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目的:细胞因子诱导的杀伤细胞具有可以快速增殖、高效和抗瘤谱广的特点。但是有关该细胞在肿瘤患者临床应用的报道甚少。本文旨在探讨自体脾细胞经黄芪皂甙(Astragalus Sapomin)和小剂量rIL-2活化后过继免疫治疗时肝癌伴有脾功能亢进的患者免疫功能的影响。方法:16例患者均接受肿瘤切除、脾脏切除、皮下肝动脉泵埋入术和自体活化脾细胞过继免疫治疗。患者于手术前、后及过继免疫治疗后采集外周血Ficoll-Hypaque gradient分离单个核细胞,流式细胞仪检测CD4+、CD4+／CD8+和NK细胞水平;MTT法检测PBMC细胞活性。结果:患者手术前、后CD4+、CD4+／CD8 +和NK细胞水平明显低于过继免疫治疗后(P<0．01),而CD8+细胞水平明显高于过继免疫治疗后(P<0．01);自体活化脾细胞过继免疫治疗后PBMC细胞活性明显高于手术前、后(P<0．05)。结论:自体活化脾细胞过继免疫治疗可有效地提高患者的细胞免疫功能,且无副作用,对肝癌伴脾亢患者是一安全而有效的治疗方法。
Objective: Cytokine-induced killer cells have the characteristics of rapid proliferation, high efficiency and broad anti-tumor spectrum. However, little is known about the clinical application of this cell in cancer patients. This article aims to investigate the immune function of patients with hepatocellular carcinoma associated with hypersplenism after adoptive immunotherapy with autologous spleen cells activated by Astragalus Sapomin and a small dose of rIL-2. Methods: Totally 16 patients underwent tumor resection, splenectomy, subcutaneous hepatic artery embedding and adoptive immunization of activated splenocytes. Peripheral blood samples were collected before and after immunotherapy. Ficoll-Hypaque gradient mononuclear cells were collected. The levels of CD4 +, CD4 + / CD8 + and NK cells were detected by flow cytometry. The activity of PBMCs was detected by MTT assay. Results: The levels of CD4 +, CD4 + / CD8 + and NK cells before and after surgery were significantly lower than those after adoptive immunotherapy (P <0.01), while the levels of CD8 + cells were significantly higher than those after adoptive immunotherapy (P <0.01) The cell viability of PBMC after adoptive immunotherapy of activated splenocytes was significantly higher than that before and after surgery (P <0.05). CONCLUSION: Adoptive immunotherapy with activated splenocytes can effectively improve the cellular immune function of patients with no side effects and is a safe and effective treatment for patients with hepatocellular carcinoma and hypersplenism.