摘要
目的探讨活化自体淋巴细胞(AAL)治疗对肝细胞癌患者免疫功能及预后的影响。方法采集66例肝细胞癌患者外周血,体外分离单个核细胞并扩增AAL自体回输后,检测治疗前后外周血白细胞总数及分类、淋巴细胞亚型;按肝癌分期评价患者治疗后4周的疗效。结果 AAL治疗后与治疗前比较,患者外周血白细胞[(5.97±2.24)×109/L vs.(5.00±1.76)×109/L,P=0.030]及淋巴细胞计数[(1.47±0.61)×109/L vs.(1.19±0.41)×109/L,P=0.016]显著升高,其中CD3+、CD8+T淋巴细胞亚群计数显著升高(P均=0.024),CD4+/CD8+比值显著下降(P=0.017)。Ⅰ期部分缓解病例占63.6%,明显高于Ⅱ期(P=0.023);Ⅱ期病情稳定病例占53.3%,明显高于Ⅲ期(P=0.011);Ⅲ期疾病加剧病例占52.0%,明显高于Ⅰ、Ⅱ期(P=0.009,P=0.028)。结论 AAL治疗对微小残余肿瘤的患者有益。以微转移为主要特点、瘤负荷小的Ⅰ、Ⅱ期肝癌患者采用AAL治疗效果显著。
Objective To investigate the effect of the activated autologous lymphocyte(AAL)therapy to immunologic function and prognosis in hepatocellular carcinoma(HCC)patients. Methods Peripheral blood from 66 HCC patients were collected, and then monocytes were isolated in vitro and AAL were expanded for auto- transfusion, then the counts and classifications of peripheral blood leukocytes before and after auto-transfusion were detected, and the clinical efficacy was evaluated for the following 4 weeks according to the stage of HCC. Results The counts of peripheral blood leukocytes and lymphocytes in HCC patients obviously increased after the AAL therapy, the counts of CD3+,CD8+T lymphocyte subsets increased obviously, and CD4+/CD8+decreased. For the patients in stage Ⅰ, 63.6% were in a partial response, which was higher than stageⅡ(P = 0.023); for those in stage Ⅱ, 53.3% were in stable condition, which was higher than stageⅢ(P = 0.011); for those in stage Ⅲ, 52.0% suffered from progressive disease, which was higher than stageⅠand Ⅱ(P = 0.009,0.028). Conclusion AAL therapy is beneficial for the patients with microscopic lesions, especially for the patients in stageⅠ, Ⅱ with micrometastasis, and less tumor burden.
出处
《北京医学》
CAS
2015年第9期828-831,共4页
Beijing Medical Journal
基金
北京市卫生系统高层次卫生技术人才培训项目(2011-2-20)
佑安肝病艾滋病基金(20150306)
关键词
肝细胞癌
过继性细胞免疫治疗
活化自体淋巴细胞
淋巴细胞亚群
疗效评价
Hepatocellular carcinoma(HCC) Adoptive immunotherapy Aactivated autologous lymphocytes (AAL) Lymphocyte subsets Clinical efficac
