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用抗癌胚抗原抗体(锝-99m MAK BW 431/26)免疫闪烁显像进行肿瘤诊断

[Tumor diagnosis by immunoscintigraphy with anti-CEA antibodies (Tc-99m MAK BW 431/26)].

作者信息

Kroiss A, Tuchmann A, Schüller J, Weiss W, Wirth M, Auinger C, Neumayr A

机构信息

Nuklearmedizinisches Institut, Krankenanstalt Rudolfstiftung, Wien.

出版信息

Wien Klin Wochenschr. 1989 Sep 29;101(18):621-6.

PMID:2815778
Abstract

We evaluated the clinical application of the monoclonal antibody MAb, BW 431/26, which is easy to label with Tc-99m for tumor localization. This is an anti-CEA antibody and a murine immunoglobulin (Ig G1, Isotype). We investigated patients with colorectal carcinoma (n = 14), with colorectal carcinoma recurrences (n = 24), breast carcinoma (n = 2), stomach carcinoma (n = 1), carcinoma of the urinary bladder (n = 3), lung carcinoma (n = 2) and patients with an elevated CEA level. In primary colorectal tumors (n = 14) all carcinomas were correctly localized by IS and ECT technique. In these patients the diagnosis was already known. The planar pictures showed a false negative result in 3 patients. In patients with colorectal recurrences the investigations were performed twice in 2 patients and three times in 1 patient. In these 31 ECT investigations we found 17 true positive results, 12 true negative results, 1 false positive result and 1 false negative result. The lesions were already visualized within 4 to 6 hours, but 24-hour pictures are desirable. SPECT pictures are absolutely necessary because sensitivity is considerably improved thereby. Elevated CEA levels increase the probability of a positive IS low CEA levels do not exclude positive tumor visualization. HAMA was found in only 1 patient, but follow-up investigations are indicated.

摘要

我们评估了单克隆抗体MAb BW 431/26的临床应用,该抗体易于用Tc-99m标记用于肿瘤定位。这是一种抗癌胚抗原(CEA)抗体,属于鼠免疫球蛋白(Ig G1,同型)。我们研究了患有结直肠癌(n = 14)、结直肠癌复发(n = 24)、乳腺癌(n = 2)、胃癌(n = 1)、膀胱癌(n = 3)、肺癌(n = 2)的患者以及CEA水平升高的患者。在原发性结直肠癌(n = 14)中,所有癌症均通过免疫闪烁(IS)和发射型计算机断层扫描(ECT)技术正确定位。在这些患者中,诊断已经明确。平面图像在3例患者中显示为假阴性结果。在结直肠癌复发患者中,2例患者进行了两次检查,1例患者进行了三次检查。在这31次ECT检查中,我们发现17例假阳性结果、12例假阴性结果、1例假阳性结果和1例假阴性结果。病变在4至6小时内即可显影,但最好拍摄24小时图像。单光子发射计算机断层扫描(SPECT)图像绝对必要,因为由此可显著提高灵敏度。CEA水平升高会增加免疫闪烁检查呈阳性的概率,CEA水平低并不排除肿瘤显影呈阳性。仅在1例患者中发现人抗鼠抗体(HAMA),但仍需进行随访检查。

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