摘要
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 effects and side effects of adoptive transfer of CD3^＋CD56^＋NKT cells on 73 patients with advanced gastric carcinoma. Methods,, The peripheral blood mononuclear cells of the patients were separated by blood cell separating machine and cultured in the medium containing rhINF - 7, rhIL - 2, rhIL - 1 and CDdMeAb. After cultured for 10 days, the CD3^＋CD56^＋NKT cells were transferred back to the patients with （5～ 10））〈 109 cells each course. 4 weeks after transferring, the peripheral bloods of the patients were tested by flowcytometry to evaluate the lymphocyte subsets and intracellular cytokine production of T cells, which reflected the immune function of patients. At the same time, the comprehensive curative effects and side effects of the therapy were evaluated. Results：The total effective rate （PR＋MR） was 56, 16%（41/73）, 22 patients acquired SD （30. 13%） and 15 ones were PD （20. 54%）. The percentage of all CDd, CD4 and CD8 T cells increased significantly after being treated with CD3^＋ CD56^＋ NKT cells（P〈0. 05） and proportion of CD4/CD8 T cells of 53 patients（73G） was adjusted to the normal state. The Thl cytokines of 59 patients （80. 51%） increased after the therapy and eytokine secreting proportion of Thl/Thl T cells of 45 patients （62. 31%） regained balance. Among treated patients, the appetite of 42 cases and performance and sleep of 51 cases improved, weight of 23 cases increased over 5% compared with that before therapy. The side effects of this therapy included ague, fever, vomiting, excitation, insomnia, rash and fatigue. All side effects were temporal symptom and could be dispelled by corresponding disposal. No blood capillary leakage syndrome and visceral damage were observed in all patients. Conclusion： Adoptive immunotherapy with CD3^＋CD56^＋NKT cells can significantly adjust the immune function and relieve clinical symptoms of patients with gastric carcinoma. It is a safe and effective treatment of advanced gastric carcinoma.
出处
《西南国防医药》
CAS
2008年第4期515-518,共4页
Medical Journal of National Defending Forces in Southwest China
