de Nardi P, Stella M, Magnani P, Paganelli G, Mangili F, Fazio F, di Carlo V
Department of Surgery, University of Milan Scientific Institute, S. Raffaele Hospital, Italy.
Int J Colorectal Dis. 1997;12(1):24-8. doi: 10.1007/s003840050073.
The use of a cocktail of monoclonal antibodies in intraoperative radioimmunodetection of colorectal tumour has been evaluated in 14 patients. Eight patients had primary and six recurrent colorectal cancer. Three different monoclonal antibodies were used included B72.3, recognizing TAG72 antigen, FO23C3 and FO23C5 directed against two epitopes of CEA. The antibodies were labeled with 125I. During surgery the radioactive emission of tumour and normal tissue was evaluated by a gamma detecting probe. Ten patients showed positive intraoperative results and in particular 6 (75%) of the 8 patients with primary tumour and 4 (67%) of the 6 patients with recurrence, with a mean tumour to normal tissue ratio of 2.2. Intraoperative radioimmunodetection was instrumental in modifying the therapeutic approach in two patients with recurrent cancer but in none of the patients with a primary presentation. Immunohistochemical analysis, to evaluate TAG72 and CEA antigen expression, was performed in 13 cases. CEA antigen was expressed in 8/13 cases and TAG72 in 5/13. Thus the sensitivity was 38.5% and 61.5% with B72.3 and anti-CEA monoclonal antibodies respectively, while in combination the sensitivity was 71.4%. The use of a cocktail of different antibodies improved the sensitivity of intraoperative radioimmunodetection of colorectal tumours, when compared with a single antibody injection. This approach might improve the clinical use of radioimmunodetection.
在14例患者中评估了单克隆抗体鸡尾酒在结直肠癌术中放射免疫检测中的应用。8例患者患有原发性结直肠癌，6例患有复发性结直肠癌。使用了三种不同的单克隆抗体，包括识别TAG72抗原的B72.3、针对癌胚抗原（CEA）两个表位的FO23C3和FO23C5。这些抗体用125I进行标记。手术期间，通过γ探测仪评估肿瘤和正常组织的放射性发射。10例患者术中结果呈阳性，特别是8例原发性肿瘤患者中的6例（75%）和6例复发性肿瘤患者中的4例（67%），肿瘤与正常组织的平均比值为2.2。术中放射免疫检测有助于改变两名复发性癌症患者的治疗方法，但对原发性癌症患者均无帮助。对13例患者进行了免疫组织化学分析，以评估TAG72和CEA抗原的表达。13例中有8例表达CEA抗原，5例表达TAG72。因此，B72.3和抗CEA单克隆抗体的敏感性分别为38.5%和61.5%，联合使用时敏感性为71.4%。与单次注射单一抗体相比，使用不同抗体的鸡尾酒提高了结直肠癌术中放射免疫检测的敏感性。这种方法可能会改善放射免疫检测的临床应用。
