北京大学学报(医学版) ›› 2020, Vol. 52 ›› Issue (3): 597-602. doi: 10.19723/j.issn.1671-167X.2020.03.031

• 短篇论著 • 上一篇    下一篇

中性粒细胞与淋巴细胞比例对评估接受过继性细胞免疫治疗的晚期胰腺癌患者预后的临床意义

姜妮,乔国梁,王小利,周心娜,周蕾,宋雨光,赵艳杰,任军()   

  1. 首都医科大学附属北京世纪坛医院肿瘤内科,肿瘤治疗性疫苗北京市重点实验室,北京 100038
  • 收稿日期:2018-11-12 出版日期:2020-06-18 发布日期:2020-06-30
  • 通讯作者: 任军 E-mail:renjun9688@yahoo.com

  • Received:2018-11-12 Online:2020-06-18 Published:2020-06-30

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关键词: 中性粒细胞, 淋巴细胞, 胰腺肿瘤, 免疫治疗, 预后

中图分类号: 

  • R730.51

表1

患者的基线特征"

Variable NLR>2.5
(n=18)
NLR≤2.5
(n=29)
P
Age/years, x?±s 68.0±11.0 66.3±11.2 0.244
Gender 0.731
Female 9 16
Male 9 13
ECOG-PS 0.529
1 7 14
2 11 15
TNM staging 0.238
2 5
16 24
Site of metastasis 0.178
Liver 5 14
Lung 4 5
Peritoneum 6 11
Others 6 10
Disease control 0.026
Stable 14 13
Progressive 4 16
CA-199 0.684
≥12 000 9 13
<12 000 9 16

图1

不同NLR组的总体生存率(A)和无进展生存期(B)"

图2

接受DC-CIK治疗患者不同NLR组的总体生存率(A)和无进展生存期(B),以及未接受DC-CIK治疗患者不同NLR组的总体生存率(C)和无进展生存期(D)"

表2

多因素Cox比例风险回归分析患者临床特征及生存"

Variables PFS OS
HR (95%CI) P value HR (95%CI) P value
ECOG-PS: 2 1.087 (0.716-1.358) 0.562 0.873 (0.761-1.132) 0.833
TNM staging: Ⅳ 1.003 (0.882-1.132) 0.638 0.944 (0.839-1.241) 0.793
NLR≤2.5 1.725 (1.448-3.103) 0.027 2.104 (1.582-4.372) 0.010
Infusion cycles 1.024 (0.899-1.219) 0.483 0.918 (0.721-1.149) 0.832
DC-CIK combined S-1 0.383 (0.127-0.639) 0.001 0.303 (0.147-0.659) 0.012

图3

第1周期DC-CIK治疗前后外周血T细胞表型"

[1] Del Chiaro M, Segersvard R, Lohr M, et al. Early detection and prevention of pancreatic cancer: is it really possible today?[J]. World J Gastroenterol, 2014,20(34):12118-12131.
doi: 10.3748/wjg.v20.i34.12118 pmid: 25232247
[2] Yabar CS, Winter JM. Pancreatic cancer: A review[J]. Gas-troenterol Clin North Am, 2016,45(3):429-445.
[3] Zhang Y, Zhang X, Zhang A, et al. Clinical applications of dendritic cells-cytokine-induced killer cells mediated immunotherapy for pancreatic cancer: an up-to-date meta-analysis[J]. Onco Targets Ther, 2017,10:4173-4192.
[4] Lin M, Liang S, Jiang F, et al. 2003-2013, a valuable study: Autologous tumor lysate-pulsed dendritic cell immunotherapy with cytokine-induced killer cells improves survival in stage Ⅳ breast cancer[J]. Immunol Lett, 2017,183(3):37-43.
[5] Koizumi W, Kurihara M, Nakano S, et al. Phase Ⅱ study of S-1, a novel oral derivative of 5-fluorouracil, in advanced gastric cancer. For the S-1 Cooperative Gastric Cancer Study Group[J]. Oncology, 2000,58(3):191-197.
pmid: 10765119
[6] Hagihara K, Ikeda M, Maeda S, et al. Effectiveness of irinotecan, S-1, and bevacizumab for rectal cancer with lung and skin metastases after adjuvant chemotherapy[J]. Gan To Kagaku Ryoho, 2016,43(12):2313-2315.
[7] Ueno H, Ioka T, Ikeda M, et al. Randomized phase Ⅲ study of gemcitabine plus S-1, S-1 alone, or gemcitabine alone in patients with locally advanced and metastatic pancreatic cancer in Japan and Taiwan: GEST study[J]. J Clin Oncol, 2013,31(13):1640-1648.
pmid: 23547081
[8] Morizane C, Okusaka T, Furuse J, et al. A phase Ⅱ study of S-1 in gemcitabine-refractory metastatic pancreatic cancer[J]. Cancer Chemother Pharmacol, 2009,63(2):313-319.
doi: 10.1007/s00280-008-0741-7
[9] Jiang N, Qiao G, Wang X-L, et al. Dendritic cell/cytokine induced killer cell immunotherapy combined with S-1 in patients with advanced pancreatic cancer: A prospective study[J]. Clin Cancer Res, 2017,23(17):5066-5073.
[10] Hainaut P, Plymoth A. Targeting the hallmarks of cancer: towards a rational approach to next-generation cancer therapy[J]. Curr Opin Oncol, 2013,25(1):50-51.
pmid: 23150341
[11] Jaiswal M, LaRusso NF, Burgart LJ, et al. Inflammatory cytokines induce DNA damage and inhibit DNA repair in cholangiocarcinoma cells by a nitric oxide-dependent mechanism[J]. Cancer Res, 2000,60(1):184-190.
[12] He W, Yin C, Guo G, et al. Initial neutrophil lymphocyte ratio is superior to platelet lymphocyte ratio as an adverse prognostic and predictive factor in metastatic colorectal cancer[J]. Med Oncol, 2013,30(1):439.
pmid: 23307251
[13] Luo G, Liu C, Cheng H, et al. Neutrophil-lymphocyte ratio predicts survival in pancreatic neuroendocrine tumors[J]. Oncol Lett, 2017,13(4):2454-2458.
pmid: 28454419
[14] Chen Y, Yan H, Wang Y, et al. Significance of baseline and change in neutrophil-to-lymphocyte ratio in predicting prognosis: a retrospective analysis in advanced pancreatic ductal adenocarcinoma[J]. Sci Rep, 2017,7(1):753.
pmid: 28392554
[15] Formica V, Morelli C, Ferroni P, et al. Neutrophil/lymphocyte ratio helps select metastatic pancreatic cancer patients benefitting from oxaliplatin[J]. Cancer Biomark, 2016,17(3):335-345.
pmid: 27434293
[16] Ren J, Di L, Song G, et al. Selections of appropriate regimen of high-dose chemotherapy combined with adoptive cellular therapy with dendritic and cytokine-induced killer cells improved progression-free and overall survival in patients with metastatic breast cancer: reargument of such contentious therapeutic preferences[J]. Clin Transl Oncol, 2013,15(10):780-788.
pmid: 23359185
[17] 王艺, 王理伟. 胰腺癌患者免疫状态及免疫治疗进展[J]. 肿瘤, 2018,38(6):610-616.
[18] Meng Y, Yu Z, Wu Y, et al. Cell-based immunotherapy with cytokine-induced killer (CIK) cells: From preparation and testing to clinical application[J]. Hum Vaccin Immunother, 2017,13(6):1-9.
pmid: 28301266
[19] Chen J, Chen Y, Feng F, et al. Programmed cell death protein-1/programmed death-ligand 1 blockade enhances the antitumor efficacy of adoptive cell therapy against non-small cell lung cancer[J]. J Thorac Dis, 2018,10(12):6711-6721.
pmid: 30746216
[20] Wang Q, Liu Y, Chen Y, et al. CD300LG improves the cytotoxic activity of CIK[J]. Cent Eur J Immunol, 2017,42(2):117-122.
pmid: 28860929
[21] Xue P, Kanai M, Mori Y, et al. Neutrophil-to-lymphocyte ratio for predicting palliative chemotherapy outcomes in advanced pancreatic cancer patients[J]. Cancer Med, 2014,3(2):406-415.
pmid: 24519894
[22] Li Y, Wang C, Xu M, et al. Preoperative NLR for predicting survival rate after radical resection combined with adjuvant immunotherapy with CIK and postoperative chemotherapy in gastric cancer[J]. J Cancer Res Clin Oncol, 2017,143(5):861-871.
doi: 10.1007/s00432-016-2330-1 pmid: 28108815
[23] Kusumanto YH, Dam WA, Hospers GA, et al. Platelets and granulocytes, in particular the neutrophils, form important compartments for circulating vascular endothelial growth factor[J]. Angiogenesis, 2003,6(4):283-287.
doi: 10.1023/B:AGEN.0000029415.62384.ba pmid: 15166496
[24] Salazar-Onfray F, Lopez MN, Mendoza-Naranjo A. Paradoxical effects of cytokines in tumor immune surveillance and tumor immune escape[J]. Cytokine Growth Factor Rev, 2007,18(1-2):171-182.
doi: 10.1016/j.cytogfr.2007.01.015 pmid: 17329145
[25] Kobayashi N, Hiraoka N, Yamagami W, et al. FOXP3+ regulatory T cells affect the evelopment and progression of hepatocarcinogenesis[J]. Clin Cancer Res, 2007,13(3):902-911.
doi: 10.1158/1078-0432.CCR-06-2363 pmid: 17289884
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