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目的:观察自体树突状细胞(dendritic cell,DC)联合细胞因子诱导的杀伤细胞(cytokine-induced kill cell,CIK)(DC-CIK)免疫疗法治疗肾癌的近期临床疗效和不良反应,及其对患者外周血淋巴细胞亚群的影响。方法:采集10例肾癌患者外周血单个核细胞,经体外诱导产生DC和CIK细胞,分次回输给患者,随访3～12个月,观察患者临床疗效和不良反应。分别于第1次治疗前1周和每次治疗后1个月取患者外周血,流式细胞仪检测其淋巴细胞亚群变化。结果:本研究中6例晚期肾癌患者接受1～3疗程DC-CIK细胞免疫治疗后,完全缓解1例,部分缓解3例,病情稳定1例,疾病进展1例;近期有效率为60%,临床反应率为90%。治疗前及1～3疗程治疗后患者外周血的CD3+CD4+CD8-、CD3+CD4-CD8+、CD3+CD19-、CD3-CD19+、CD3-CD16+CD56+、CD3+CD16+CD56+、CD3+HLA-DR-、CD3+HLA-DR+、CD3+CD28+CD8+细胞无明显变化(P>0.05),CD4+CD25+T细胞(Treg细胞)治疗后有降低趋势(P<0.05)。除1例患者出现一过性发热外,余患者无不良反应。结论:DC-CIK免疫治疗肾癌能改善患者免疫抑制状态,提高机体的抗肿瘤免疫效应,有较好的近期疗效,无明显不良反应。
Objective: To observe the recent clinical efficacy and adverse reactions of dendritic cell (DC) combined with cytokine-induced kill cell (CIK) (DC-CIK) immunotherapy in the treatment of renal cell carcinoma Effect on Peripheral Blood Lymphocyte Subsets in Patients. Methods: Peripheral blood mononuclear cells were collected from 10 patients with renal cell carcinoma. DCs and CIK cells were induced in vitro and were transfused to patients in different stages. The patients were followed up for 3 to 12 months. The clinical efficacy and adverse reactions were observed. Peripheral blood samples were taken from the patients before the first treatment and one month after each treatment. The changes of lymphocyte subsets were detected by flow cytometry. Results: In this study, 6 patients with advanced renal cell carcinoma received 1 ~ 3 cycles of DC-CIK cell immunotherapy after complete remission in 1 case, partial remission in 3 cases, stable disease in 1 case, disease progression in 1 case; the recent effective rate was 60% , The clinical response rate was 90%. The levels of CD3 + CD4 + CD8-, CD3 + CD4-CD8 +, CD3 + CD19-, CD3- CD19 +, CD3- CD16 + CD56 +, CD3 + CD16 + CD56 +, CD3 + HLA in peripheral blood before and 1 to 3 courses of treatment (P <0.05). There was a trend of decrease in CD4 (superscript +) CD25 (superscript +) T cells and CD3 + HLA-DR + CD3 + CD8 + CD8 + cells. Except one patient had transient fever, the remaining patients had no adverse reactions. Conclusion: DC-CIK immunotherapy of renal cell carcinoma can improve immunosuppressive status of patients and improve the body’s anti-tumor immune effect, has a good short-term efficacy, no significant adverse reactions.