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[用锝-99m标记的单克隆抗体174H.64对头颈部癌进行免疫闪烁显像。一种新的诊断方法]

[Immunoscintigraphy of carcinomas in the area of the head-neck with technetium-99m marked monoclonal antibody 174H.64. A new diagnostic procedure].

作者信息

Kiefer J, Baum R P, Knecht R, Hertel A, Niesen A, von Ilberg C, Hör G

机构信息

Zentrum der Hals-Nasen-Ohren-Heilkunde, Johann Wolfgang Goethe-Universität, Frankfurt am Main.

出版信息

HNO. 1994 Sep;42(9):546-52.

PMID:7989226
Abstract

Twenty-one patients with squamous cell carcinomas of the head and neck were studied by immunoscintigraphy and immunoemission, computed tomography (ECT) using monoclonal antibody 174H.64 (Biomira Edminton) labelled with 99Tcm (Schwartz Method). Immunoscintigraphic results were compared with routine clinical assessments, including CT and ultrasonography, and were controlled by histopathological examination after surgery. All primary localizations (pT1 = 3, pT2 = 3, pT3 = 7, pT4 = 5; oropharynx 7, larynx 5, hypopharynx 3, oral cavity 3, lymph nodes 3) could be visualized, while 15 out of 18 neck lesions from tumor metastases could also be visualized (pN1 = 8, pN2 = 8, pN3 = 2). In one case with micrometastases in lymph nodes that could not be demonstrated by other methods, staging was upgraded by the immunoscintigraphic results. Three other micrometastases in lymph nodes could not be visualized. Distant metastases were suspected in 5 cases, three of which were confirmed either histologically or by radiography. Two of the cases with distant metastases were detected by the immunoscintigraphy. The present results indicate that immunoscintigraphy in combination with immuno-ECT can improve preoperative staging of head and neck carcinomas, especially with regard to metastatic neck disease, tumor recurrences and some cases of distant metastases.

摘要

采用99锝标记的单克隆抗体174H.64(Biomira公司,埃德蒙顿),通过免疫闪烁显像和免疫发射计算机断层扫描(ECT)对21例头颈部鳞状细胞癌患者进行了研究(施瓦茨法)。将免疫闪烁显像结果与包括CT和超声检查在内的常规临床评估结果进行比较,并在术后通过组织病理学检查进行对照。所有原发部位(pT1 = 3例,pT2 = 3例,pT3 = 7例,pT4 = 5例;口咽7例,喉5例,下咽3例,口腔3例,淋巴结3例)均可显影,而18例肿瘤转移所致颈部病变中的15例也可显影(pN1 = 8例,pN2 = 8例,pN3 = 2例)。在1例其他方法未能显示的淋巴结微转移病例中,免疫闪烁显像结果使分期得以提升。另外3例淋巴结微转移未能显影。5例怀疑有远处转移,其中3例经组织学或影像学检查得到证实。2例远处转移病例通过免疫闪烁显像被检测出来。目前的结果表明,免疫闪烁显像联合免疫ECT可改善头颈部癌的术前分期,尤其是在转移性颈部疾病、肿瘤复发和部分远处转移病例方面。

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