【摘要】 目的探讨放疗联合DC-CIK对晚期非小细胞肺癌患者生存和免疫功能的影响。方法选取2014年1月—2017年12月接受治疗的Ⅲb/Ⅳ期晚期非小细胞肺癌患者58例,将其随机分为对照组和观察组,对照组采用放疗方案,观察组采用DC-CIK细胞联合放疗方案进行治疗。疗程结束后,流式检测治疗前后患者外周血CD4+、CD3+、CD8+、CD4+CD25+、CD16+CD56+细胞比例和CD4+/CD8+比值,比较观察组和对照组治疗前后的患者免疫功能变化;采用酶联免疫法比较治疗前后的患者外周血中Th1/Th2细胞因子水平变化;比较两组患者治疗后的累积生存率。结果联合治疗后观察组的淋巴细胞水平的改善优于对照组,差异比较明显有统计学意义(P<0.05);治疗后观察组外周血血清Th1细胞因子(IL-2、IFN-γ)水平与治疗前和对照组治疗后相比显著升高(P<0.05),Th2细胞因子(IL-4、IL-10)水平与治疗前和对照组治疗后相比显著下降(P<0.05);1、2和3年的累积生存率分别为82.8%(24例),69.0%(20例)和58.6%(17例);观察组1、2和3年的累积生存率分别为93.1%(27例),82.8%(24例)和72.4%(21例),观察组和对照组的累积生存率的差异比较明显有统计学意义(P<0.05)。结论放疗联合DC-CIK能够有效调节Ⅲb/Ⅳ期非小细胞肺癌患者的体内淋巴细胞比例以及Th1/Th2平衡,明显改善患者机体免疫功能,提高生存率。更多还原

【Abstract】 Objective To investigate the influence of radiotherapy combined DC-CIK treatment on immune function and survival of patients with non-small cell lung cancer of stage Ⅲ/Ⅳ. Methods Totally 58 patients with non-small cell lung cancer of stage Ⅲ/Ⅳ in our hospital from January 2014 to December 2017 were randomly divided into control group and observation group. Patients in the control group were treated with radiotherapy only. Patients in the observation group were treated with DC-CIK cells combined with radiotherapy. CD4 +,CD3 +,CD8 +,CD4 + CD25 +,CD16 + CD56 + cell percentage and CD8 +/CD4 + ratios were evaluated by FCM before and after treatment. Th1/Th2 cytokine levels were analyzed using ELISA method before and after treatment. The cumulative survival rate was estimated in control group and observation group. Results The level of lymphocytes in the observe group after treatment significantly improved than that before treatment and control group( P < 0. 05). IL-2 and IFN-γ levels in the observation group increased significantly compared with before treatment and the control group( P < 0. 05). IL-4 and IL-10 levels in the observation group decreased significantly compared with before treatment and the control group( P < 0. 05).1、2 and 3 year cumulative recurrence rate were 82. 8%( 24 cases),69. 0%( 20 cases) and 58. 6%( 17 cases) in the control group,while 93. 1%( 27 cases),82. 8%( 24 cases) and 72. 4%( 21 cases) the observe group. There was significantly difference in cumulative recurrence rates between two groups( P < 0. 05). Conclusion Radiotherapy combined DC-CIK treatment can effectively regulate lymphocyte ratio of patients with non-small cell lung cancer of stageⅢb/Ⅳ as well as Th1/Th2 balance,significantly improving immune function and survival rate.更多还原