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目的:探讨以树突状细胞(dendritic cells,DC)联合细胞因子介导杀伤细胞(cytokine induced killer,CIK)为基础的免疫途径治疗恶性实体肿瘤的临床疗效。方法:将60例临床确诊的肾透明细胞癌患者随机分为两组:治疗组给予手术联合细胞免疫治疗,对照组给予手术及细胞因子治疗。采集肿瘤患者的外周血单核细胞,体外诱导培养成熟DC及CIK细胞,最后再回输给患者。观察疗效和治疗前后细胞免疫指标变化(CD3~+、CD4~+、CD8~+、CD4~+/CD8~+、NK细胞)、外周血象、肝肾功能变化(白细胞、转氨酶、尿素氮、肌酐)及不良反应。结果:治疗组有效率43.33%,对照组有效率26.67%,治疗组与对照组相比,差异有统计学意义(P<0.05)。治疗组CD3~+、CD4~+、CD4~+/CD8~+免疫学指标治疗前后比较,差异有统计学意义(P值分别为0.010,0.026,0.021),治疗组细胞免疫学指标(CD3~+、CD4~+、CD4~+/CD8~+)在治疗前后变化与对照组相比,结果差异有统计学意义(P值分别为0.001,0.023,0.012)。两组患者外周血象及肝肾功能检测无异常,免疫治疗过程中未出现明显的毒副作用。结论:以DC、CIK细胞为基础的细胞免疫治疗可以明显改善肾癌术后患者临床疗效,提高外周血淋巴细胞亚群及NK细胞水平,临床应用无明显不良反应,是肾癌术后重要的辅助治疗手段。
Objective: To investigate the clinical efficacy of dendritic cells (DCs) in combination with cytokine induced killer (CIK) -based immunotherapy for malignant solid tumors. Methods: Sixty patients with clinically diagnosed renal clear cell carcinoma were randomly divided into two groups: the treatment group received operation combined with cellular immunotherapy, the control group received operation and cytokine therapy. Peripheral blood mononuclear cells from patients with cancer were collected and induced to mature DC and CIK cells in vitro. The changes of cell immune index (CD3 ~ +, CD4 ~ +, CD8 ~ +, CD4 ~ + / CD8 ~ +, NK cells), peripheral blood and liver and kidney function were observed before and after treatment (leukocyte, transaminase, urea nitrogen, creatinine ) And adverse reactions. Results: The effective rate was 43.33% in the treatment group and 26.67% in the control group. The difference between the treatment group and the control group was statistically significant (P <0.05). There were significant differences in the immunological indexes of CD3 ~ +, CD4 ~ +, CD4 ~ + / CD8 ~ + before and after treatment in the treatment group (P = 0.010,0.026,0.021, respectively) CD4 +, CD4 + / CD8 +) before and after treatment were significantly different from the control group (P = 0.001,0.023 and 0.012, respectively). There were no abnormalities in peripheral blood and liver and kidney function tests in the two groups, and no obvious toxic and side effects occurred during the immunotherapy. CONCLUSION: Cellular immunotherapy based on DC and CIK cells can significantly improve the clinical curative effect of patients with renal cell carcinoma and improve the level of peripheral blood lymphocyte subsets and NK cells. There is no obvious adverse reactions in clinical application, which is an important postoperative renal cell carcinoma Assisted treatment.