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目的研究改良的细胞因子诱导杀伤细胞(i CIK)过继性治疗口腔鳞状细胞癌(OSCC)的疗效。方法回顾2008年7月至2013年4月60例OSCC患者,根据治疗方式分为i CIK组(手术治疗+i CIK治疗)及对照组(手术治疗),不良预后者术后行放疗或放化疗。统计两组的复发转移率、生存率、无病生存期及总生存期。分析i CIK组培养前后外周血单个核细胞(PBMC)及i CIK细胞的T细胞亚群比例及Th1细胞因子分泌水平。结果 i CIK组复发转移率低于对照组(16.67%vs 40.00%,χ2=4.022,P=0.045),且无病生存期高于对照组(50.96±3.69 vs 38.15±4.90,χ2=4.163,P=0.041)。但两组的死亡率及总体生存期差异无统计学意义。i CIK培养后T细胞及CTL细胞比例、IL-2及IFN-γ水平显著增高。不良反应发生率为1.17%,无严重不良反应。结论 i CIK辅助治疗可延长OSCC患者无病生存期,减少复发或转移的发生,但未改变最终的预后,长期疗效有待进一步观察。i CIK高表达CD3+CD8+,分泌高浓度的Th1细胞因子,具有较强的细胞免疫及抗肿瘤能力,且治疗安全性良好。
Objective To study the curative effect of iCK-mediated adoptive treatment of oral squamous cell carcinoma (OSCC). Methods From July 2008 to April 2013, 60 OSCC patients were divided into i CIK group (surgery + i CIK group) and control group (surgical group) according to the treatment method. Patients with poor prognosis were treated with radiotherapy or radiotherapy and chemotherapy . The recurrence rate, survival rate, disease-free survival and overall survival of the two groups were calculated. The proportion of T lymphocyte subsets and the level of Th1 cytokines in peripheral blood mononuclear cells (PBMC) and i CIK cells in i CIK group before and after culture were analyzed. Results The recurrence and metastasis rate of i CIK group was lower than that of control group (16.67% vs 40.00%, χ2 = 4.022, P = 0.045), and the disease-free survival was higher than that of control group (50.96 ± 3.69 vs 38.15 ± 4.90, χ2 = 4.163, P = 0.041). However, there was no significant difference in mortality and overall survival between the two groups. CIK cultured T cells and CTL cells ratio, IL-2 and IFN-γ levels were significantly higher. The incidence of adverse reactions was 1.17%, no serious adverse reactions. Conclusions i CIK adjuvant therapy can prolong the disease-free survival and reduce the recurrence or metastasis in patients with OSCC. However, the long-term curative effect needs further observation without changing the final prognosis. i CIK high expression of CD3 + CD8 +, secretion of high concentrations of Th1 cytokines, with strong cellular immunity and anti-tumor ability, and the treatment of good security.