| Objective:Discussion on cytokine induced killer cells(CIK cells) to evaluate the clinical efficacy of adoptive immunotherapy in the treatment of lung cancer.Methods:From 2013 november to 2015 February in Hebei province Cangzhou combine traditional Chinese and Western Medicine Hospital Department of internal medicine, tumor in the surgical patients in 27 cases, including male 18 cases, female 9 cases.All patients were pathologically diagnosed as lung cancer, recently not put, chemotherapy, 15 cases of small cell lung cancer,12 cases of non small cell lung cancer, according to the WHO classification standard. According to the grouping requirements select the same period in the treatment of 11 cases of lung cancer patients as control group; monitoring in the process of culture, proliferation activity and cell phenotype in CIK cells, Flow cytometry was used to dynamic monitoring of CIK cell in peripheral blood of patients with changes of immune function in T, Th1/Th2,Treg and NK cells after transfusion;by Roche automatic chemilumin- escence changes in patients with peripheral blood tumor markers PRO-GRP,CYFRA21-1,NSE levels after analyzer monitoring treatment; observat- ion of CIK cells after treatment, autoimmune clinical symptoms and patient change.Results:1 Treatment of CIK cells in patients with lung cancer than before cultured autologous group were significantly increased, in cultured fourth d started its rapid proliferation, 13~19d can reach the peak, the total number of CIK cells after culture can reach(5.10~8.98)×107/m L(average of 6.6×107/ m L).CD3+,CD56+T cells to obtain a large number of proliferation in the 2 weeks after the value-added ratio: 1.15 + 0.55% rise to 32.25 + 5.01%.2 The treatment group in CIK cells after treatment for 2 weeks, the peripheral blood CD3+,CD4+,CD4+/CD8+T cell were increased compared with before treatment, after treatment 4 weeks and reached the peak, then decreased gradually, but the indicators are still higher than the control group.CD3+T cells before treatment was 44.11 ± 5.12%, rose in fourth weeks to 72.31±7.11%, reduced to 55.12±5.12% in 8 weeks. CD4+T cells before treatment was 24.13± 5.13%, after treatment has increased, from fourth weeks to 41.32± 6.55%, reduced to 27.71±6.95 %in 8 weeks. CD4+CD8+ T cells were 1.03± 0.25 % before treatment, 1.99 ± 0.92 %to fourth weeks after the treatment, then decreased gradually,and the eighth weeks up to 1.35± 0.33%.3 The percentage of Treg cells in patients with lung cancer treatment group reduced gradually after treatment, the treatment group ratio from 8.98± 3.12% down to 5.92±1.99%, But NK cells compared with pretreatment levels, increased the proportion from 10.14±3.12% to 13.34±3.10%.4 The level of Th2 in peripheral blood of lung cancer treatment group decreased to the lowest, 28 days,Peripheral blood IL-2,INF-γlevels increased significantly after treatment, achieved the peak in 4 weeks, 8 weeks after the fall. IL-4 from 23.41±5.19 pg/ml before treatment continued to decline,and 4 weeks to reach 9.11±6.52pg/m L,picked up in the 8 week,reaching17.11±6.31 pg/ml,IL-10 from 16.31±5.17 pg/ml before treatment continuous decline, reaching 5.13±1.91pg/m L at week 4, increased in 8 weeks, up to 10.22±4.98 pg/ml, IL- 2 from 21.1± 8.98 pg/ml before treatment continuously increased, reaching 72.31±7.11pg/m L in 4 weeks, decreased at 8 weeks, up to 55.1±5.12 pg/ml, INF-γconsists of 29.13±9.88 pg/ml before the treatment continued to increase,reaching 61.71±10.03pg/m L in 4 weeks,decreased at 8 weeks, up to 35.28±9.18 pg/ml.5 CYFBA21-1,PRO-GRP, NSE and other tumor markers in were statistically significant difference before and after treatment of CIK cells. CYFBA21-1 decreased from 6.12±0.21 to 3.02±0.13 ng/ml,PROGRP is composed of 92.11±5.10 drops to 48.72±4.92pg/ml,NSE: from 29.44±2.95 down to 14.93±2.98ng/ml.6 27 cases of patients with lung cancer by CIK cells after treatment, the treatment of the patients with lung cancer after treatment group quality of life has improved significantly, no other adverse reactions during treatment.Conclusions:1 Lung cancer patients before and after the treatment in CIK cells, decreased significantly in most dynamic observation in the peripheral blood of patients with NSE,the CYFRA21-1 logo,PRO-GRP tumor,dynamic observati- on of therapeutic effect in patients with different types of lung cancer. Blood tumor markers appear before symptoms appear, can detect 1-6 months. Especially the occurrence of tumor recurrence and metastasis, blood tumor markers,than signs and imaging diagnosis of 3-6 months in advance. Therefore,tumor marker a means of monitoring object detection can be used as a standard treatment of CIK cells.2 Treatment of CIK cells play an important role in inhibiting immune Th1 Th2 drift and the restoration of balance of Th1/Th2,so that the lung cancer patients maintain a good state of anti tumor immunity.3 Increase the proportion of regulatory T cells is closely related to the occurrence, development,lung cancer, which had a negative effect on the antitumor immune reaction. In the autologous CIK after treatment, the ratio of Treg or its activity decreased obviously.4 CIK cell adoptive immunotherapy for lung cancer is not only a significant effect,can effectively improve and enhance the immune function of patients, and the side effect is small. Moreover, the patient’s immune system more perfect, more likely to benefit from immunotherapy. We should try to maintain and extend the antitumor immunity of patients with lung cancer itself. |
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