树突状细胞和细胞因子诱导杀伤细胞联合白介素2治疗肾癌临床观察

目的 观察树突状细胞(dendritic cells,DC)和细胞因子诱导的杀伤细胞(cytokine-induced killer cells,CIK)联合白介素-2(interleukin-2,IL-2)治疗肾癌的疗效.方法 回顾性分析2005年7月至2011年6月间60例肾癌术后患者,分离外周血单核细胞,体外诱导生成DC细胞;T淋巴细胞体外诱导生成CIK细胞.患者在切除原发病灶后,接受DC+CIK细胞免疫治疗,并给予IL-2静滴21 d.免疫学反应和临床疗效分别通过淋巴细胞亚群分析、影像学检查进行评估.结果 治疗后患者外周血细胞毒T细胞、NK细胞、NKT细胞百分比较治疗前增高,差异有统计学意义.42例Ⅰ～Ⅲ期行根治性肾切除术患者,2例失访,1例复发,余未见复发、转移,随访时间7～67个月,中位随访时间16个月;18例Ⅳ期行姑息性肾切除患者中1例失访,随访的17例中1例CR,3例PR,8例SD,5例PD,随访时间6～66个月,中位随访时间15个月,无显著不良反应出现.结论 DC+CIK联合IL-2治疗能够增强肾癌术后患者的免疫功能,降低根治性切除术后肿瘤的复发率,并且对于转移性肾癌的治疗也显现一定的疗效,耐受性良好.

Efficacy of dendritic cells and cytokine-induced killer cells in combination with interleukin-2 on renal cell carcinoma

Objective To evaluate the clinical efficacy of dendritic cells（DCs） and cytokine-induced killer（CIK） cells in combination with Interleukin-2（IL-2）on renal cell carcinoma（RCC）.Methods Peripheral blood mononuclear cells were isolated from 60 patients with RCC and cultured to produce DCs and CIKs.After nephrectomy,the patients received one course of DCs＋CIKs and IL-2 therapy.Immunologic and clinical responses were evaluated by examination of T lymphocytes subset changes and imaging between July 2005 and July 2011.Results The levels of CD3＋CD8＋ T lymphocyte subtypes,NK cells and NKT cells increased after treatment,which showed significant statistical difference compared with those before treatment.Among forty-two cases of stageⅠ-Ⅲ after radical nephrectomy that were followed up for 7-67 months（median,16 months）,2 cases were lost and only one case relapsed.Among the eighteen cases of stage Ⅳ after palliative nephrectomy that were followed up for 6-66 months（median,15 months）,there was one case lost,one case of complete remission（CR）,three cases of partial remission（PR）,eight cases of stable disease（SD）,and five cases of progressive disease（PD）.Except for transient fever and chill,no remarkable adverse event happened during or after the treatment.Conclusions Immunotherapy using dendritic cells,cytokine-induced killer cells and interleukin-2 combined can enhance the immune function of patients with renal cancer after operation.It shows efficacy for renal cell carcinoma and improve prognosis.No severe side effects are observed.