Department of Supply Room, Shandong Binzhou Central Hospital, Binzhou, China.
J BUON. 2020 May-Jun;25(3):1643-1649.
To explore the efficacy and safety of irreversible electroporation (IRE) ablation combined with natural killer (NK) cells in the treatment of locally advanced pancreatic cancer (LAPC).
A total of 92 LAPC patients treated in our hospital from January 2016 to January 2017 were enrolled, and there were 46 cases of percutaneous IRE as IRE group, and 46 cases of IRE combined NK cell therapy as IRE-NK group. The clinical information of all the patients was collected, and the short-term efficacy, changes in the serum immunological indicators after treatment, carbohydrate antigen 19-9 (CA19-9) level, and incidence of adverse reactions were compared between the two groups of patients. Besides, the overall survival (OS) and disease-free survival (DFS) of patients were followed up and recorded.
On 1 month after treatment, all the patients underwent efficacy assessment, which showed the overall response rate of patients in IRE-NK group was significantly superior to that in IRE group. One and 7 days after operation, the level of CA19-9 was obviously raised in the two groups, with a statistically significant difference, and it declined 30 days postoperatively. Seven and 30 days after operation IRE-NK group had a notably lower level of CA19-9 than IRE group. After treatment, all the patients exhibited considerably higher lymphocyte count and notably enhanced lymphocyte function, and all the indicators in IRE-NK group were higher than those in IRE group. Besides, the levels of serum interleukin (IL)-2, TNF-β and IFN-γ in IRE-NK group were remarkably higher than those in IRE group, whereas there were no statistically significant differences in the levels of IL-4, IL-6 and IL-10 between the two groups. All the patients were followed up for 6-29 months, and there were no statistically significant differences in the DFS and OS between IRE group and IRE-NK group.
IRE ablation combined with NK cells has excellent efficacy in treating LAPC, and they can exert a synergistic treatment effect to enhance the immune function of patients and reduce CA19-9 expression, with tolerable adverse reactions.
探讨不可逆电穿孔（IRE）消融联合自然杀伤（NK）细胞治疗局部进展期胰腺癌（LAPC）的疗效和安全性。
选取 2016 年 1 月至 2017 年 1 月我院收治的 92 例 LAPC 患者，其中经皮 IRE 治疗 46 例（IRE 组），IRE 联合 NK 细胞治疗 46 例（IRE-NK 组）。收集所有患者的临床资料，比较两组患者的近期疗效、治疗后血清免疫指标变化、糖抗原 19-9（CA19-9）水平及不良反应发生率，随访并记录患者的总生存（OS）和无病生存（DFS）情况。
治疗后 1 个月对所有患者进行疗效评估，IRE-NK 组患者的总体缓解率明显优于 IRE 组。两组患者术后 1、7 天 CA19-9 水平明显升高，差异有统计学意义，术后 30 天下降；IRE-NK 组术后 7、30 天 CA19-9 水平明显低于 IRE 组。治疗后，所有患者的淋巴细胞计数明显升高，淋巴细胞功能明显增强，IRE-NK 组各项指标均高于 IRE 组。此外，IRE-NK 组血清白细胞介素（IL）-2、肿瘤坏死因子（TNF）-β和干扰素（IFN）-γ水平明显高于 IRE 组，而两组间 IL-4、IL-6 和 IL-10 水平差异无统计学意义。所有患者均随访 6-29 个月，IRE 组与 IRE-NK 组患者的 DFS 和 OS 差异均无统计学意义。
IRE 消融联合 NK 细胞治疗 LAPC 疗效确切，可发挥协同治疗作用，增强患者免疫功能，降低 CA19-9 表达，不良反应可耐受。
