Boeckmann W, Baum R P, Schuldes H, Kramer W, Hertel A, Baew-Christow T, Hanke P, Jonas D, Hör G
Department of Urology, J.W. Goethe University Frankfurt/Main, West Germany.
Br J Cancer Suppl. 1990 Jul;10:81-4.
Fifty-one patients with muscle-infiltrating bladder carcinoma (T2-T4, N0-3, M0-1) were studied with a new imaging technique using murine monoclonal antibody directed against the carcinoembryonic antigen (CEA). A total number of 67 investigations were performed. The intact 111indium-labelled antibody (BW 431/26, Behringwerke Marburg) detected 86% of primary tumours, 93% of local and 75% of distant metastases whether there was an elevated CEA level in serum or not. Immunohistologically (avidin-biotin-peroxidase method) positive frozen tissue sections from tumour biopsies stained with the same monoclonal anti-CEA antibody, thus confirming the presence of the CEA antigen in vitro. The method was of much higher sensitivity in detecting even very small metastases than X-ray computed tomography (86% versus less than 30%). The specificity was in the region of 90%. The response to chemotherapy (MVEC regimen) was shown by repeated studies demonstrating reduced uptake (partial remission) or no accumulation (complete remission) in the second immunoscan. We suggest immunoscintigraphy of bladder tumours and their metastases as an additional method in preoperative staging and postoperative care.
采用一种使用针对癌胚抗原（CEA）的鼠单克隆抗体的新成像技术，对51例肌肉浸润性膀胱癌患者（T2-T4，N0-3，M0-1）进行了研究。共进行了67次检查。无论血清中CEA水平是否升高，完整的111铟标记抗体（BW 431/26，德国马尔堡贝林werke公司）检测到86%的原发性肿瘤、93%的局部转移和75%的远处转移。免疫组织化学（抗生物素蛋白-生物素-过氧化物酶法）显示，用相同的抗CEA单克隆抗体对肿瘤活检的阳性冷冻组织切片进行染色，从而在体外证实了CEA抗原的存在。该方法在检测即使非常小的转移灶方面比X线计算机断层扫描具有更高的敏感性（86%对小于30%）。特异性在90%左右。重复研究显示了对化疗（MVEC方案）的反应，在第二次免疫扫描中显示摄取减少（部分缓解）或无聚集（完全缓解）。我们建议将膀胱肿瘤及其转移灶的免疫闪烁显像作为术前分期和术后护理的一种辅助方法。
