^(131)I标记单克隆抗体C50在胃癌放射免疫导向手术中的应用

^(131)I labeled monoclonal antibody C50 in radioimmunoguided surgery in gastricarcinoma

目的:探讨采用131I标记的癌胚抗原C50单克隆抗体在胃癌放射免疫导向手术(RIGS)中的应用价值。方法:胃癌患者22例术前通过胃镜直视下癌周粘膜下注射131I标记单克隆抗体C50(131I-C50mAb)进行放射免疫导向手术,术中取得组织标本离体测量其重量及γ计数,计算每克靶组织(T)和对照本底组织(NT)放射性计数比值(T/NT)。结果:胃镜直视下癌周粘膜下注射131I-C50mAb可有效区分组织有无癌浸润,分别选用T/NT界值8.0与9.0后判断胃壁肿瘤浸润、淋巴结转移的准确率分别为87.3%和92.6%。结论:C50可作为胃癌放射免疫导向手术的导向单克隆抗体,可为进一步使用手持式γ探测仪进行术中探测提供相应依据。

Objective： To investigate the value of ^131I labeled monoclonal antibody（MAb）C50 in radioimmunoguided surgery （RIGS） of gastricarcinoma, Methods ： A clinical trial of radioimmunoguided surgery （RIGS） was performed on 22 cases with tissue-proved gastricarcinoma in this study. Before operation subrnucosal was taken injection via endoscope with ^131I labeled monoclonal antibody （MAb） C50 was giren; in the operation get tissue specimen to measure their weight and count; then target sites （T） and normal tissues （T/NT）were calculated. Results： Submucosal injection via endoscope using ^131I labeled monoclonal antibody（MAb）C50 can detect tumor infiltrated tissues effectively. For the detection of metastatic lymph nodes,the accuracy rate of RIGS was 92.6% （83/90） with the ratio of T/NT as 8.0. The accuracy rate in detecting tumor infiltration of gastric wall was 87.3% （19/22） with the with the ratio of T/NT as 9.0. Conclusion： C50 can act as monoclonal antibody for the RIGS and provide a basis for using hand held gamma probe to detect in the operation.