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免疫化疗对一名晚期胆囊癌患者的临床疗效:病例报告

Clinical effect of immunochemotherapy for a patient with advanced gallbladder cancer: report of a case.

作者信息

Murakami K, Tanimura H, Yamaue H, Mizobata S, Noguchi K, Nakamori M, Shimamoto T

机构信息

Second Department of Surgery, Wakayama Medical School, Japan.

出版信息

Surg Today. 1998;28(9):923-8. doi: 10.1007/s005950050253.

Abstract

A 56-year-old woman was admitted presenting with a sensation of abdominal fullness. She was diagnosed to have advanced gallbladder cancer with carcinomatous peritonitis, as well as lymph node and liver metastases. We obtained highly purified tumor cells and tumor-infiltrating lymphocytes (TIL) from extirpated cervical lymph nodes and peritoneal effusion, and the chemosensitivity of these cells was tested with an MTT assay. Intensive chemotherapy with cisplatin (CDDP) and 5-fluorouracil (5-FU) was then performed according to the results of the MTT assay. Thereafter, cytotoxic T-lymphocytes (CTL) were induced in mixed cultures of autologous tumor cells and peripheral blood lymphocytes, and adoptive immunotherapy was performed with TIL and CTL. The malignant ascites and metastatic lesions disappeared after the intraperitoneal administration of CDDP and the transfer of TIL and CTL, and subsequently the patient's quality of life improved. This patient could return to work; however, liver metastasis was later observed, and she died 14 months after the initial diagnosis. Combination therapy with anticancer drugs and activated killer cells was thus found to be effective in a patient with advanced gallbladder cancer.

摘要

一名56岁女性因腹部胀满感入院。她被诊断为晚期胆囊癌伴癌性腹膜炎以及淋巴结和肝转移。我们从切除的颈部淋巴结和腹腔积液中获取了高度纯化的肿瘤细胞和肿瘤浸润淋巴细胞(TIL),并用MTT法检测了这些细胞的化疗敏感性。然后根据MTT检测结果进行了顺铂(CDDP)和5-氟尿嘧啶(5-FU)的强化化疗。此后,在自体肿瘤细胞和外周血淋巴细胞的混合培养物中诱导细胞毒性T淋巴细胞(CTL),并用TIL和CTL进行过继免疫治疗。在腹腔内注射CDDP以及输注TIL和CTL后,恶性腹水和转移灶消失,患者的生活质量随后得到改善。该患者能够重返工作岗位;然而,后来观察到肝转移,她在初次诊断后14个月死亡。因此,发现抗癌药物与活化杀伤细胞的联合治疗对一名晚期胆囊癌患者有效。

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