic cells-cytokine induced killer (DC-CIK) cell maintenance therapy in patients with negative and positive gastric cancer infected by Helicobacter pylori (Hp) . Methods: Seventy-two patients with advanced gastric cancer who were admitted to Cancer Center of the 174th Hospital of PLA from June 2010 to June 2012 were aged 29 to 90 years old with a median age of 56 years. Gastroscopy was used to diagnose gastric cancer and detect Hp, The patients were divided into Hp positive group (n = 45) and Hp negative group (n = 27). After receiving operation and / or radiotherapy and chemotherapy, they received 2 cycles of autologous DC-CIK maintenance treatment. Differences in clinical efficacy. Results: There was no difference in morphology between the two groups during DC maturation. The expression of CD83 and CD86 on DCs in Hp positive group was significantly higher than that in Hp negative group (P <0.01). There was no significant difference in HIA-DR expression between the two groups (P> 0.05). (P <0.05). The expression of tumor markers (CEA, CA199, CA724) in Hp positive group was significantly higher than that before treatment (KPS) and the percentage of T cell subsets (CD3 +, CD4 +, CD8 + Before falling (P <0.05). The expression of tumor markers in Hp-negative group was significantly lower than that before treatment (P <0.05). The KPS score had no significant change before treatment (P> 0.05). The improvement of KPS score, expression of CEA and CA199 and the number of CD3 + and CD4 + T cells in Hp positive group were better than those in Hp negative group (P <0.05), but there was no significant difference in the stability of the tumor, the ratio of CA724 and CD8 + T cells Difference (P> 0.05). A total of 2 years of follow-up showed that the median survival time was 12.64 months in the positive group, which was longer than the 11.42 months in the negative group (P <0.05). CONCLUSION: DC vaccines carrying Hp antigens in combination with CIK can improve the autoimmune function of Hp-infected patients with advanced gastric cancer and achieve the purpose of stabilizing the tumor, improving the quality of life and prolonging the survival period.