链式激活的免疫细胞治疗恶性肿瘤胸腹腔积液的效果观察

摘要

Objective To explore efficacy of cascade primed immune (Capri) cells in treatment of malignant hydrops combined with hydrothorax.Methods A total of 82 patients with hydrothorax and malignant neoplasm were randomly divided into Capri cells group (group A,n =41) and chemotherapy group (group B,n =41).Effective rates,improvement of life quality,and changes of T-lymphocyte subsets and CK19mRNA levels before and after treatment in the two groups were observed.Other 82 health adults were recruited as control group.Results Control rate of hydrops and score of life quality in group A were significantly better than those in group B (P ＜0.05).Before treatment,contents of CD3 +,CD4+ and NK cells in groups A and B were significantly lower,contents of CD8 + were increased,expressions of CK19mRNA were enhanced,and the differences were statistically significant compared with those in control group (P ＜0.05) ; after treatment,contents of CD3+ and CD4+ cells were significantly increased,and contents of CD8 + and expressions of CK19mRNA were obviously lower.The differences in contents of CD3 +,CD4 + and NK cells,and expressions of CK19mRNA in group A between those treatment for 1 month and those treatment for 3 d were statistically significant (P ＜0.05) ; the differences in contents of CD3 + and CD4 + in group B between those treatment for 1 month and those treatment for 3 d were also statistically significant (P ＜ 0.05) ; and the differences of one group in same period and before treatment were statistically significant (P ＜ 0.05).After treatment,content of NK cells was increased in group A and was reduced in group B,and the differences were statistically significant (P ＞0.05).Conclusion Capri cells may be used to treat malignant neoplasm combined with hydrothorax by improving immune function,increasing the number of NK cells,clearing circulating tumor cells and enhancing patients'antineoplastic abilities and quality of life.%目的 探讨级联激活的免疫细胞(cascade primed immune cells,Capri)治疗恶性肿瘤胸腹腔积液的效果.方法 收集伴胸腹腔积液的恶性肿瘤82例,分别观察Capri治疗组(试验组)41例及常规化疗组41例治疗的有效性、生活质量改善情况、治疗前后T淋巴细胞亚群及细胞角质蛋白(CK)19 mRNA变化.另选择82例健康体检者(对照组)作对照.结果 试验组积液改善有效率、生活质量评分均明显优于化疗组,差异有统计学意义(P＜0.05).两组治疗前CD3+ 、CD4+ 、NK细胞含量明显降低,CD8+细胞含量升高,CK19 mRNA基因表达增强,与对照组比较差异有统计学意义(P＜0.05)；治疗后CD3+ 、CD4+细胞含量升高,CD8+细胞含量及CK19 mRNA基因表达量明显降低,组间同期比较及与治疗前比较差异均有统计学意义(P＜0.05).试验组治疗后1个月CD3+ 、CD4+ 、NK细胞、CK19 mRNA与治疗后3d比较,差异有统计学意义(P＜0.05)；化疗组治疗后1个月 CD3+、CD4+细胞与治疗后3 d比较,差异有统计学意义(P＜0.05).治疗后试验组NK细胞含量升高,化疗组下降,组内不同期、组间同期比较差异均有统计学意义(P＜0.05).结论 应用Capri细胞治疗恶性肿瘤胸腹腔积液,可通过改善其免疫功能,增加NK细胞数量,清除外周血循环中肿瘤细胞,提高患者抗肿瘤的能力及生存质量.