引用本文:胡博文,杜玲玉,杨 勇.DC-CIK免疫治疗联合化疗对晚期肺癌患者的疗效及对血清miR-137 miR-155水平的影响[J].中国临床新医学,2022,15(4):304-309.
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DC-CIK免疫治疗联合化疗对晚期肺癌患者的疗效及对血清miR-137 miR-155水平的影响
胡博文,杜玲玉,杨 勇
215001 江苏,南京医科大学附属苏州医院胸外科
摘要:
[摘要] 目的 探讨树突状细胞-细胞因子诱导的杀伤细胞(DC-CIK)免疫治疗联合化疗对晚期肺癌患者的治疗效果,分析患者肿瘤标志物、免疫功能指标、血清miR-137、miR-155的水平变化情况。方法 选择2020年1月至2021年1月南京医科大学附属苏州医院收治的晚期肺癌患者83例,根据其治疗意愿分为联合组(接受DC-CIK免疫治疗联合化疗方案,40例)和化疗组(接受单纯化疗方案,43例)。对比两组临床疗效、生存预后,以及治疗前后肿瘤标志物[癌胚抗原(CEA)、细胞角蛋白19片段(Cyfra21-1)]、免疫功能指标[CD3+ T细胞、CD4+ T细胞、自然杀伤(NK)细胞]以及血清miR-137、miR-155水平。结果 联合组客观有效率(ORR)、疾病控制率(DCR)高于化疗组,但差异无统计学意义(25.00% vs 18.60%,75.00% vs 60.47%;P>0.05)。治疗后,两组CEA、Cyfra21-1水平和miR-137、miR-155水平均较治疗前显著降低(P<0.05),且联合组水平低于化疗组,差异有统计学意义(P<0.05)。治疗后,联合组CD3+ T细胞、CD4+ T细胞、NK细胞水平均较治疗前显著升高(P<0.05),而化疗组免疫功能指标变化不显著(P>0.05);联合组免疫功能指标水平高于化疗组,差异有统计学意义(P<0.05)。联合组无进展生存期(PFS)、总生存期(OS)情况均优于化疗组(P<0.05)。结论 与单纯化疗相比,DC-CIK免疫治疗联合化疗能够降低晚期肺癌患者肿瘤标志物CEA、Cyfra21-1水平及血清miR-137、miR-155水平,改善其免疫功能,延长患者生存期。
关键词:  晚期肺癌  树突状细胞-细胞因子诱导的杀伤细胞  肿瘤标志物  免疫功能  生存预后
DOI:10.3969/j.issn.1674-3806.2022.04.05
分类号:R 734.2
基金项目:苏州市科技计划项目(编号:SKJY2021116)
Effects of dendritic cell-cytokine-induced killer cells immunotherapy combined with chemotherapy on efficacy of patients with advanced lung cancer and on serum miR-137 and miR-155 levels
HU Bo-wen, DU Ling-yu, YANG Yong
Department of Thoracic Surgery, Suzhou Hospital Affiliated to Nanjing Medical University, Jiangsu 215001, China
Abstract:
[Abstract] Objective To investigate the therapeutic effect of dendritic cell-cytokine-induced killer cells(DC-CIK) immunotherapy combined with chemotherapy on patients with advanced lung cancer, and to analyze the changes of tumor markers, immune function indicators, serum miR-137 and miR-155 levels. Methods Eighty-three patients with advanced lung cancer who were admitted to Suzhou Hospital Affiliated to Nanjing Medical University from January 2020 to January 2021 were selected and divided into the combination group(receiving DC-CIK immunotherapy combined with chemotherapy, 40 cases) and the chemotherapy group(receiving chemotherapy alone, 43 cases) according to their treatment intentions. The clinical efficacy, survival prognosis, tumor markers[carcinoembryonic antigen(CEA), cytokeratin 19 fragment(Cyfra21-1)], immune function indicators[CD3+ T cells, CD4+ T cells, natural killer(NK) cells], and serum miR-137 and miR-155 levels before and after treatment were compared between the two groups. Results The objective response rate(ORR) and disease control rate(DCR) of the combination group were higher than those of the chemotherapy group, but the differences were not statistically significant(25.00% vs 18.60%, 75.00% vs 60.47%; P>0.05). After treatment, the levels of CEA, Cyfra21-1, miR-137 and miR-155 in the two groups were significantly lower than those before treatment(P<0.05), and the levels in the combination group were lower than those in the chemotherapy group, and the differences were statistically significant(P<0.05). After treatment, the levels of CD3+ T cells, CD4+ T cells and NK cells in the combination group were significantly higher than those before treatment(P<0.05), while the changes in the immune function indicators of the chemotherapy group were not significantly different(P>0.05). The levels of immune function indicators in the combination group were higher than those in the chemotherapy group, and the differences were statistically significant(P<0.05). The progression-free survival(PFS) and overall survival(OS) of the combination group were better than those of the chemotherapy group(P<0.05). Conclusion Compared with chemotherapy alone, DC-CIK immunotherapy combined with chemotherapy can reduce the levels of tumor markers CEA and Cyfra21-1 and the levels of serum miR-137 and miR-155 in patients with advanced lung cancer, improve their immune function and prolong their survival.
Key words:  Advanced lung cancer  Dendritic cell-cytokine-induced killer cells(DC-CIK)  Tumor markers  Immune function  Survival prognosis