艾月琴 江龙委 赵华 高艳荣 贾绍昌

[摘要] 目的 探討分析树突状细胞（DC）、细胞因子诱导的杀伤细胞（CIK）治疗对局部非小细胞肺癌术后生存率及免疫功能的影响。 方法 选取2014年1月～2017年1月南京中医药大学附属八一医院收治的非小细胞肺癌术后患者40例，采用随机数字表法将其分为治疗组（22例）和对照组（18例）。治疗组患者术后采用DC、CIK细胞联合放化疗，对照组患者采用单纯辅助放化疗的方式；比较两组患者术后生存率、血清肿瘤标志物、免疫功能及不良反应情况。 结果 治疗组中位生存期与对照组比较，差异无统计学意义（P > 0.05），而无病生存期高于对照组，差异有统计学意义（P < 0.05）。治疗后两组患者血清肿瘤标志物（CEA）及细胞角质素片段抗原21-1（CYFRA21-1）比较，差异无统计学意义（P > 0.05）。治疗后治疗组患者辅助性T细胞及CD4+/ CD8+T细胞的比值与对照组比较显著上升，且治疗后治疗组T淋巴细胞rDNA转录活性显著高于对照组，差异有统计学意义（P < 0.05）。两组患者化疗相关不良反应无明显差别，治疗组患者有3例发生DC、CIK治疗相关发热反应。 结论 对局部晚期非小细胞肺癌患者手术后序贯采用DC-CIK细胞治疗能使患者无病生存期延长，免疫功能增强，是一种安全有效的治疗方法，值得临床推广和应用。

[关键词] 局部晚期非小细胞肺癌；树突状细胞；细胞因子诱导的杀伤细胞；免疫功能；生存率

[中图分类号] R734.2 [文献标识码] A [文章编号] 1673-7210（2018）10（b）-0100-05

[Abstract] Objective To investigate the influence of Dendritic cell （DC） and Cytokine-induced killer （CIK） cell therapy on the survival rate and immune function of local non-small cell lung cancer. Methods From January 2014 to January 2017， in Bayi Hospital Affiliated Nanjing University of Chinese Medicine， 40 NSCLC patients were selected， they were divided into treatment group （22 cases） and control group （18 cases） by random sampling table method. The control group was treated with adjuvant chemotherapy alone， and the treatment group was treated with DC， CIK combined with chemotherapy. The postoperative survival rate， serum tumor markers， immune function， and adverse reactions of patients in two groups were compared. Results The median survival time of the treatment group was compared with the control group， the difference was not statistically significant （P > 0.05）， but the disease-free survival time of the treatment group was higher than the control group， the difference was statistically significant （P < 0.05）. After treatment， serum tumor markers CEA and CYFRA21-1 in two groups were compared， the difference was not statistically significant （P > 0.05）. After treatment， the ratio of helper T cells and CD4+/CD8+ T cells in the treatment group were significantly higher than the control group， the differences were statistically significant （P < 0.05）， and the rDNA transcription activity of T lymphocytes in the treated group was significantly higher than the control group， the difference was statistically significant （P < 0.05）. There was no significant difference in chemotherapy-related adverse effects between the two groups， in the treatment group， 3 patients with DC and CIK treatment had related fever reactions. Conclusion Sequential use of DC-CIK cells in patients with locally advanced non-small cell lung cancer can lead to clinical benefit of disease-free survival and enhanced immune function. It is a safe and effective treatment and worthy of clinical promotion and application.

[Key words] Local advanced non-small cell lung cancer； Dendritic cell； Cytokine-induced killer； Immune function； Survival rate

在全球范围内，肺癌是导致肿瘤相关死亡的首要因素，也占据了每年新发肿瘤的第一位，尤其是在男性中其发病率和死亡率均远高于其他肿瘤[1]。非小细胞肺癌（none small cell lung cancer，NSCLC）是一种主要的肺癌类型，发病率约占肺癌的85%[2]。NSCLC的病理类型有大细胞癌、腺癌、鳞状细胞癌。相比小细胞肺癌而言，其恶性程度较低，大部分患者在发现时已处于中晚期[2]。其中，局部晚期的患者的治疗方法选择是临床上的一个难点。局部晚期NSCLC是指肿瘤仅局限于肺部而无远处转移的ⅢA及ⅢB期NSCLC。手……