化疗联合细胞因子诱导的杀伤细胞治疗中晚期胃癌临床研究

目的评估化疗联合细胞因子诱导的杀伤细胞（cytokine induced killers，CIK）治疗中晚期胃癌的临床疗效。方法参照美国斯坦福大学骨髓移植中心建立的CIK培养方法诱导扩增CIK联合化疗，培养14d后分次回输给病人，观察病人治疗前后瘤体变化、生活质量、卡氏评分等，同时记录生存期。结果21例胃癌单纯化疗后，完全缓解（CR）2例，部分缓解（PR）4例，好转（MR）8例，稳定（SD）3例，无改变（PD）4例，总有效率为28．6％。21例化疗联合CIK治疗后，完全缓解（CR）4例，部分缓解（PR）9例，好转（MR）6例，稳定（SD）1例，无改变（PD）1例，总有效率为52．38％。两组之间具有明显的差异（x^2=6．43，P〈0．05），胃癌单纯化疗后1a生存期为90．5％，2a生存期为81．0％，3a生存期为71．4％。胃癌化疗联合CIK治疗后1a生存期为95：2％，2a生存期为85．7％，3a生存期为81．0％。两组3a生存期没有明显差异（P〉0．05）。用Karnofsky评分及体重的改变来评估生存质量的改善。胃癌单纯化疗后Karnofsky评分平均提高10分，其中提高5例，稳定8例，下降8例，提高率为23．8％。化疗联合CIK治疗后Karnofsky评分平均提高10-20分，其中提高10例，稳定5例，下降6例，提高率为47．6％。两组生存质量变化没有明显差异（P〉0．05）。结论化疗联合CIK治疗对为那些手术、放疗、单纯化疗已无适应证的病人提供了一种可以继续延长生存期，提高生活质量的新的途径。

Clinical trial on effects of chemotherapy treatment combined with CIK in patients with advanced gastric cancer

Objective To estimate the clinical effects of CIK with chemotherapy treatment in patients with advanced gastric cancer. Methods 42 cases of advanced gastric cancer were divided into combination treatment group （ chemotherapy ＋CIK） （n =21） and chemotherapy group （n =21 ）. CIK ceils were induced by culturing PBMC of healthy people by incubation in vitro with IL-2, γ-IFN, anti-CD3 monoclonal antibody and IL-1, then were transfused back to the patients of Combination treatment group with advanced gastric cancer after two weeks, and the changes of tumor weight; life quality, immunity indexes, tumor markers（TM） and the Karnofsky＇s score were observed. Results The effective rate of combination treatment group and chemotherapy group were 52.38% and 28.6%, respectively. There was a significant difference between combination treatment group and chemotherapy group （x^2=6.43, P〈0.05） . The survival rate in chemotherapy group was 90.5% after 1 year, 81.0% after 2 years, and 71.4% after 3 years, but it was 95.2%, 85.7% and 81.0% in combination treatment group, respectively. There was no significant difference in two groups （P〉0.05） . There was no significant difference of the Karnofsky＇s score and survival period in two groups （P〉0.05） . Conclusions CIK cells therapy might enhance effect of the anti-cancer, improve survival quantity and prolong survival period., which probably provide a potent immune therapeutic strategy for patients with advanced gastric cancer.