Löffler K U, Bräutigam P, Simon J, Althauser S R, Moser E, Witschel H
Augenklinik, Universität Freiburg.
Ophthalmologe. 1994 Aug;91(4):529-32.
For several years, immunoscintigraphy (IS) using a 99mTc-labeled monoclonal antibody for tumor localization has been used as an additional tool in the diagnosis of malignant melanoma. The aim of our study was to verify previously published data with respect to our own patients and to correlate immunoscintigraphic results with histological findings. In particular, we wanted to compare the outcome of IS in ocular melanoma with that in cutaneous melanoma. We examined 28 patients (15 females, 13 males, average age 64 years) with clinically suspected ocular melanoma. IS was performed using the monoclonal antibody 225.28S (Tecnemab-K-1, Fa. Sorin/Solco), and images were obtained in a standard fashion (planar) as well as with the SPECT technique. In 16 patients, the tumor was examined afterwards histologically. The control group consisted of 102 patients with histologically proven metastasizing cutaneous melanoma who were investigated by IS in an identical fashion. In contrast to the literature published so far, we demonstrated a positive IS reaction in only 42% (and 56% in histologically proven cases, respectively) in our patients with ocular melanoma, while in patients with cutaneous melanoma, we found a sensitivity of more than 80%. In the 3 patients who turned out not to have ocular melanoma, we found one false-positive reaction (subretinal hemorrhage). No correlation was found between the various histological features of ocular melanoma and the immunoscintigraphic results. We conclude that IS using the antibody 25.28S is of limited value in patients with ocular melanoma and should only be recommended in selected cases.(ABSTRACT TRUNCATED AT 250 WORDS)
数年来,使用99mTc标记的单克隆抗体进行肿瘤定位的免疫闪烁显像(IS)已被用作恶性黑色素瘤诊断的辅助手段。我们研究的目的是根据我们自己的患者来验证先前发表的数据,并将免疫闪烁显像结果与组织学发现相关联。特别是,我们想比较眼部黑色素瘤与皮肤黑色素瘤的IS结果。我们检查了28例临床疑似眼部黑色素瘤的患者(15名女性,13名男性,平均年龄64岁)。使用单克隆抗体225.28S(Tecnemab-K-1,Sorin/Solco公司)进行IS检查,并以标准方式(平面)以及SPECT技术获取图像。之后对16例患者的肿瘤进行了组织学检查。对照组由102例经组织学证实有转移性皮肤黑色素瘤的患者组成,他们以相同方式接受了IS检查。与迄今发表的文献不同,我们发现眼部黑色素瘤患者中只有42%(组织学证实病例中分别为56%)出现IS阳性反应,而皮肤黑色素瘤患者中,我们发现敏感性超过80%。在3例最终被证实没有眼部黑色素瘤的患者中,我们发现了1例假阳性反应(视网膜下出血)。未发现眼部黑色素瘤的各种组织学特征与免疫闪烁显像结果之间存在相关性。我们得出结论,使用抗体25.28S的IS对眼部黑色素瘤患者价值有限,仅在特定病例中推荐使用。(摘要截短至250字)