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恶性胸水常是晚期癌症常见的并发症之一,消除胸水可以提高患者的生存质量,自1996年12月至1998年12月,我们应用肿瘤浸润性淋巴细胞(Tumor Infiltrating Lymphocytes TIL)治疗了38例恶性胸水患者,现将结果报告如下: 1 临床资料 1.1 病例选择 38例患者均经B超,胸片,CT,病理或细胞学确诊,预计生存期>3个月。男性20例,女性18例;年龄39岁～81岁,平均年龄58岁;原发肿瘤:肺癌21例,乳腺癌7例,胃癌3例,结肠癌2例,肾透明细胞癌、恶性间皮瘤、卵巢癌各1例,原发灶不明的腺癌2例。 1.2 TIL液的制备 常规消毒无菌条件下抽取癌性胸1500ml以上,梯度密度离心分离纯化淋巴细胞,用含有白介素2(IL—Ⅱ)1000U/ml,及含10％的人AB血清的RPMI 1640液培养3天,常规换液,再培养4天,倒置镜检无癌细胞。输入前进行细菌检测,台盘兰染色,活细胞数不少于90％。 1.3 治疗方法 采取患侧胸腔内注入的方法,临床上常规胸腔穿刺,尽量抽取胸水,然后把培育好的TIL细胞悬液30ml(含TIL细胞数0.5～1.0×10~9)
Malignant pleural effusion is one of the common complications of advanced cancer. Eliminating pleural effusion can improve the quality of life of patients. From December 1996 to December 1998, we treated 38 patients with Tumor Infiltrating Lymphocytes TIL Malignant pleural effusion, the results are reported as follows: 1 Clinical data 1.1 Case Selection 38 patients were diagnosed by B-, chest X-ray, CT, pathology or cytology, the expected survival of> 3 months. 20 males and 18 females; aged 39 to 81 years, mean age 58 years; primary tumors: 21 cases of lung cancer, 7 cases of breast cancer, 3 cases of gastric cancer, 2 cases of colon cancer, 2 cases of clear cell carcinoma of renal cell and malignant mesothelioma 1 case of tumor and ovarian cancer, 2 cases of primary adenocarcinoma of unknown origin. 1.2 Preparation of TIL fluid Conventional sterile sterilization under sterile conditions extracted more than 1500ml of cancer, centrifugal separation and purification of lymphocytes by gradient density, with interleukin 2 (IL-Ⅱ) 1000U / ml, and containing 10% of human AB serum RPMI 1640 Liquid culture for 3 days, conventional liquid exchange, and then cultured for 4 days, inverted microscope without cancer cells. Enter bacteria test before import, Panlan staining, the number of viable cells is not less than 90%. 1.3 treatment of ipsilateral thoracic injection method, clinically conventional thoracentesis, try to extract pleural effusion, and then cultivate good TIL cell suspension 30ml (containing TIL cell number 0.5 ~ 1.0 × 10 ~ 9)