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目的:评估CD3+CD56+NK T细胞治疗73例中晚期胃癌的疗效及不良反应。方法:血细胞分离机采集患者外周血单个核细胞,加入细胞因子rhINF-γ、rhIL-2、rhIL-1及CD3McAb培养,10 d后定向诱导成CD3+CD56+NKT细胞,分次回输给患者,每疗程回输细胞总数为(5~10)×109个。治疗4 w后,用流式细胞仪检测患者外周血T细胞亚群状态及细胞因子水平,以评价细胞免疫功能,结合临床指标综合评价疗效,同时观察不良反应。结果:在73例接受治疗的患者中,部分缓解(PR)+微效(MR)为37例(50.68%),稳定(SD)21例(28.76%),进展(PD)15例(20.54%);CD3、CD4、CD8T细胞的百分比在治疗后均较治疗前显著增高(P<0.05),且72.60%(53例)的患者CD4/CD8比例调整至正常;80.82%(59例)的患者治疗后Th1类细胞因子分泌增加,61.64%(45例)的患者Th1/Th2细胞因子比例恢复平衡;治疗后42例食欲增加,51例体力及睡眠改善,23例体重回升大于治疗前体重的5%;输注后的副反应包括寒颤、发热、呕吐、兴奋失眠、皮疹、疲乏,经对症处理后短时缓解,无1例出现毛细血管渗漏综合征(SCLS)及实质脏器的损害。结论:过继性CD3+CD56+NKT细胞输注治疗能显著调整中晚期胃癌患者的免疫功能,改善临床症状,是一种安全、有效的辅助治疗手段。
Objective: To evaluate the efficacy and adverse reactions of CD3 + CD56 + NK T cells in the treatment of 73 cases of advanced gastric cancer. Methods: Peripheral blood mononuclear cells (PBMCs) were collected by hematology separator and cultured with rhINF-γ, rhIL-2, rhIL-1 and CD3McAb. Ten days later, CD3 + CD56 + The total number of reinfusion cells per treatment was (5 ~ 10) × 109. After 4 weeks of treatment, the peripheral blood T lymphocyte subsets and cytokine levels were detected by flow cytometry in order to evaluate the cellular immune function, combined with clinical indicators comprehensive evaluation of the curative effect, and to observe the adverse reactions. Results: Of the 73 patients treated with PR, 37 cases (50.68%) had partial response (PR) + microemission (MR), 21 cases (28.76%) had stable (SD) and 15 cases (20.54% ). The percentages of CD3, CD4 and CD8 T cells were significantly higher than those before treatment (P <0.05), and the percentage of CD4 / CD8 in 72.60% (53 cases) was adjusted to normal; 80.82% (59 cases) After treatment, the secretion of Th1 cytokines increased, and the proportion of Th1 / Th2 cytokines returned to balance in 61.64% (45 cases). After appetite was increased in 42 cases, physical and sleep improvement was observed in 51 cases and body weight rose more than 5 %; Side effects after infusion include shivering, fever, vomiting, excitement insomnia, rash, fatigue, symptomatic treatment of short-term relief, no case of capillary leak syndrome (SCLS) and the damage of real organs. Conclusion: Adoptive adoptive CD3 + CD56 + NKT cell infusion therapy can significantly adjust the immune function of patients with advanced gastric cancer, improve clinical symptoms, is a safe and effective adjuvant therapy.