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目的探讨负载自体肿瘤抗原的树突状细胞(DC)联合细胞因子诱导的杀伤细胞(CIK细胞)在晚期肾癌治疗中的临床疗效,并监测患者的免疫状态及不良反应。方法回顾分析2011-01/2013-12期间在我科治疗的82例晚期肾癌患者,单采其外周血单个核细胞(PBMC),其中贴壁细胞经体外诱导产生DC,并负载自体肿瘤细胞裂解物(Ag)制备Ag-DC;T淋巴细胞经体外诱导产生CIK细胞,将Ag-DC与CIK细胞共培养制备Ag-DC-CIK瘤苗,检测DC表面分子的表达及IL-12的分泌,监测CIK细胞增殖情况,并将Ag-DC-CIK分次回输给其中41名患者,以41例单纯的CIK细胞治疗作为对照,治疗2疗程后,检测患者外周血细胞因子水平及T细胞亚群变化,结合影像学等检查综合评价疗效,同时观察不良反应。结果负载肿瘤细胞冻融抗原的DC,高表达CD11c、CD83、CD86、HLA-DR表面分子,IL-12的分泌显著增加。Ag-DC与CIK细胞共培养后,可明显刺激CIK细胞的增殖,同时CD3+CD8+细胞及CD3+CD56+细胞的含量明显增加,此外,Ag-DC-CIK瘤苗的临床疗效明显高于单纯CIK细胞治疗组,2组均未发生严重的不良反应。结论晚期肾癌PBMC来源的DC负载自身肿瘤细胞冻融抗原能提高晚期肾癌患者的免疫状态。
Objective To investigate the clinical efficacy of dendritic cells (DCs) loaded with autologous tumor antigen combined with cytokine-induced killer cells (CIK cells) in the treatment of advanced renal cell carcinoma and to monitor their immune status and adverse reactions. Methods A total of 82 patients with advanced renal cell carcinoma treated in our department from January 2011 to December 2013 were retrospectively analyzed. Peripheral blood mononuclear cells (PBMCs) were collected from the peripheral blood mononuclear cells (PBMCs). The adherent cells were induced by in vitro generation of DCs and loaded with autologous tumor cells The Ag-DC-CIK cells were co-cultured with CIK cells to produce CIK cells induced by T lymphocytes in vitro. The expression of DCs and the secretion of IL-12 , To monitor the proliferation of CIK cells, and to which 41 patients were divided into four groups. 41 cases of pure CIK cells were used as a control. After 2 cycles of treatment, the levels of peripheral blood cytokines and T cell subsets Change, combined with imaging and other tests comprehensive evaluation of efficacy, while observing adverse reactions. Results The DCs loaded with tumor cells freezing-thawing antigen showed high secretion of CD11c, CD83, CD86 and HLA-DR surface molecules, and IL-12 secretion. After co-cultured with CIK cells, the proliferation of CIK cells was obviously stimulated by Ag-DC and the levels of CD3 + CD8 + cells and CD3 + CD56 + cells were significantly increased. In addition, the clinical efficacy of Ag-DC-CIK cells was significantly higher than that of CIK Cell treatment group, two groups did not occur serious adverse reactions. CONCLUSION: DCs derived from PBMC derived from advanced renal cell carcinoma can enhance the immune status of patients with advanced renal cell carcinoma by freezing and thawing antigens of their own tumor cells.