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增加 CIK 细胞过继免疫治疗的频率可能会降低胃癌患者的死亡风险。

Increasing the frequency of CIK cells adoptive immunotherapy may decrease risk of death in gastric cancer patients.

机构信息

Key Laboratory of Stem Cell of Jiangsu Province, Institute of Biotechnology, Key Laboratory of Clinical Immunology of Jiangsu Province, Soochow University, Suzhou 215123, Jiangsu Province, China.

出版信息

World J Gastroenterol. 2010 Dec 28;16(48):6155-62. doi: 10.3748/wjg.v16.i48.6155.

Abstract

AIM

to analyze the correlation between cytokine-induced killer (cik) cells adoptive immunotherapy and cancer-related death in gastric cancer patients. methods: One hundred and fifty-six gastric cancer patients after operation at the Third Affiliated Hospital of Soochow University were enrolled in this study. Their clinical data including demographic characteristics, operation time, tumor size, pathological type and staging, tumor metastasis, outcome of chemotherapy or CIK cells adoptive immunotherapy, survival time or time of death were collected with a standard structured questionnaire. Kaplan-Meier method was used to estimate the median survival time, and the 2- and 5- year survival rates. Hazard risk (HR) and 95% confidence interval (95% CI) of CIK cells adoptive immunotherapy for gastric cancer were calculated using the two-stage time-dependent covariates Cox model.

RESULTS

the survival time of gastric cancer patients was longer after CIK cells adoptive immunotherapy than after chemotherapy (χ(2) = 10.907, P = 0.001). The median survival time of gastric cancer patients was also longer after CIK cells adoptive immunotherapy than after chemotherapy (49 mo vs 27 mo, P < 0.05). The 2- and 5-year survival rates of gastric cancer patients were significantly higher after CIK cells adoptive immunotherapy than after chemotherapy (73.5% vs 52.6%, 40.4% vs 23.9%, P < 0.05). A significant difference was observed in the survival curve for patients who received CIK cells adoptive immunotherapy (0, 1-10, 11-25, and over 25 frequencies) (χ(2) = 14.534, P = 0.002). The frequencies of CIK cells adoptive immunotherapy were significantly related with the decreasing risk of death in gastric cancer patients after adjustment for sex and age of the patients, tumor stage and relapse (HR = 0.54, 95% CI: 0.36-0.80) when the first stage Cox model was used to define the subjects who remained alive beyond 36 mo as survivors. However, no correlation was observed between the frequencies of death in CIK cells adoptive immunotherapy and the risk of gastric cancer patients (HR = 1.09, 95% CI: 0.63-0.89) when the second stage Cox model was used to define the subjects who survived for more than 36 mo as survivors.

CONCLUSION

the survival time of the gastric cancer patients treated with chemotherapy combined with CIK cells adoptive immunotherapy is significantly longer than that of the patients treated with chemotherapy alone and increasing the frequency of CIK cells adoptive immunotherapy seems to benefit patients more.

摘要

目的

分析细胞因子诱导的杀伤(CIK)细胞过继免疫治疗与胃癌患者癌症相关死亡的相关性。方法:本研究纳入了 156 例在苏州大学附属第三医院接受手术的胃癌患者。通过标准结构问卷收集了他们的临床数据,包括人口统计学特征、手术时间、肿瘤大小、病理类型和分期、肿瘤转移、化疗或 CIK 细胞过继免疫治疗的结果、生存时间或死亡时间。Kaplan-Meier 法用于估计中位生存时间和 2 年及 5 年生存率。使用两阶段时依变量 Cox 模型计算 CIK 细胞过继免疫治疗对胃癌的危险风险(HR)和 95%置信区间(95%CI)。

结果

与化疗相比,接受 CIK 细胞过继免疫治疗的胃癌患者的生存时间更长(χ²=10.907,P=0.001)。与化疗相比,接受 CIK 细胞过继免疫治疗的胃癌患者的中位生存时间也更长(49 个月 vs 27 个月,P<0.05)。与化疗相比,接受 CIK 细胞过继免疫治疗的胃癌患者的 2 年和 5 年生存率显著更高(73.5% vs 52.6%,40.4% vs 23.9%,P<0.05)。接受 CIK 细胞过继免疫治疗的患者的生存曲线存在显著差异(0、1-10、11-25 和超过 25 次)(χ²=14.534,P=0.002)。当使用第一阶段 Cox 模型定义在 36 个月以上仍存活的患者为幸存者时,CIK 细胞过继免疫治疗的频率与胃癌患者死亡风险的降低显著相关,调整患者的性别和年龄、肿瘤分期和复发因素后(HR=0.54,95%CI:0.36-0.80)。然而,当使用第二阶段 Cox 模型定义在 36 个月以上存活的患者为幸存者时,CIK 细胞过继免疫治疗的频率与胃癌患者的死亡风险无相关性(HR=1.09,95%CI:0.63-0.89)。

结论

与单独化疗相比,接受化疗联合 CIK 细胞过继免疫治疗的胃癌患者的生存时间明显更长,增加 CIK 细胞过继免疫治疗的频率似乎对患者更有益。

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