自体CIK细胞治疗对不同阶段肿瘤患者免疫功能的影响

目的 探讨自体细胞因子诱导的杀伤细胞（CIK）治疗对不同阶段的恶性肿瘤患者免疫功能的影响。方法 162例恶性肿瘤患者分为A组（肿瘤晚期临终患者，预计生存期＜3个月）、B组（存在远处转移或局部晚期肿瘤患者，预计生存期＞3个月）和C组（根治术后患者），另选取健康志愿者作为空白对照组（D组）。检测治疗前后A、B、C 3组患者及D组免疫功能的变化，包括CD3+、CD3+CD4+、CD3+CD8+、CD3+CD56+和CD4+／CD8+T淋巴细胞亚群水平，并监测治疗相关的不良反应。结果 自体CIK细胞治疗前，A、B、C组患者CD3+、CD3+CD4+T细胞亚群水平低于D组，CD3+CD8+T淋巴细胞亚群水平高于D组，差异均有统计学意义（P＜0.05）。经过2次自体CIK细胞治疗后，A组患者CD3+T细胞水平较治疗前降低（P＜0.05），CD3+、CD3+CD4+、CD3+CD8+、CD3+CD56+和CD4+／CD8+与D组比较差异有统计学意义（P＜0.05）；B组治疗后CD3+、CD3+CD56+T淋巴细胞水平较治疗前升高（P＜0.05），CD3+、CD3+CD4+、CD3+CD8+与D组比较差异有统计学意义（P＜0.05）；C组治疗后CD3+、CD3+CD4+、CD3+CD56+T细胞亚群水平较治疗前升高（P＜0.05），CD3+、CD3+CD4+、CD3+CD8+、CD3+CD56+和CD4／CD8与D组比较差异无统计学意义（P＞0.05）。各组患者因回输CIK引起的不良反应发生率较低，组间差异均无统计学意义。结论 自体CIK细胞治疗可增强细胞免疫功能，纠正恶性实体瘤患者外周血T细胞亚群紊乱状态，治疗相关的不良反应可耐受，经对症处理后均可缓解，且不良反应与肿瘤所处阶段无关。

The influence of autologous cytokine-induced killer cells therapy on immunity function of cancer patients in different stages

Objective To investigate the autologous cytokine-induced killer（ CIK） cells on the immunity function of cancer patients in different stages. Methods One hundred and sixty-two malignant tumor patients were divided into 3 groups,terminal-stage patients and the expected survival time less than 3 months were the group A,the patients who existed distant metastases or locally advanced cancer and the expected survival time longer than 3 months were the group B,and the cases who finished postoperative adjuvantherapy were the group C,meanwhile the health volunteers were as the group D. We detected immunity function of the patients,including the levels of CD3^＋,CD3^＋ CD4^＋,CD3^＋ CD8^＋,CD3^＋ CD56^＋ T cells and the ratio of CD4^＋ /CD8^＋,meanwhile the adverse reactions were monitored. Results Before the CIK cells therapy,the baseline level of CD3^＋,CD3^＋ CD4^＋,CD3^＋ CD8^＋ T cell subsets and the ratio of CD4^＋ /CD8^＋ among the groups were statistically significant differences（ P〈0. 05）. After twice CIK cells therapy,the level of CD3^＋ T cells decreased in group A（ P〈0. 05）; and compared with group D,the levels of CD3^＋,CD3^＋ CD4＋,CD3^＋ CD8^＋,CD3^＋ CD56^＋ and CD4^＋ /CD8^＋ were still significantly different（ P〈0. 05）. The levels of CD3^＋,CD3^＋ CD56＋ T lymphocytes increased（ P〈0. 05） in group B,CD3^＋,CD3^＋ CD4^＋ and CD3^＋ CD8^＋ were still significantly different（ P〈0. 05）. The levels of CD3^＋,CD3^＋ CD4^＋,CD3^＋ CD56^＋ T cell subsets also increased（ P〈0. 05） in group C,and CD3^＋,CD3^＋CD4^＋,CD3^＋ CD8^＋,CD3^＋ CD56^＋ and CD4^＋ /CD8^＋ were not significantly different compared with group D. The adverse reaction among each groups were in a low rate during treatment and had no statistical significance. Conclusion The autologous CIK cells treatment may help to improve T-lymphocyte subsets distribution and improve the host＇s immune functions. Meanwhile the adverse reactions in the process of treatment can