目的：评价肿瘤特异性个体化多靶点自体树突状细胞-细胞因子诱导的杀伤细胞（DC-CIK）治疗中晚期原发性肝癌 （PLC）的临床疗效与安全性。方法：回顾性分析2019年10月至2021年9月东部战区总医院肿瘤科行DC-CIK治疗的119例中晚 期PLC患者的临床资料。根据患者治疗时负载DC的抗原不同将患者分为两组，一组使用患者自体特异性多肽负载为pDC-CIK 组（n = 21），另一组使用肿瘤细胞裂解物负载为DC-CIK组（n = 98）。分析两组患者治疗前后的临床资料，包括治疗效果和治疗 前后甲胎蛋白、淋巴细胞亚群、细胞因子（IL-2、IFN-γ、TNF-α和IL-6）水平的变化、不良反应发生情况等。结果：119例PLC患者 治疗后，pDC-CIK和DC-CIK组两组客观缓解率均为0%，疾病控制率分别为76.1%和72.4%（P > 0.05）。治疗后两组患者CD3+ 、 CD4+ 、CD8+ 、CD56+ 、CD25+ 和CD4+ /CD8+ T淋巴细胞水平无统计学差异（均P > 0.05），治疗后两组患者外周血IL-2、IFN-γ、TNF-α 和IL-6的平均水平均显著高于治疗前（均P < 0.001），两组患者治疗后外周血IL-2、TNF-α和IL-6的平均水平无显著差异（均P > 0.05），而pDC-CIK组IFN-γ水平显著高于DC-CIK组（P < 0.05）。pDC-CIK组患者平均生存时间为59.84个月，高于DC-CIK组的 46.54个月，但无统计学差异（P = 0.16）。治疗过程中无严重不良反应的发生。结论：PLC 患者行肿瘤特异性个体化多靶点 DC-CIK治疗是安全有效的，并能改善免疫功能，相较肿瘤细胞裂解物负载DC-CIK有进一步获益趋势。

Objective: To evaluate the clinical efficacy and safety of tumor-specific individualized multi-target autologous dendritic cells (DC)-cytokine-induced killer cells (CIK) in patients with advanced primary liver cancer (PLC). Methods: The clinical data of 119 patients with advanced PLC who received DC-CIK therapy in the Oncology Department of the General Hospital of the Eastern Theater Command from October 2019 to September 2021 were retrospectively analyzed. Patients were divided into two groups based on the type of antigen used to load DCs during treatment: the pDC-CIK group (n = 21) that used patient-specific polypeptide loaded DCs and the DC-CIK group (n = 98) that used tumor cell lysate-loaded DCs. Clinical data of the two groups before and after treatment were analyzed, including the treatment efficacy and the changes in fetoprotein, lymphocyte subsets, cytokines (IL-2, IFN-γ, TNF-α and IL-6), and adverse reactions. Results: Amont the 119 PLC patients, the objective response rates in both the pDC-CIK and DC-CIK groups were 0%, with disease control rates of 76.1% and 72.4%, respectively (P > 0.05). There was no statistical difference in the levels of CD3+ , CD4+ , CD8+ , CD56+ , CD25+ , CD4+ /CD8+ T lymphocytes between the two groups after treatment (all P > 0.05). However, both groups experienced significantly increased mean levels of IL-2, IFN-γ, TNF-α and IL-6 in peripheral blood after treatment (all P < 0.001). There was no significant difference in the mean levels of IL-2, TNF-α and IL-6 in peripheral blood between the two groups after treatment (all P > 0.05), but the IFN-γ level was significantly higher in the pDC-CIK group than that in the DC-CIK group (P < 0.05). The average survival time of patients in the pDC-CIK group was 59.84 months, which was slightly higher than 46.54 months in the DC-CIK group (P > 0.05). No serious adverse reactions occurred during the treatment. Conclusion: Tumor-specific individualized multi-targeted DC-CIK therapy is safe and effective for PLC patients and can enhance immune function, with a trend toward further benefits compared to tumor cell lysate-loaded DC-CIK therapy.

东部战区总医院院管课题（No. 22JCYYYB1）