肝癌细胞裂解物致敏的树突状细胞瘤苗预防肝癌术后转移复发

目的探讨人自体肝癌细胞裂解物致敏的树突状细胞(D C)瘤苗预防肝癌术后转移复发的价值。方法从肝癌患者外周血单核细胞中诱导D C,用重组人粒细胞-巨噬细胞集落刺激因子(rhGM-CSF) 和重组人白细胞介素-4(rhIL-4)刺激活化,经自体肝癌细胞裂解物致敏D C制备瘤苗。将3 0例肝癌术后患者随机分为D C瘤苗治疗组1 5例,对照组1 5例。对两组病例治疗前后免疫功能、临床疗效、肿瘤转移复发率及生存率进行观察比较。结果DC瘤苗治疗后外周血CD 3 、CD4 /CD 8 及自然杀伤细胞比率较治疗前明显升高(P<0.0 5),且明显高于对照组治疗后的相应水平(P<0.05)。DC瘤苗治疗后血清IL-1 0水平明显下降(P<0.0 5)。随访18个月,DC瘤苗治疗组的转移复发率为13.3 3%,明显低于对照组53.33%(P <0.05);而治疗组的生存率为93.33%,明显高于对照组60.00%(P<0.05)。结论肝癌术后行自体肝癌细胞裂解物致敏的DC瘤苗治疗,可改善患者的免疫功能,降低肿瘤转移复发率,提高患者术后生存率,为肝癌的免疫治疗开辟一条新途径。

Clinical effects of dendritic cells pulsed with autologous hepatoma cell lysates on the postoperative recurrence and metastasis of hepatocellular carcinoma

Objective To investigate clinical effects of dendritic cells (DCs) pulsed with autologous hepatoma cell lysates on postoperative recurrence and metastasis of hepatocellular carcinoma (HCC). Methods DCs isolated from peripheral blood mononuclear cells of HCC patients were cultured and propagated in vitro using rhGM-CSF and rhIL-4, and then were pulsed with autologous hepatoma cell lysates. Thirty postoperative patients with HCC were randomly divided into two groups. Fifteen cases were treated with DC vaccine; fifteen cases received chemotherapy only as a control group. Immune function, clinical effects, hepatic tumor recurrence rate and the survival rate of patients of the two groups were observed and compared. Results The levels of CD3 , CD4 /CD8 and NK cells in the DC vaccine group were significantly increased after vaccination (P < 0.05), while those of the control group had no significant changes. The concentration of IL-10 in the DC vaccine group was significantly decreased after the vaccination (P < 0.05). The hepatic tumor recurrence rate at 18 months in the DC vaccine group was 13.33%, compared with 53.33% in the control group (P < 0.05). The survival rate in the former was 93.33%, compared with that of 60% in the later (P < 0.05). Conclusion Hepatoma cell lysates pulsed DC vaccine may improve the immune function of the postoperative HCC patients and play an important role in prevention of postoperative recurrence and metastasis of HCC, which would provide an innovative approach for the immunotherapy of HCC.