Hinkle G H, Burgers J K, Olsen J O, Williams B S, Lamatrice R A, Barth R F, Rogers B, Maguire R T
Department of Radiology, The Ohio State University Medical Center, Columbus 43210, USA.
J Nucl Med. 1998 Apr;39(4):650-2.
To provide appropriate therapy for prostate cancer, accurate staging of the patient's disease is essential. Determination of tumor size, location, periprostatic extension and metastatic disease in the skeleton and soft tissue are needed to stage properly. Current diagnostic modalities may lead to understaging in 40%-70% of prostate cancer. Detection of metastatic disease, both at the time of initial diagnosis and in patients with suspected local recurrence, can significantly alter the type of therapy given. Clinical studies using the (111)In radiolabeled immunoconjugate, MAb 7E11-C5.3-GYK-DTPA (capromab pendetide), have shown the superiority of radioimmunoscintigraphy over other diagnostic modalities in the detection of both primary and metastatic prostate cancer. Radioimmunoscintigraphy with capromab pendetide depends on expression of tumor-associated antigen rather than lesion size. Earlier detection of extraprostatic invasion and metastases by means of radioimmunoscintigraphy provides valuable information for treatment decisions. A case of metastatic prostate cancer in the abdomen of a patient without local disease, in which the extent of disease was confirmed at autopsy after sudden cardiac arrest, is presented.
为了给前列腺癌患者提供恰当的治疗,准确对患者的疾病进行分期至关重要。需要确定肿瘤大小、位置、前列腺周围浸润情况以及骨骼和软组织中的转移病灶,以便进行正确分期。目前的诊断方法可能会导致40% - 70%的前列腺癌患者分期过低。在初始诊断时以及疑似局部复发的患者中检测转移病灶,会显著改变所给予的治疗类型。使用(111)铟标记的免疫缀合物单克隆抗体7E11 - C5.3 - GYK - DTPA(卡普单抗)的临床研究表明,在检测原发性和转移性前列腺癌方面,放射免疫闪烁显像优于其他诊断方法。卡普单抗放射免疫闪烁显像依赖于肿瘤相关抗原的表达而非病灶大小。通过放射免疫闪烁显像更早地检测前列腺外侵犯和转移,可为治疗决策提供有价值的信息。本文介绍了一例腹部转移性前列腺癌患者,该患者无局部病变,在心脏骤停后经尸检证实了疾病范围。