Koscielniak E, Reuland P, Schilling F, Feine U, Treuner J
Abt. für Onkologie und Hämatologie, Pädiatrisches Zentrum Olgahospital, Stuttgart.
Klin Padiatr. 1990 Jul-Aug;202(4):230-4. doi: 10.1055/s-2007-1025525.
Radio-labelled antimyosin-monoclonal antibodies (AMA) have been introduced to demonstrate myocardial necrosis after cardiac infarction or in cardiac allograft transplants. As rhabdomyosarcoma (RMS) and leiomyosarcoma (LMS) are tumors of myogenic origin, thus often containing myosin, we decided to use the 111In-labelled Fab fragment of AMA (Centocor) in scintigraphic tumor detection. We examined 13 children with histologically-confirmed RMS and LMS, and five other children with other types of soft tissue sarcomas. Conventional techniques were used to determine the extent of the tumor. An uptake of the tracer was observed in all known tumor sites in seven RMS patients. As the scans were negative in three RMS patients who were in complete remission (CR) and in two other patients (fibrosarcoma and haemangiopericytoma) with a measurable tumor mass, we considered them to be "true negative". In the three remaining CR patients (1 RMS, 2 LMS) the scans were positive but weak in the primary tumor site in two cases and in a distant site (bone) in the third respectively. We considered them to be "false positive" as no tumor cells were evident in the biopsy specimen. In one case, the antimyosin uptake was presumably the result of damage to the muscles after radiation. Interestingly, in three patients with other malignancies such as rhabdoid and peripheral neuroectodermal tumors there was a noticeably strong uptake of the tracer in the primary tumors and the scans turned negative after complete remission was achieved. The diagnostic AMA scanning showed no side-effects. The reason why antimyosin antibodies permeate the membrane of the tumor cells is yet undetermined.(ABSTRACT TRUNCATED AT 250 WORDS)
放射性标记的抗肌球蛋白单克隆抗体(AMA)已被用于显示心肌梗死或心脏同种异体移植后的心肌坏死。由于横纹肌肉瘤(RMS)和平滑肌肉瘤(LMS)是肌源性肿瘤,因此通常含有肌球蛋白,我们决定使用111In标记的AMA(Centocor)Fab片段进行肿瘤闪烁显像检测。我们检查了13例经组织学确诊为RMS和LMS的儿童,以及另外5例患有其他类型软组织肉瘤的儿童。采用传统技术确定肿瘤范围。在7例RMS患者的所有已知肿瘤部位均观察到示踪剂摄取。由于3例处于完全缓解(CR)的RMS患者以及另外2例有可测量肿瘤肿块的患者(纤维肉瘤和血管外皮细胞瘤)的扫描结果为阴性,我们认为它们是“真阴性”。在其余3例CR患者(1例RMS,2例LMS)中,扫描结果为阳性,但其中2例在原发肿瘤部位较弱,第3例在远处部位(骨骼)较弱。由于活检标本中未发现肿瘤细胞,我们认为它们是“假阳性”。在1例中,抗肌球蛋白摄取可能是放疗后肌肉损伤的结果。有趣的是,在3例患有其他恶性肿瘤(如横纹肌样和外周神经外胚层肿瘤)的患者中,原发肿瘤中示踪剂摄取明显强烈,在实现完全缓解后扫描结果转为阴性。AMA诊断扫描未显示副作用。抗肌球蛋白抗体渗透肿瘤细胞膜的原因尚不确定。(摘要截短至250字)