Chetanneau A, Lehur P A, Ripoche D, Peltier P, Saccavini J C, Vuillez J P, Tournemaine N, Thedrez P, Chatal J F
Department of Nuclear Medicine, Centre René Gauducheau, Nantes, France.
Eur J Nucl Med. 1989;15(6):302-6. doi: 10.1007/BF00435470.
Seventeen patients (mean age 55 years) with suspected recurrence in previously operated and histologically confirmed colorectal adenocarcinomas were explored by immunoscintography (IS) associating planar and emission computed tomography (ECT) and using the 111In-labeled anti carcinoembryonic antigen (CEA) and(or) 19-9 monoclonal antibodies (MoAbs). The results of IS were compared blind with those of computed tomography (CT) and ultrasonography (US). The final diagnosis of recurrence and(or) metastasis was done in 16 cases by second-look surgery and in another patient by rectal biopsy. Overall per-patient sensitivity for the pelvis and extrahepatic abdomen was 69% for IS and 31% and 25% respectively for computed tomography and ultrasonography. No false positive of IS, as well as US and CT, for the pelvis and the extrahepatic abdomen was seen. Based on the number of anatomical sites tested, sensitivity of IS was 91% in the pelvis. In our series, scintigraphic computer subtraction did not allow adequate resolution of the problem of intense liver uptake of 111In-labeled MoAbs. It is concluded that IS using 111In-labeled anti CEA and(or) 19-9 MoAbs should be carried out prospectively in patients at high risk of recurrence of colorectal cancer.
对17例(平均年龄55岁)曾接受手术且经组织学确诊为大肠腺癌、怀疑复发的患者,采用免疫闪烁显像(IS)联合平面显像和发射型计算机断层扫描(ECT)进行检查,并使用铟-111标记的抗癌胚抗原(CEA)和(或)抗19-9单克隆抗体(MoAb)。将IS的结果与计算机断层扫描(CT)和超声检查(US)的结果进行盲法比较。16例患者通过二次手术、另1例患者通过直肠活检做出复发和(或)转移的最终诊断。IS对骨盆和肝外腹部的总体患者敏感性为69%,CT和超声检查分别为31%和25%。未发现IS以及US和CT对骨盆和肝外腹部有假阳性。根据所检测的解剖部位数量,IS在骨盆的敏感性为91%。在我们的系列研究中,闪烁扫描计算机减影不能充分解决铟-111标记的MoAb在肝脏摄取强烈的问题。得出结论,对于结直肠癌复发高危患者,应前瞻性地开展使用铟-111标记的抗CEA和(或)抗19-9 MoAb的IS检查。