BT—BAK细胞和BCG膀胱腔内过继免疫治疗对膀胱癌患者全身免疫功能影响的比较

目的：观察BT-BAK细胞与BCG膀胱腔内灌注治疗对患者全身免疫功能的影响。方法：由手术切除的膀胱瘤标本制备膀胱肿瘤可溶性抗原，以BCG为佐剂，从PBMNC中诱导出抗膀胱肿瘤特异性细胞毒性BT-BAK细胞，临床选择72例浅表性膀胱癌术后患者随机平均分成2组分别进行BT-BAK和BCG的膀胱腔内灌注治疗。于不同阶段采用ELISA法测定患者外周血中IL-2、TNF-α及IFN-γ的含量；观察治疗后患者PBMNC对T24膀胱肿瘤细胞株杀伤活性的变化。结果：BT-BAK组患者血清中IL-2、TNF-α及IFN-γ的水平均较治疗前明显提高（P＜0.01)；患者PBMNC对T24膀胱肿瘤细胞株的杀伤活性显著增强（P＜0.01)。BT-BAK组上述指标均高于BCG组（P＜0.05)。平均随访18.16个月，两组的复发率分别为2.7%和11.11%。结论：BT-BAK细胞及其培养上清进行膀胱腔内灌注治疗，能够有效提高膀胱癌术后患者的全身免疫水平，降低膀胱癌的术后复发率。

COMPARISON OF THE EFFECTS OF BT-BAK CELLS WITH BCG ON GENERAL IMMUNOREACTIVITY AFTER INTRAVESICAL ADOPTIVE IMMUNOTHERAPY FOR PATIENTS WITH BLADDER

Objective To observe the effects of BT-BAK cells and BCG on thegeneral immunoreactivity after intravesical adoptive immunotherapy. Methods Bladder tumor soluble antigen (BTSA) was prepared from autologous bladder tumor, and with the adjuvant of BCG, BT-BAK cells were induced from human peripheral blood mononuclear cells (PBMNC). 72 patients with superficial bladder cancer who underwent operations were intravesically treated with BT-BAK and BCG respectively. The levels of cytokines IL-2, TNF-αand IFN-r were measured with ELISA assays0 Cytotoxicity of PBMNC to T24 human bladder cancer cell lines were evaluated by MTT methods. Results Compared with the BCG group,the serum levels of cytokines IL-2, TNF-αand IFN-τin BT-BAK group were increased significantly (P＜0.01), and the killing activity of the patients' PBMNC to T24 human bladder cancer cell lines was obviously enhanced (P＜0.01). All the indexes in BT- BAK group were higher than in the BCG group (P＜0.05). Follow- up visits for 18.16 months in average showed that the recurrence rates in the BT-BAK group and the BCG group were 2.7% and 11 1196 respectively. Conclusion Intravesical infusion of BT-BAK together with their supernatants in the culture can effectively improve the immunological reactivity of the whole body with a low recurrence rate.