[关键词]
[摘要]
目的:评价自体树突状细胞(dendritic cell, DC)疫苗联合细胞因子诱导的杀伤(cytokine-induced killer, CIK)细胞治疗中晚期宫颈癌患者的临床疗效和安全性,并分析预后因素。方法:回顾性分析2011年8月至2014年12月解放军81医院进行细胞免疫治疗的的39例Ⅱb~Ⅳ期宫颈癌患者。观察DC-CIK细胞治疗前后患者临床疗效和安全性,比较治疗前后患者的肿瘤标志物及淋巴细胞亚群。单因素及多因素分析预后因素。结果: 39例中晚期宫颈癌患者经DC-CIK细胞免疫治疗后,客观缓解率为20.5%,疾病控制率为66.7%;1年生存率为61%,2年生存率为46%,3年生存率为46%。经细胞治疗后外周血淋巴细胞亚群无显著改变,外周血肿瘤标记物CA125水平显著降低(51.79 vs 36.52,P<0.01),SCCA水平无显著变化。单因素分析显示,是否有远端转移、是否有淋巴结转移是影响细胞治疗疗效和患者预后的影响因素。多因素分析提示年龄、是否有淋巴结转移、治疗前CA125水平正常与否是独立预后因素。结论: DC-CIK细胞免疫治疗可产生临床获益,并可能改善中晚期宫颈癌患者远期生存率,无明显不良反应,安全可行。
[Key word]
[Abstract]
Objective:To evaluate the safety and clinical efficacy of the dendritic cells (DCs) and cytokine-induced killer (CIK) cells combination therapy in the treatment of moderate and advanced cervical cancer and analyze the prognostic factors. Methods: Thirty-nine patients with stage Ⅱb~Ⅳ cervical cancer who received DC-CIK cells treatment in the No. 81 hospital of PLA from Aug. 2011 to Dec. 2014 were enrolled into this retrospective analysis. Clinical response and changes of lymphocyte subsets and serum levels of tumor makers following the treatment were evaluated. Single and multiple-variable analyses were performed to identify the prognostic factors.Results: For the 39 patients received our DC-CIK cells immunotherapy, the overall response rate and the disease control rate were 20.5% and 66.7% respectively. Their 1-year overall survival rate was 61%, and both 2-year and 3-year survival rates were 46%. While there were no significant changes in lymphocyte subsets and SCCA levels in patients received the DC-CIK cells treatment, their CA125 levels were significantly decreased after after the therapy (51.79 vs 36.52, P<0.01). A single-factor analysis found that lymph node as well as distant metastasis can significantly affect the survival time of these patients. The multivariate Cox model indicated that age, lymph node metastasis, and the CA125 level before treatment were significantly associated with the risk of cancer-related death in the patients.Conclusion: Autologous DC-CIK cells immunotherapy is a safe and feasible treatment for patients with moderate and advanced cervical cancer and it may improve the long-term survival of these patients.
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[基金项目]
南京市科技发展计划项目资助(No.201303040)