^(99m)Tc-C_(50)放射免疫显像与B超对盆腔包块定性诊断的初探

PRELIMINARY EXPLORATION OF DIFFERENTIAL DIAGNOSIS OF PELVIC MASSES WITH 99m Tc C 50 LABELED RADIOIMMUNOIMAGING COMBINATION WITH B TYPE ULTRASONOGRAPHY

应用９９ｍＴｃ标记抗癌胚抗原单克隆抗体（Ｃ５０）放射免疫显像（ＲＩ）对８１例盆腔包块进行诊断定性。全部病例均以病理为对照标准，部分病例还以“Ｂ”超行对照检测，以确定本法、Ｂ超的特异性、敏感性。其中１６例为恶性肿瘤、ＲＩ的敏感性，特异性和准确性分别为１００％、７５．４％、８０．２％。盆腹腔转移灶检出率为８８．６％（３９／４４），检出最小直径为１．５ｃｍ。６５例良性肿瘤及其他妇科疾患，ＲＩ假阳性１６例，占２４．６％。７０例同时行ＲＩ及Ｂ超检查，ＲＩ的敏感性、特异性、准确性和盆腔浸润灶检出率分别为１００％、７６．８％、８１．４％、８８．３％，Ｂ超分别为７１．４％、９６．４％、９１．４％、５０％，两者比较，特异性和盆腔浸润灶检出率在统计学上有显著性差异（Ｐ＜０．００５）。９９ｍＴｃ－Ｃ５０对盆腔、腹腔转移灶、术后残留及复发灶的检出率明显高于Ｂ超，ＲＩ与Ｂ超联合应用，可提高诊断准确性，对提高卵巢恶性肿瘤早期诊断有积极意义。

Eighty one patients with pelvic masses were examined by 99m Tc C 50 monoclonal antibody against to carcinoembryonic antigen labeled radioimmunoimaging(RII) alone or combined were B type ultrasonography(B US). All of them were pathologic examined. The results show that 16 cases were diagnosed as malignant tumors by RII. The sensitivity, specificity and accuracy of RII were 100%, 75.4% and 80.2% respectively. The positive detection rate of metastases in abdominal and pelvic was 88.6%(39/43), the detectable minimum diameter of RII was 1.5 cm, 16 cases of 65 patients with benign tumor or other gynecological diseases were diagnosed as malignant tumor, the false positive rate was 24.6%, 70 cases of 81 patients were examined with RII and B US at the same time, the sensitivity, specificity, accuracy and positive detection rate were 100%, 76.8%, 81.4% and 88.3% respectively by RII, while 71.4%, 96.4%, 91.4%, and 50% by B US. The differences in specificity and positive detection rate between RII and B US were significant ( P <0.005). The results suggest that RII is superior to B US on positive detection rate in the metastases in abdominal and pelvic, residuals and recurrences after operation. The accuracy will be improved if RII used combined with B US. These methods are useful to the early diagnosis of ovarian malignant tumor.