[摘 要] 目的：回顾性分析树突状细胞-细胞因子诱导的杀伤细胞（DC-CIK）不同抗原负载后在治疗恶性黑色素瘤（MM）中的 临床疗效与安全性。方法：采集2012年10月至2024年12月期间东部战区总医院秦淮医疗区收治的42例晚期MM患者的外周 血单个核细胞，经实验室体外诱导培养成DC和CIK。根据患者HLA-A2的表达将患者分为多肽组和细胞组，多肽组负载混合多 肽，细胞组负载肿瘤细胞A375裂解物。DC与CIK培养成熟后再回输给患者。比较两组患者的客观临床反应及生存期，检测治 疗前后两组患者外周血淋巴细胞亚群，观察患者回输后的不良反应。结果：42例MM患者中，0例达CR，0例PR，31例SD，11例 PD；其中，多肽组18例SD，6例PD，细胞组13例SD，5例PD。多肽组疾病控制率为75.0%，细胞组为72.2%；42例患者中死亡12 例，其中细胞组4例，多肽组8例。1年OS率多肽组为76.6%，细胞组为66.7%；2年OS率多肽组为43.8%，细胞组为66.7%；3年OS 率多肽组为43.8%，细胞组为33.3%，多肽组 3 年 OS 率略高于细胞组，但两组之间无统计学差异（P = 0.445）。两组MM患者 治疗前后淋巴细胞亚群无显著差异（均P > 0.05），两组患者均未出现严重不良反应。结论：细胞负载DC-CIK与混合多肽负载 DC-CIK治疗MM患者是安全的，能使患者临床获益，但两组的近期疗效和长期生存有差异以及免疫反应均无显著性差异。

[Abstract] Objective: To retrospectively analyze the clinical efficacy and safety of DC-CIK loaded with different antigens in the treatment of malignant melanoma (MM). Methods: Peripheral blood mononuclear cells were collected from 42 melanoma patients admitted to the Qinhuai Medical Area of Eastern Theater General Hospital between October 2012 and December 2024. DCs and CIKs were induced and cultured in vitro in the laboratory. Patients were divided into a polypeptide group and a cell group based on their HLA-A2 expression. The polypeptide group was loaded with a mixed peptide cocktail, and the cell group was loaded with lysate from the tumor cell A375. After maturation, DC and CIK were reinfused into the patients. The objective clinical response and survival period of the two groups of patients were compared. Peripheral blood lymphocyte subsets of the two groups of patients were detected before and after treatment, and adverse reactions after reinfusion were observed. Results: Among the 42 patients, 0 achieved CR; 0 achieved PR; 31 had SD, and 11 had PD. Specifically, in the peptide group, 18 had SD and 6 had PD; in the cell group, 13 had SD and 5 had PD. The disease control rate (DCR) was 75% in the polypeptide group and 72.2% in the cell group. Among the 42 patients, 12 died (4 in the cell group, 8 in the polypeptide group). The 1-year OS rate was 76.6% in the polypeptide group vs 66.7% in the cell group; the 2-year survival rate was 43.8% vs 66.7%; the 3-year survival rate was 43.8% .33.3%. The 3-year OS rate of the polypeptide group was slightly higher than that of the cell group, with no significant difference between the two groups (P = 0.445). Lymphocyte subsets of the two groups of MM patients before and after treatment showed no significant difference（P > 0.05）. No severe adverse reactions occurred in either group. Conclusion: Both tumor cell-loaded DC-CIK therapy and mixed polypeptide-loaded DC-CIK therapy are safe for MM patients and can provide clinical benefits. However, there are no significant differences in short-term efficacy, long-term survival, or immune responses between the two methods.

[基金项目] 2022东部战区总医院院管课题（No. 22JCYYYB1）