【摘要】 目的探讨MHC-Ⅰ类相关分子A(MHC classⅠ-related molecules A,MICA)表达是否能预测非小细胞肺癌术后化疗联合NK细胞输注治疗的疗效。方法流式细胞仪检测92例非小细胞肺癌组织MICA表达。非小细胞肺癌患者手术后,单纯化疗41例(多西他赛+顺铂方案)、化疗联合NK细胞治疗51例,单因素与多因素比较临床因素与生存期关系。结果非小细胞肺癌组织46.74%MICA阴性表达,53.26%MICA阳性表达,NK细胞培养14~17 d后NKG2D高达(97.8%±2.5)%,明显高于培养前(88.2%±7.2)%(P<0.05)。MICA是否表达与NKG2D高低无关(P=0.189)。非小细胞肺癌患者术后Ⅱ期患者的3年及5年的生存率分别为70.8%及47.9%,ⅢA期患者的3年及5年的生存率分别为54.5%及22.7%,中位生存期在是否联合NK治疗(P=0.037)及临床分期(TNM)(P=0.009)存在差异,而患者在年龄(P=0.999)、性别(P=0.412)、病理类型(P=0.782)及MICA表达(P=0.172)均无差异。多因素分析显示,中位生存期在是否联合NK治疗(P=0.044)、临床分期(TNM)(P=0.002)及NK与MICA交叉分析(P=0.002)存在差异。结论 MICA在非小细胞肺癌患者术后化疗联合NK细胞免疫治疗中起重要作用,MICA表达可作为NK细胞免疫治疗的预后因素。更多还原

【Abstract】 This study was designed to investigate whether MICA expression can predict the efficacy of postoperative chemotherapy combined with NK cell infusion in non-small cell lung cancer(NSCLC). MICA expression in 92 cases lung cancer tissue was evaluated by Flow cytometry, in which 41 patients received adjuvant chemotherapy alone(Docetaxel + Cisplatin) and 51 patients received adjuvant chemotherapy combined with autologous NK cell therapy. Factors associated with survival of patients with non-small cell lung cancer were subjected to univariate and multivariate analysis. Data showed that MICA negative expression of non-small cell lung cancer was 46.74% while MICA positive expression was 53.26%; NKG2 D was up to(97.8% ± 2.5)% after NK cellculture for 14-17 days, which was significantly higher than before culture(88.2% ± 7.2)%(P<0.05). MICA expression was not significantly related to NKG2D(P=0.189). The 3-year and 5-year survival rates of patients with non-small cell lung cancer at stage Ⅱ were 70.8% and 47.9%; the 3-year and 5-year survival rates of patients at stage ⅢA were 54.5% and 22.7%. Median overall survival(mOS) was significantly different in patients treated with or without NK(P=0.037), and in patients with different clinical stages(TNM)(P=0.009), but the mOS showed no correlation with age(P=0.999), gender(P=0.412),pathological type(P=0.782) and MICA expression(P=0.172). Multivariate analysis indicated that NK therapy(P=0.172), and the stage(P=0.002) and the interaction of MICA status and NK therapy(P=0.002) were independent prognostic factors for mOS. Taken together, MICA plays an important role in postoperative chemotherapy combined with NK cell immunotherapy in patients with non-small cell lung cancer, and MICA expression is a good prognostic factor for NK cell immunotherapy.更多还原