目的 探讨肝动脉灌注化学治疗栓塞(TACE)联合细胞因子诱导的杀伤细胞(CIK)治疗原发性肝癌(PHC)患者的细胞免疫功能变化.方法 65例PHC患者分为2组.对照组和研究组分别为32例和33例.单纯TACE治疗组(对照组)常规行肝动脉灌注化学治疗栓塞术;TACE联合细胞免疫治疗组(研究组)采集外周血单个核细胞(PBMC),并诱导分化获得成熟的CIK细胞,行TACE联合CIK治疗.观察治疗前及治疗结束后1周、4周的T细胞亚群等细胞免疫功能变化.结果 对照组治疗后1周与治疗前CD3+、CD4+、CD8+和CD4+/CD8+等各项免疫指标相比较,差异无统计学意义(P>0.05),单纯的TACE治疗后4周与治疗前及治疗后1周比较,CD8+明显降低,差异有统计学意义(P<0.05);CD19+变化不明显.研究组治疗1周、4周后CD3+、CD4+较治疗前明显升高(P<0.01),治疗后1周CD4+/CD8+比值升高,CD16+CD56+比例有下降趋势(P>0.05),治疗后4周CD19+较治疗前下降(P<0.05).结论 TACE联合CIK应用具有提高PHC患者细胞免疫功能的作用.%Objective To evaluate the variation of cellular immune function in patients with primary hepatic carcinoma (PHC) treated with transcatheter arterial chemoembolization (TACE) combined with self-derived cytokine-induced killer cells (CIK). Methods A total of 65 consecutive PHC patients were divided into 2 groups: control group(32 patients) and study group(33 patients). Control group were treated only with TACE. Peripheral blood mononuclear cells(PBMC) were collected from the patients in study group by blood cell separator to induce PBMC to develop into mature cytokine-induced killer cells, so that study group were treated by adoptive immunotherapy combined with TACE. Variations of cellular immune functions including the T cell subsets were observed. Results In control group, following the treatment,the percentage of CD3 + , CD4+ ,CD8+ , CD4+/CD8+ had no significant differences compared with before treatment(P＞0.05), while CD8+ decreased after circumference treatment(P＜ 0.05). In study group, after the treatment, the positive percentage of CD3 + , CD4+ obviously higher than that before treatment(P＜0.01 ) ;after one week treatment, the percentage of CD4+/CD8+ increased(P＜0.05 ), and that of CD16+ CD56+ level was inclined to decreased slightly without statistical significance (P＞0. 05). The amount of CD19+obviously lower after circumference treatment than before treatment (P＜0.05). Conclusion Combined therapy of TACE with CIK enhances the cellular immune function of PHC patients.
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