目的 评估采用负载抗原的DC疫苗联合多种细胞因子诱导的杀伤细胞(CIK)、γδ受体的T细胞(γδT)和自然杀伤细胞(NK)治疗非小细胞肺癌的近期疗效与不良反应。方法 经机采后分离出单个核细胞(peripheral blood mononuclear cell, PBMC),体外经相应的细胞因子诱导产生DC、γδT、CIK和NK细胞。所有患者接受一疗程治疗,即静脉输注或皮内注射4次DC疫苗,静脉输注γδT、CIK各3次,静脉输注NK细胞2次,共12次治疗。通过影像学检查及外周血T淋巴细胞亚群改变评估疗效和免疫学反应。结果 22例有可评价病灶的患者中9例部分缓解(PR),11例疾病稳定(SD),2例进展(PD);2例没有可评价病灶中1例PD,1例未见疾病进展。与治疗前比较,治疗2个月后CD3⁺、CD4⁺、CD56⁺有较大升高,差异有统计学意义(P<0.01)。结论 负载抗原的DC疫苗联合多种T细胞治疗非小细胞肺癌有一定的近期临床疗效,能诱导出特异的抗非小细胞肺癌免疫反应。

Objective To evaluate the clinical efficacy and adverse reaction of antigen-loaded dendritic cells(DC)vaccine in combination with cytokine-induced killer cells(CIK), gamma delta receptors of T cells(γδT)and natural killer cells(NK)on 24 patients with lung cancer. Methods Mononuclear cells isolated by blood apheresis were induced into productions of DC, γδT, CIK and NK cells by corresponding cytokines in vitro. All patients received a course of treatment including intravenous infusion and intradermal injection of DC vaccine for four times, intravenous infusion of γδT, CIK each 3 times and intravenous infusion of NK cells twice, a total of 12 times. Clinical and immunologic responses were evaluated by imaging examination,T lymphocytes subset changes, respectively. Results 22 patients were enrolled in this study. During 5-24 months follow-up(median,10 months),partial remission(PR)in 9 cases,stability of disease(SD) in 11 cases,and progression of disease(PD) in 2 cases was identified with measurable diseases progress. After 2 months treatment,the levels of CD3⁺、CD4⁺、CD56⁺ increased very significantly(P<0.001). No severe adverse events were observed except 2 patients with mild fever and 1 patient had muscular soreness. Conclusions Antigen-pulsed DCs in combination with various T cells shows short-term efficacy on lung cancer through inducing specific antitumor immunity.