Peltier P, Dutin J P, Chatal J F, Fumoleau P, Bourguet P, Liehn J C, Vuillez J P, Hérry J Y, Loboguerrero A
Service de médecine nucléaire, Centre René Gauducheau, Nantes, France.
Ann Oncol. 1993 Apr;4(4):307-11. doi: 10.1093/oxfordjournals.annonc.a058488.
A progressive rise in serum CA 125 concentration during follow-up monitoring of ovarian cancer after treatment of primary tumor is suggestive of a recurrence.
A study was carried out in 19 patients with suspected recurrence of a previously treated ovarian carcinoma. All patients underwent ultrasonography (US), computed tomography (CT) and immunoscintigraphy (IS) using F(ab')2 fragments of indium-111-labeled OC 125 monoclonal antibody (specific for CA 125 antigen). The definitive diagnosis of recurrence was made on the basis of histological data obtained at surgery.
In all 15 of the patients with recurrence, all three of the imaging methods had false negative results once. In 7 patients, only the IS method had positive results; six of these 7 benefited from a macroscopically total resection of the recurrence. IS was positive and concordant with US and/or CT in 7 further patients. Two of them benefited from a total resection of their recurrence. The usefulness of IS was more evident when serum CA 125 concentration was below 500 U/ml. The absence of recurrence was correctly indicated by IS and CT in 1 case and by IS associated with negative US and CT in 2 other cases. IS and CT were falsely positive in 1 case.
Thus, immunoscintigraphy would appear to be an efficient method for detecting a recurrence early when limited involvement can make it possible for the surgeon to achieve total resection.
在原发性肿瘤治疗后对卵巢癌进行随访监测期间，血清CA 125浓度的逐步升高提示复发。
对19例疑似先前治疗过的卵巢癌复发患者进行了一项研究。所有患者均接受了超声检查（US）、计算机断层扫描（CT）以及使用铟-111标记的OC 125单克隆抗体（对CA 125抗原具有特异性）的F(ab')2片段进行的免疫闪烁成像（IS）。根据手术时获得的组织学数据做出复发的明确诊断。
在所有15例复发患者中，这三种成像方法均有一次出现假阴性结果。在7例患者中，仅IS方法呈阳性结果；这7例患者中有6例从复发灶的肉眼下全切术中获益。另外7例患者中，IS呈阳性且与US和/或CT结果一致。其中2例从复发灶的全切术中获益。当血清CA 125浓度低于500 U/ml时，IS的有效性更为明显。IS和CT在1例患者中正确显示无复发，IS联合阴性的US和CT在另外2例患者中也正确显示无复发。IS和CT在1例患者中出现假阳性。
因此，当受累范围有限使得外科医生有可能实现全切时，免疫闪烁成像似乎是一种早期检测复发的有效方法。
