Lind P, Lechner P, Arian-Schad K, Klimpfinger M, Cesnik H, Kammerhuber F, Eber O
Internal Department/Nuclear Medicine, Barmherzige Brüder Eggenberg Hospital, Graz, Austria.
J Nucl Med. 1991 Jul;32(7):1319-25.
This study comprises a total of 141 patients with suspected primary and recurrent colorectal carcinomas, in whom immunoscintigraphy with 99mTc-Mab BW 431/26 was performed. Whole-body scans were done 5.5 hr and SPECT imaging of the abdominal region was done at 6 and 24 hr postinjection of 1100 MBq 99mTc-labeled Mab (1 mg). In the course of primary tumor identification (n = 65), sensitivity of anti-CEA immunoscintigraphy was 95%, specificity 91%. In the diagnosis of early recurrences (n = 76), immunoscintigraphy was the method of choice to clarify the problem (sensitivity 94%; specificity 86%). Overall sensitivity of immunoscintigraphy in patients with suspected colorectal carcinomas and early recurrences was 95%, specificity 88%. Human anti-mouse antibodies were found in 29% (80% predominantly anti-isotypic, 20% predominantly anti-idiotypic). In contrast to anti-CEA immunoscintigraphy, the results of serum CEA levels were rather disappointing. Only 18 out of the 43 surgically verified primary colorectal carcinomas and 17 out of 32 patients with recurrences showed elevated serum CEA levels. In our clinical experience with this 99mTc-labeled anti-CEA antibody, immunoscintigraphy can play an important role in the identification of early colorectal recurrences and in postoperative colorectal cancer patients it should be performed in cases with unclear transmission computed tomography.
本研究共纳入141例疑似原发性和复发性结直肠癌患者，对其进行了99mTc-Mab BW 431/26免疫闪烁显像检查。静脉注射1100MBq 99mTc标记的单克隆抗体（1mg）后5.5小时进行全身扫描，6小时和24小时进行腹部单光子发射计算机断层显像（SPECT）。在原发性肿瘤诊断过程中（n = 65），抗癌胚抗原（CEA）免疫闪烁显像的灵敏度为95%，特异度为91%。在早期复发诊断中（n = 76），免疫闪烁显像为明确问题的首选方法（灵敏度94%；特异度86%）。疑似结直肠癌和早期复发患者免疫闪烁显像的总体灵敏度为95%，特异度为88%。29%的患者检测到人抗鼠抗体（80%主要为抗同种型，20%主要为抗独特型）。与抗CEA免疫闪烁显像不同，血清CEA水平的结果相当令人失望。43例经手术证实的原发性结直肠癌患者中只有18例血清CEA水平升高，32例复发患者中只有17例升高。根据我们使用这种99mTc标记抗CEA抗体的临床经验，免疫闪烁显像在早期结直肠癌复发的诊断中可发挥重要作用，对于术后结直肠癌患者，在计算机断层扫描结果不明确的情况下应进行该项检查。
