用锝-99m标记的单克隆抗体E48 IgG或F(ab')2对头颈部癌症进行临床成像。

Clinical imaging of head and neck cancer with technetium-99m-labeled monoclonal antibody E48 IgG or F(ab')2.

作者信息

de Bree R, Roos J C, Quak J J, den Hollander W, van den Brekel M W, van der Wal J E, Tobi H, Snow G B, van Dongen G A

机构信息

Department of Otolaryngology/Head and Neck Surgery, Free University Hospital, Amsterdam, The Netherlands.

出版信息

J Nucl Med. 1994 May;35(5):775-83.

PMID:8176458

Abstract

METHODS

In 32 patients who were suspected of having a neck lymph node metastasis from a histologically proven squamous-cell carcinoma of the head and neck (HNSCC), the diagnostic value of 99mTc-labeled (750 MBq) monoclonal antibody (1-2 mg) E48 IgG (n = 17) and its F(ab')2 fragment (n = 15) was evaluated and compared. Preoperative findings on lymph node status obtained by radioimmunoscintigraphy (RIS), computerized tomography (CT), magnetic resonance imaging (MRI) and palpation were defined per side (left and/or right side of the neck) as well as per lymph node level (I through V) and compared to the histopathological outcome of the neck dissection specimen.

RESULTS

All 31 tumors at the primary site were visualized. RIS was correct in 201 of 221 levels (accuracy 91%) and in 38 of 47 sides (accuracy 81%). Fifteen levels and seven sides with limited tumor load were scored false-negative and five levels and two sides were scored false-positive. Sensitivity and specificity of RIS were similar to those of palpation, CT and MRI. The diagnostic value of RIS with E48 F(ab')2 or E48 IgG appeared to be similar.

CONCLUSIONS

The present study shows that RIS with either E48 F(ab')2 or E48 IgG is as valuable as the other imaging techniques. The selective accumulation of radioactivity in tumor tissues, in combination with the known intrinsic radiosensitivity of HNSCC, justifies the development of radioimmunoconjugates for radioimmunotherapy.

摘要

方法

在32例疑似头颈部鳞状细胞癌（HNSCC）颈部淋巴结转移的患者中，评估并比较了99mTc标记（750MBq）单克隆抗体（1 - 2mg）E48 IgG（n = 17）及其F(ab')2片段（n = 15）的诊断价值。通过放射免疫闪烁显像（RIS）、计算机断层扫描（CT）、磁共振成像（MRI）和触诊获得的术前颈部淋巴结状态结果，按每侧（颈部左侧和/或右侧）以及每个淋巴结水平（I至V）进行定义，并与颈部清扫标本的组织病理学结果进行比较。

结果

原发部位的所有31个肿瘤均被显像。RIS在221个水平中的201个判断正确（准确率91%），在47个侧别中的38个判断正确（准确率81%）。15个水平和7个侧别肿瘤负荷有限被判定为假阴性，5个水平和2个侧别被判定为假阳性。RIS的敏感性和特异性与触诊、CT和MRI相似。E48 F(ab')2或E48 IgG的RIS诊断价值似乎相似。