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细胞因子诱导的杀伤细胞疗法在中国人群胃癌治疗中的积极作用:一项系统的Meta分析。

A Positive Role of Cytokine-Induced Killer Cell Therapy on Gastric Cancer Therapy in a Chinese Population: A Systematic Meta-Analysis.

作者信息

Liu Kang, Song Guiqin, Hu Xin, Zhou Yuchuan, Li Ying, Chen Qiaoling, Feng Gang

机构信息

Institute of Tissue Engineering and Stem Cells, North Sichuan Medical College, Nanchong, Sichuan, China (mainland).

Biotherapy Center, Nanchong Central Hospital, Nanchong, Sichuan, China (mainland).

出版信息

Med Sci Monit. 2015 Nov 4;21:3363-70. doi: 10.12659/msm.894504.

Abstract

BACKGROUND

Chemotherapy and radiation therapy provide limited improvement in survival of gastric cancer patients after tumor resection. It is essential to develop a novel therapeutics for gastric cancer. In the recent years, cytokine-induced killer cells (CIKs)-based adoptive immune therapy has been explored in gastric cancer patients. Due to the small number of patients included in each clinical trial and low-power statistical analysis, the effectiveness of this approach is still unclear. To address this issue, we systemically analyzed the relevant clinical trial data published in recent years by powerful statistical meta-analysis.

MATERIAL AND METHODS

Clinical data was searched by multiple electronic databases with a term "gastric cancer" and "cytokine-induced killer cells". Six relevant clinical trials with case-control studies were extracted for our meta-analysis, including 318 patients receiving CIK cell therapy and 369 patients receiving conventional therapy.

RESULTS

Overall survival (OS) and odds ratio (OR) were analyzed for patients at 1, 2, 3, and 5 years post-CIK cell therapy and post-conventional therapy. Heterogeneity and publication bias were analyzed for included data quality and publication bias. Our meta-analysis from 6 clinical trials suggests that CIK cell therapy significantly increased 5-year OS from 27±2.44% to 49±7.62% (p<0.05) and 5-year OR up to 1.77 (p<0.05). The increased 5-year survival rate was also highly correlated with the increased CD3+ T cell number and ratio of CD4+/CD8+ in the CIK treated patients.

CONCLUSIONS

CIK cell therapy significantly increased 5-year survival rate compared to conventional chemotherapy among gastric cancer patients. The study provides powerful statistical evidence for large-scale clinical trials with CIK cell therapy.

摘要

背景

化疗和放疗对胃癌患者肿瘤切除后的生存率改善有限。开发一种新的胃癌治疗方法至关重要。近年来,已在胃癌患者中探索基于细胞因子诱导杀伤细胞(CIK)的过继性免疫疗法。由于每项临床试验纳入的患者数量较少且统计分析功效较低,这种方法的有效性仍不明确。为解决这一问题,我们通过强大的统计荟萃分析系统地分析了近年来发表的相关临床试验数据。

材料与方法

通过多个电子数据库,以“胃癌”和“细胞因子诱导杀伤细胞”为关键词搜索临床数据。提取了六项相关的病例对照研究临床试验用于我们的荟萃分析,其中包括318例接受CIK细胞治疗的患者和369例接受传统治疗的患者。

结果

分析了CIK细胞治疗和传统治疗后1年、2年、3年和5年患者的总生存期(OS)和比值比(OR)。对纳入数据的质量和发表偏倚进行了异质性和发表偏倚分析。我们对6项临床试验的荟萃分析表明,CIK细胞治疗显著提高了5年总生存期,从27±2.44%提高到49±7.62%(p<0.05),5年比值比高达1.77(p<0.05)。CIK治疗患者5年生存率的提高也与CD3+T细胞数量增加以及CD4+/CD8+比值增加高度相关。

结论

与传统化疗相比,CIK细胞治疗显著提高了胃癌患者的5年生存率。该研究为CIK细胞治疗的大规模临床试验提供了有力的统计证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b688/4638280/822df6892e0a/medscimonit-21-3363-g001.jpg

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