目的： 比较自身免疫细胞联合放疗与单纯放疗后宫颈癌患者的细胞免疫功能变化和生存期差异。 方法: 68例宫颈癌患者，放疗组38例，联合治疗组30例；分离患者外周血单个核细胞（peripheral blood mononuclear cell，PBMC），分别诱导培养CD3AK细胞、CIK细胞（cytokine-induced killer cell )、树突状细胞（dendritic cell，DC）、γδT细胞和NK细胞。流式细胞术检测治疗前后患者外周血CD3+、CD4+、CD8+、CD19+、CD16+CD56+和γδT细胞的比例和数量及PBMC中穿孔素、颗粒酶B和CD107a阳性表达率。对患者进行5年随访。 结果: 联合治疗组大多患者生活质量均有改善，联合组卡氏评分高于放疗组（P<0.05）。联合组治疗后患者的免疫细胞绝对值显著高于放疗组（P<0.05）；PBMC的穿孔素、颗粒酶及CD107a均高于治疗前（P<0.05），并显著高于放疗组（P<0.05）。联合治疗组中，患者（Ⅰb-Ⅳ期）1、2和5年总生存率分别为93.3%（28/30）、83.3%（25/30）和76.6%（23/30），明显高于放疗组的86.82%（33/38）、68.4%（26/38）和57.9%（22/38）（P<0.05）；以Ⅱb和Ⅲ期患者疗效最显著。 结论: 放疗联合自身免疫细胞治疗宫颈癌能提高患者的免疫功能，并延长生存期。

Objective:To compare changes of cellular immune function and survival of cervical carcinoma patients receiving radiotherapy combined with self-immune cell therapy with those receiving radiotherapy alone. Methods: Sixty-eight cases of cervical carcinoma were divided into 2 groups: 38 cases in radiotherapy group; 30 cases in combination group (radiotherapy combined with self-immune cell therapy). Peripheral blood mononuclear cells (PBMCs) were separated, and then CD3AK cells, cytokine-induced killer cells (CIKs), dendritic cells (DCs), γδT cells and NK cells were induced and cultured. CD3+, CD4+, CD8+, CD19+, CD16+CD56+ and γδT cell numbers and ratios as well as the rate of positive expression of perforin, granzyme B (GraB), and CD107a of PBMCs were evaluated by FCM before and after treatment. The patients were followed by 5 years follow up study. Results: In most patients of the combination group, the quality of life was improved. The scores of Karnofsky in the combination group were significantly higher than those in the radiotherapy group (P<0.05). The immune cell numbers in the combination group were significantly higher than those in the radiotherapy group (P<005). The rates of the positive expression of perforin, GraB and CD107a of PBMCs were higher in the combination group than in the radiotherapy group correspondingly (P<0.05). The over-all 1-, 2- and 5-year survival rates of Ⅰb-Ⅳ stage patients were 93.3%(28/30), 83.3%(25/30) and 76.6%(23/30) in the combination group, and were 86.82%(33/38), 68.4%(26/38) and 57.9%(22/38) in the radiotherapy group, respectively (P<0.05) with Ⅱb and Ⅲ stage patients showing the most significance. Conclusion: Radiotherapy combined with self-immune cell therapy for cervical carcinoma can enhance the immune function and increase the survival.

南京军区医学科技创新基金资助项目（No. 11MA040）