免疫毒素导向治疗膀胱癌的实验与临床研究

An experimental and clinical study of targeted therapy of human bladder carcinoma with immunotoxin

用抗人膀胱癌单克隆抗体ＢＤＩ－１与苦瓜毒素（ＭＤ）通过化学交联制备的抗人膀胱癌免疫毒素（ＢＤＬ－１－ＭＤ）在体外可以特异地杀伤人膀胱癌细胞；在载瘤裸鼠体内可以明显地抑制人膀胱癌的生长。临床对１８例膀胱癌患者施行膀胱灌注免疫毒素的导向治疗，其中肿瘤Ⅰ级６例，Ⅱ级７例，Ⅲ级５例；首发瘤１４例，复发瘤４例。随访８～２８个月，平均１２．５个月，１７例未复发，１例复发（５．５％）。表明ＢＤＬ－１－ＭＤ在清除膀胱内小于１ｃｍ小瘤灶及防止术后复发方面具有明显效果。

Anti-human-bladder carcinoma immunotoxin,BDI-1-MD,was prepared by coupling chemically MD-I-1 with momordin toxin and was found to have specific cytotoxicity to human bladder cancer in nude mice.BD-I-1-MD was given intravesically to 18 bladder cancer patients as the targeted imunotoxin therapy.6 of the patients were with grade Ⅰtumor,7 with grade Ⅱ and 3 with grade Ⅲ tumor.In 14 cases,the tumor has been primary,being recurrent in the other 4.The patients have been followed up for 8 to 28 months with an average of 12.5 months,All the cases have been free from recurrence except one(5.5%).So BD-I-1-MD has been very effective in the clearance of small bladder carcinoma less than 1cm in size.