Li Xiaofeng, Dai Dong, Song Xiuyu, Liu Jianjing, Zhu Lei, Xu Wengui
Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Huan-Hu-Xi Road, 300060 Ti-Yuan-Bei, He Xi District, Tianjin, PR China.
Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Huan-Hu-Xi Road, 300060 Ti-Yuan-Bei, He Xi District, Tianjin, PR China.
Clin Res Hepatol Gastroenterol. 2014 Oct;38(5):583-91. doi: 10.1016/j.clinre.2014.04.010. Epub 2014 Jun 9.
There was a continuing controversy on whether the adoptive transfusion of cytokine-induced killer cells (CIK) therapy should have been recommended to reduce the recurrence and metastasis of hepatocellular carcinoma (HCC) after minimally invasive therapy such as TACE (transarterial chemoembolization) or TACE plus RFA (radiofrequency ablation) treatment. The meta-analysis was conducted to compare the effectiveness of CIK cells transfusion therapy combined with TACE or TACE plus RFA treatment with that of minimally invasive therapy alone.
Relevant studies were identified by electronic search using a combination of "hepatocellular carcinoma" and "cytokine-induced killer cells". Overall survival (OS) rates and recurrence-free survival (RFS) rates were compared as the major outcome measures. The meta-analysis was divided into two sub-studies (sub-study 1: CIK+TACE+RFA versus TACE+RFA; sub-study 2: CIK+TACE versus TACE) to avoid the risk of bias as we could.
Meta-analysis data suggested that CIK cells transfusion therapy combined with TACE plus RFA treatment was associated with higher 1-year RFS rate (odds ratio [OR]=2.46) and 1-year, 2-year OS rates (OR: 1-year=2.09; 3-year=2.16) than TACE plus RFA treatment alone in sub-study 1. For sub-study 2, there were significant differences between CIK+TACE group and TACE group for OS rates (OR: half-year=3.29; 1-year=3.71; 2-year=7.37).
CIK cells transfusion therapy truly showed a synergistic effect for HCC patients after minimally invasive treatment especially for a long-term survival.
对于经动脉化疗栓塞术（TACE）或TACE联合射频消融术（RFA）等微创治疗后，是否应推荐采用细胞因子诱导的杀伤细胞（CIK）过继性输血疗法以降低肝细胞癌（HCC）的复发和转移，一直存在争议。本荟萃分析旨在比较CIK细胞输血疗法联合TACE或TACE联合RFA治疗与单纯微创治疗的有效性。
通过电子检索，结合“肝细胞癌”和“细胞因子诱导的杀伤细胞”进行相关研究的识别。将总生存率（OS）和无复发生存率（RFS）作为主要结局指标进行比较。为尽可能避免偏倚风险，将荟萃分析分为两个子研究（子研究1：CIK+TACE+RFA对比TACE+RFA；子研究2：CIK+TACE对比TACE）。
荟萃分析数据表明，在子研究1中，CIK细胞输血疗法联合TACE联合RFA治疗相比单纯TACE联合RFA治疗，1年RFS率更高（优势比[OR]=2.46），1年、2年OS率也更高（OR：1年=2.09；2年=2.16）。在子研究2中，CIK+TACE组和TACE组在OS率方面存在显著差异（OR：半年=3.29；1年=3.71；2年=7.37）。
CIK细胞输血疗法对于微创治疗后的HCC患者确实显示出协同效应，尤其是对于长期生存。
