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医学临床研究  2022, Vol. 39 Issue (8): 1202-1205    DOI: 10.3969/j.issn.1671-7171.2022.08.022
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同步放化疗联合DC-CIK细胞免疫治疗对NSCLC患者的预后及其肿瘤标志物的影响
袁应选1, 李桥涛2*, 袁琳3
1.西安电力中心医院检验科,陕西 西安 710032;
2.榆林市中医医院普外一科,陕西 榆林 719000;
3.西安市第一医院医学检验科,陕西 西安 710000
Prognosis and Tumor Marker Changes of Concurrent Chemoradiotherapy Combined with DC-CIK Cell Immunotherapy in NSCLC
YUAN Ying-xuan, LI Qiao-tao, YUAN Lin
Department of Laboratory Medicine,Xi'an Electric Power Central Hospital,Xi'an Shaanxi 710032
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摘要 【目的】探讨同步放化疗联合树突状细胞-细胞因子诱导的自然杀伤(DC-CIK)细胞免疫治疗对非小细胞肺癌(NSCLC)患者的预后及肿瘤标志物水平的影响。【方法】72例NSCLC患者,随机分为对照组和观察组,每组36例。对照组采用TP方案(紫杉醇+顺铂)联合调强适形放疗(IMRT)治疗,观察组在对照组基础上联合DC-CIK细胞免疫治疗。比较两组疗效及治疗前后外周血T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+),血清微小RNA-137(miR-137)、微小RNA-29a(miR-29a)和血清肿瘤标志物[糖类抗原125(CA-125)、癌胚抗原(CEA)、细胞角蛋白19片段抗原21-1(CYFRA21-1)]水平的变化,比较两组不良反应发生率。【结果】观察组客观缓解率(RR)为94.44%(34/36),高于对照组的77.78%(28/36)(P<0.05)。两组治疗后CD3+、CD4+、CD4+/CD8+较治疗前升高(P<0.05),CD8+较治疗前降低(P<0.05);且观察组治疗后CD3+、CD4+、CD4+/CD8+均高于对照组(P<0.05),CD8+与对照组比较,差异无统计学意义(P>0.05)。两组治疗后miR-137、miR-29a和CA-125、CEA、CYFRA21-1水平较治疗前降低(P<0.05),且观察组治疗后各指标水平低于对照组(P<0.05)。两组不良反应发生率相比较,差异无统计学意义(P>0.05)。【结论】同步放化疗联合DC-CIK细胞免疫治疗可提高NSCLC患者疗效,下调miR-137、miR-29a表达,改善患者免疫功能及血清肿瘤标志物水平,且不良反应发生风险低,值得临床推广。
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袁应选
李桥涛
袁琳
关键词 癌, 非小细胞肺/药物疗法癌,非小细胞肺/放射疗法免疫疗法预后    
Abstract:【Objective】To investigate the effect of concurrent chemoradiotherapy combined with dendritic cell-cytokine-induced natural killer (DC-CIK) cell immunotherapy on the prognosis and tumor marker levels of non-small cell lung cancer (NSCLC). 【Methods】Seventy-two NSCLC patients were randomly divided into the control group and the observation group,with 36 cases in each group. The control group was treated with TP regimen (paclitaxel + cisplatin) combined with intensity-modulated radiotherapy (IMRT),while the observation group was treated with DC-CIK cellular immunotherapy on the basis of treatment in the control group. The curative effect,peripheral blood T lymphocyte subsets (CD3+,CD4+,CD8+,CD4+/CD8+),serum microRNA-137 (miR-137),microRNA-29a (miR-29a) and serum tumor markers were compared between the two groups before and after treatment. Changes in the levels of substances [carbohydrate antigen 125 (CA-125),carcinoembryonic antigen (CEA),cytokeratin 19 fragment antigen 21-1(CYFRA21-1)] were compared as well. The incidence of adverse reactions in the two groups was observed. 【Results】The objective remission rate (RR) of the observation group was 94.44% (34/36),which was higher than that of the control group of 77.78% (28/36) (P<0.05). After treatment,CD3+,CD4+,CD4+/CD8+ in the two groups were higher than those before treatment (P<0.05),and CD8+ was lower than those before treatment (P<0.05). And after treatment,CD3+,CD4+,CD4+/CD8+ in the observation group were higher than those in the control group (P<0.05),there was no significant difference in CD8+ compared with the control group (P>0.05). After treatment,the levels of miR-137,miR-29a,CA-125,CEA,and CYFRA21-1 in the two groups were lower than those before treatment (P<0.05); and the levels of each index in the observation group were lower than those in the control group after treatment (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】Concurrent chemoradiotherapy combined with DC-CIK cellular immunotherapy can improve the curative effect of NSCLC patients,down-regulate the expression of miR-137 and miR-29a,improve the immune function and serum tumor markers of patients. And the risk of adverse reactions is low,which is worthy of clinical promotion.
Key wordsCarcinoma, Non-Small-Cell Lung/DT    Carcinoma, Non-Small-Cell Lung/RT    Immunotherapy    Prognosis
收稿日期: 2022-03-15     
中图分类号:  R734.2  
通讯作者: *E-mail:410406029@qq.com   
引用本文:   
袁应选, 李桥涛, 袁琳. 同步放化疗联合DC-CIK细胞免疫治疗对NSCLC患者的预后及其肿瘤标志物的影响[J]. 医学临床研究, 2022, 39(8): 1202-1205.
YUAN Ying-xuan, LI Qiao-tao, YUAN Lin. Prognosis and Tumor Marker Changes of Concurrent Chemoradiotherapy Combined with DC-CIK Cell Immunotherapy in NSCLC. JOURNAL OF CLINICAL RESEARCH, 2022, 39(8): 1202-1205.
链接本文:  
http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2022.08.022     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2022/V39/I8/1202
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