自然杀伤细胞治疗肝癌的前瞻性研究

目的:评价自然杀伤细胞（natural killer cell，NK cell）治疗肝癌的短期临床有效性、安全性以及对肝癌患者外周血淋巴细胞亚群的影响。方法:研究对象为暨南大学附属复大肿瘤医院2016年2月至2017年9月收治的17例肝癌患者，采集患者本身或其亲属的外周血，体外培养诱导产生高活性NK（HANK）细胞，在第14、15和16天进行静脉输注，连续3次输注为1个疗程，每个患者接受至少1个疗程的治疗。分别于每疗程治疗前及疗程治疗结束后3周取患者外周血检测淋巴细胞亚群，比较治疗前后淋巴细胞亚群的变化及其与短期临床疗效的关系。结果:经HANK细胞治疗后，17例肝癌患者PR 2例，SD 8例，PD 4例，失联3例；缓解率为14.3%，疾病控制率为71.4%；HANK细胞治疗前后淋巴细胞亚群无明显变化。治疗过程中17例患者并未发生不良反应。结论:异体NK细胞免疫治疗可缓解病情且安全无副作用，在肝癌治疗中有潜在的应用价值。

Prospective study of natural killer cell therapy in patients with hepatic carcinoma

Objective:To evaluate the short-term clinical efficacy and safety of natural killer (NK) cell in the treatment of liver cancer and the effects on the number of peripheral blood lymphocyte subsets in patients with liver cancer.Methods:17 patients were enrolled from February 2016 to September 2017，and peripheral blood from patients or allogenic donors (patients' kinsfolk) was collected.NK cells were expanded and activated ex vivo.Highly activated NK (HANK) cells were infused on 14th，15th and 16th days of culture.Each patient received at least one course (3 infusions constitute one course) of HANK cell infusion.We detected the number of lymphocyte subsets before and 3 weeks after HANK cell infusion to observe and evaluate the changes of lymphocyte subsets as well as short-term clinical efficacy.Results:Among the 17 patients，2 patients achieved PR，8 patients achieved SD and 4 patients achieved PD.3 patients missed follow-up.The response rate and disease control rate was 14.3% and 71.4%，respectively.The lymphocyte subsets of the patients had no significant change.No side effect was observed.Conclusion:HANK cell therapy can alleviate the disease of liver cancer patients and shows no side effect during the treatment.HANK cell has potential application in the treatment of hepatic carcinoma.