Pinkas L, Robins P D, Forstrom L A, Mahoney D W, Mullan B P
Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN 55905, USA.
Nucl Med Commun. 1999 Aug;20(8):689-96. doi: 10.1097/00006231-199908000-00002.
A retrospective study was carried out to determine the diagnostic value of OncoScint CR/OV immunoscintigraphy in assessing patients with suspected recurrence of carcinoma of the colon and ovary. The scintigraphic results of 31 patients were compared with surgical and histopathological findings, conventional radiological examinations and clinical disease outcome over an average 3-year follow-up. Detected lesions were divided by location into hepatic or extrahepatic and the latter group was classified as local recurrence at the resection site, pelvic or abdominal regional lymph node involvement and distant metastatic disease. The combined sensitivity and accuracy of immunoscintigraphy in the detection of extra-hepatic disease was significantly higher than that of cross-sectional radiological imaging (87% and 83% vs 44% and 53% respectively) with equal specificity of 74%. Scintigraphy identified 14 (36%) of 39 extra-hepatic malignant lesions not diagnosed by conventional radiological techniques and influenced therapeutic planning in 8 (26%) of 31 patients studied. In the liver, conventional imaging had a significantly higher detection rate than immunoscintigraphy (sensitivity 93% vs 28%). In conclusion, these results show that OncoScint scintigraphy is a sensitive method for the detection of local recurrence and extra-hepatic metastases in colorectal and ovarian carcinoma and has an important role in the therapeutic decision-making process.
开展了一项回顾性研究,以确定癌胚抗原单克隆抗体CR/OV免疫闪烁成像在评估疑似结肠癌和卵巢癌复发患者中的诊断价值。将31例患者的闪烁成像结果与手术及组织病理学检查结果、传统放射学检查以及平均3年随访期内的临床疾病转归进行了比较。检测到的病变按位置分为肝内或肝外,后者又分为切除部位的局部复发、盆腔或腹部区域淋巴结受累以及远处转移疾病。免疫闪烁成像检测肝外疾病的联合敏感性和准确性显著高于横断面放射成像(分别为87%和83%,而放射成像为44%和53%),特异性均为74%。闪烁成像识别出39例传统放射学技术未诊断出的肝外恶性病变中的14例(36%),并影响了31例研究患者中8例(26%)的治疗方案制定。在肝脏方面,传统成像的检测率显著高于免疫闪烁成像(敏感性分别为93%和28%)。总之,这些结果表明,癌胚抗原单克隆抗体CR/OV闪烁成像对于检测结直肠癌和卵巢癌的局部复发及肝外转移是一种敏感方法,并且在治疗决策过程中具有重要作用。