進行腎細胞癌に対するInterferon-γ療法の免疫学的検討

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対象は他臓器転移を有する腎癌患者6名である.IFN-γ1,000万/JRU/m2を1日1回点滴静注により5日間連続投与した後,9日間休薬した.これを2回繰り返した後,同量隔日3回投与し9日休薬し,さらに同量を3回隔日投与した.IFN-γ投与前後で,末梢血のリンパ球数,単球数に変動はなかった.CD 4陽性細胞は減少し,逆にCD 8陽性細胞は有意に増加した.CD 16細胞も有意に増加し,Leu HLA-DRの値も有意に増加した.NK活性は増加の傾向,非誘導LAK活性は有意の増加を示した.血清ネオプテリン値も有意に増加した.臨床的にIFN投与により画像診断的に転移巣の縮小はなかった.1例は投与10ヵ月後,1例は3ヵ月後,2例は1ヵ月後に死亡したImmunologic and anti-tumor effects of interferon-gamma were studied in six patients with advanced renal cell carcinoma. A daily dose of 10 x 10(6) JRU/m2 of interferon-gamma (IFN-gamma) was given consecutively for five days and the treatment reiterated nine days later. Then the same dose was given every two days for three times and this regimen was also reiterated nine days later. Peripheral blood lymphocytes were analyzed before and one, three, five and eight weeks after the initial administration of IFN-gamma. Although the total number of lymphocytes and monocytes were not changed, CD8 (23.4 to 31.2%, p < 0.05), CD16 (12.4 to 19.3%, p < 0.01) and LeuHLA-DR (29.0 to 39.5%, p < 0.01) positive lymphocytes were significantly increased after the therapy. Non-induced LAK activity (0.6 to 10.8%, p < 0.05) and serum neopterin (3.5 to 10.8 nmol/L, p < 0.01) were also increased. These immunological parameters drastically changed during the consecutive administration of IFN-gamma, and tended to return to the previous value after this period. However, tumor regression was not clinically obtained. Our findings indicate that interferon-gamma stimulated the anti-tumor activity of the host, and administration of IFN-gamma is thought to be of immunological significance even in the advanced high stage cases.

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木村文宏
防衛医科大学校泌尿器科

進行腎細胞癌に対するInterferon-γ療法の免疫学的検討

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