目的：评价胃癌患者术后化疗联合细胞因子诱导的杀伤细胞（cytokine-induced killer cell,CIK）治疗的临床疗效。方法：收集1999年3月至2007年12月在天津医科大学附属肿瘤医院65例胃癌术后化疗联合CIK治疗的患者（化疗联合CIK治疗组）及同期对照130例术后单纯化疗的胃癌患者（单纯化疗组），比较两组的生存率及生存时间；分析受试者工作特征（receiver operating characteristic，ROC）曲线，确定化疗周期数与CIK治疗次数的分组点；Kaplan-Meier法绘制两组患者的生存曲线，Log-rank法检测两组患者的生存差异。结果：化疗联合CIK治疗组胃癌患者的3、5年总生存率稍高于单纯化疗组，但差异无统计学意义（60% vs 47%，55% vs 23%，P>0.05）。化疗联合CIK治疗组胃癌患者的3、5年无进展生存率明显高于单纯化疗组（48% vs 31%，47% vs 20%，P<0.05）。化疗联合CIK治疗组患者的中位生存时间（overall survival，OS）为96个月，明显高于单纯化疗组的32个月（P=0.001）；化疗联合CIK治疗组患者的中位无病进展时间（progression-free survival，PFS）为36个月，高于单纯化疗组的23个月（P=0.011）。单因素分析发现，TNM分期、化疗周期数和CIK治疗周期数与胃癌患者的OS相关；TNM分期、手术方式和CIK治疗周期数与患者的PFS相关。多因素结果显示，化疗周期数是影响OS的独立危险因素，CIK治疗周期数不仅是影响OS，也是影响PFS的独立危险因素。结论：与术后单纯化疗相比，化疗联合CIK治疗明显延长胃癌患者的OS，而且CIK治疗次数增加，临床疗效会更显著。

Objective:To estimate the clinical efficacy of chemotherapy combined with cytokine-induced killer cell（CIK）treatment after curative resection for gastric cancer patients. Methods: 65 gastric cancer patients treated with chemotherapy combined with CIK (chemotherapy combined with CIK group) and 130 patients treated with chemotherapy only after radical gastrectomy (chemotherapy-only group) were included in this study (from March 1999 to December 2007 in Affiliated Cancer Hospital of Tianjin Medical University). The survival rate and live time was compared between two groups. The receiver operating characteristic (ROC) was analyzed, and the periodicity of chemotherapy and the frequency of CIK treatment was determined. The survival curve was made by Kaplan-Meier method, and the survival difference was compared by Log-rank test. Results: The overall 3- and 5-year survival rates of the chemotherapy combined with CIK group were slightly higher than those of the chemotherapy-only group, and without significant difference (60% vs 47%, 55% vs 23%, P>005). The 3- and 5-year progression free survival rates of the chemotherapy combined with CIK group were lower than those of the chemotherapy-only group (48% vs 31%, 47% vs 20%, P<0.05). The median overall survival (OS) of chemotherapy combined with CIK group was 96 months, which was longer than that of 32 months in the chemotherapy-only group (P=0.001). The median progression free survival (PFS) was 36 months in the chemotherapy combined with CIK group and was longer than that of 23 months in the chemotherapy-only group (P=0.011). In univariate analysis, the TNM stage, chemotherapy cycle and CIK frequency were related to OS of the patients; the TNM stage, the modes of surgery and CIK frequency were related to PFS of patients. Multivariate analysis revealed that the chemotherapy cycle independently influenced OS. However, CIK frequency was an independent risk factor of both OS and PFS. Conclusion: OS is significantly longer in the gastric patients treated with chemotherapy combined with CIK than the patients treated with chemotherapy alone, and the higher CIK frequency shows more clinical benefits.

国家自然科学基金资助项目（No.30901754，No.20090133）