Baum R P, Lorenz M, Hertel A, Baew-Christow T, Schwarz A, Hör G
Abteilung Nuklearmedizin, Johann Wolfgang Goethe-Universität, Frankfurt am Main.
Onkologie. 1989 Aug;12 Suppl 1:26-9. doi: 10.1159/000216680.
Twenty patients aged 32-76 years (median 56 years) with various primary cancers or tumor recurrences (colorectal n = 14; lung, breast, medullary thyroid carcinoma n = 2, each) were studied with a technetium-99m labeled anti-CEA antibody. Intact monoclonal antibody BW 431/26 (Scintimum CEA-Tc-99m, Behringwerke AG, Marburg) was successfully labeled (Schwarz Method) by an instant 2-vial kit (labeling efficiency greater than 95% (TLC, HPLC), preserved immunoreactivity). The most frequent clinical indications were (1) the detection of tumor recurrences in patients with a steadily increasing serum CEA level (at a mean 2.3 years after complete removal of the primary tumor) but normal findings by conventional imaging modalities, (2) the search for extrahepatic tumor involvement in patients with known liver metastases scheduled for regional chemotherapy. Gamma camera scintigrams (planar and ECT) were performed 6-12 h and 18-26 h postinjection yielding a sensitivity of 95% (positive tumor contrast in 19/20 patients) with a specificity of 90% (positive predictive value 95%). Immunoscintigraphy successfully depicted tumor recurrences in 4/6 patients with elevated serum CEA values where all conventional imaging modalities had failed. The successful labeling of monoclonal antibodies with 99mTc represent an important step in clinical progress for the more practically orientated use of immunoscintigraphy and also opens new diagnostic fields.
对20例年龄在32 - 76岁（中位年龄56岁）患有各种原发性癌症或肿瘤复发的患者（结直肠癌14例；肺癌、乳腺癌、甲状腺髓样癌各2例）进行了99m锝标记抗癌胚抗原（CEA）抗体的研究。完整的单克隆抗体BW 431/26（闪烁癌胚抗原-99m锝，贝林格殷格翰公司，马尔堡）通过即时双瓶试剂盒成功标记（施瓦茨法）（标记效率大于95%（薄层色谱法、高效液相色谱法），保留免疫反应性）。最常见的临床适应证为：（1）血清CEA水平持续升高（在原发肿瘤完全切除后平均2.3年）但传统成像方式检查结果正常的患者中检测肿瘤复发；（2）计划进行区域化疗的已知肝转移患者中寻找肝外肿瘤累及情况。注射后6 - 12小时和18 - 26小时进行γ相机闪烁扫描（平面和断层），敏感性为95%（20例患者中有19例肿瘤对比阳性），特异性为90%（阳性预测值95%）。免疫闪烁成像成功描绘了6例血清CEA值升高且所有传统成像方式均失败的患者中的4例肿瘤复发情况。用99mTc成功标记单克隆抗体代表了免疫闪烁成像在临床应用中更具实用性方面的重要进展，也开辟了新的诊断领域。
