Petronis J D, Regan F, Lin K
Department of Radiology, Johns Hopkins Bayview Medical Center, Johns Hopkins Medical Institutions, Baltimore, Maryland 21224-2780, USA.
Clin Nucl Med. 1998 Oct;23(10):672-7. doi: 10.1097/00003072-199810000-00005.
This study evaluated the utility of In-111 capromab pendetide imaging to detect prostate cancer metastases or local recurrence. The specific goal was to identify clinical factors such as prostate-specific antigen, pathologic stage, and Gleason score that were most predictive of a positive scan outcome. In addition, a new concept of a weighted Gleason score was defined and correlated with the scan outcome. Fifty-one patients with an elevated prostate-specific antigen level and otherwise negative workup were studied. Forty-eight patients had been treated by radical prostatectomy, two by radiation therapy, and one patient was studied before prostatectomy. Each patient received an intravenous injection of approximately 5 mCi of In-111 containing 0.5 mg of CYT 356, a conjugated site-specific monoclonal antibody against prostate specific membrane antigen. Tomographic blood pool images were obtained the day of injection. Four days later planar images and tomographic images of the abdomen and pelvis were obtained. Scans were interpreted by two experienced nuclear medicine physicians. Differences in the scan interpretation were settled by consensus. Scan outcomes were correlated with prostate-specific antigen levels, pathologic stage, Gleason score, weighted Gleason score, and clinical data. Of 51 scans, 70.6% (36 of 51) were positive. Eight patients had abnormal activity in the prostatic fossa, 12 patients had abnormal activity in the abdominal or pelvic lymph nodes, and 16 patients demonstrated abnormal activity in both areas. One patient with a positive scan underwent lymphadenectomy and was confirmed to be a true positive. Patients with a prostate-specific antigen level greater than 10 ng/ml, a weighted Gleason score higher than 4.5, or prostate-specific antigen levels greater than 2 ng/ml plus a weighted score higher than 4.5 showed positive rates of 100% (6 of 6), 88.2% (14 of 16), and 100% (6 of 6), respectively. In-111 capromab pendetide imaging was useful to detect metastases or local recurrence. Serum prostate-specific antigen levels and weighted Gleason scores are good predictive factors of the likelihood of a positive scan outcome.
本研究评估了铟 - 111 卡普单抗显像检测前列腺癌转移或局部复发的效用。具体目标是确定诸如前列腺特异性抗原、病理分期和 Gleason 评分等临床因素，这些因素最能预测扫描结果为阳性。此外，定义了加权 Gleason 评分的新概念，并将其与扫描结果相关联。对 51 例前列腺特异性抗原水平升高且其他检查结果为阴性的患者进行了研究。48 例患者接受了前列腺根治术治疗，2 例接受了放射治疗，1 例患者在前列腺切除术前接受了研究。每位患者静脉注射约 5 mCi 含 0.5 mg CYT 356 的铟 - 111，CYT 356 是一种针对前列腺特异性膜抗原的位点特异性单克隆抗体偶联物。在注射当天获取断层血池图像。四天后获取腹部和骨盆的平面图像和断层图像。扫描结果由两位经验丰富的核医学医师解读。扫描解读的差异通过协商解决。扫描结果与前列腺特异性抗原水平、病理分期、Gleason 评分、加权 Gleason 评分及临床数据相关联。在 51 次扫描中，70.6%（51 例中的 36 例）为阳性。8 例患者前列腺窝有异常放射性，12 例患者腹部或盆腔淋巴结有异常放射性，16 例患者在这两个区域均显示异常放射性。1 例扫描结果为阳性的患者接受了淋巴结切除术，证实为真阳性。前列腺特异性抗原水平大于 10 ng/ml、加权 Gleason 评分高于 4.5 或前列腺特异性抗原水平大于 2 ng/ml 加上加权评分高于 4.5 的患者，其阳性率分别为 100%（6 例中的 6 例）、88.2%（16 例中的 14 例）和 100%（6 例中的 6 例）。铟 - 111 卡普单抗显像有助于检测转移或局部复发。血清前列腺特异性抗原水平和加权 Gleason 评分是扫描结果为阳性可能性的良好预测因素。
