^99mTc—ccM4嵌合抗体肺癌放射免疫显像初步临床应用

Clinical application of radioimmunoscintigraphy by use of 99m Tc ccM4 chimeric antibody in patients with lung cancer

目的：研究９９ｍ Ｔｃｃｃ Ｍ ４嵌合抗体用于肺癌放射免疫诊断。方法：用直接法９９ｍ Ｔｃ 标记嵌合抗体 ｃｃ Ｍ ４对１７例疑肺癌患者行放射免疫显像（ Ｒ Ｉ Ｉ），同时用１２５Ⅰ标记 ｃｃ Ｍ ４检测患者血清中的 Ｔ Ａ Ｇ７２抗原水平。显像后２周检测病人血清中的人抗鼠抗体（ Ｈ Ａ Ｍ Ａ）水平。结果：肺癌患者中 Ｔ Ａ Ｇ７２抗原水平明显高于正常对照者（ Ｐ＜ ００５），阳性率为４６４％ 。注射９９ｍ Ｔｃｃｃ Ｍ ４后１２ ｈ 癌灶对心肝的靶／非靶比值分别为２６６和２０８，选取此时的显像结果与手术及病理对比，灵敏度为７２２％ （１３／１８），对于１４个原发灶 Ｒ Ｉ Ｉ示１１个有放射性浓集，灵敏度为７８６％ ，纵隔转移灶３个中２个 Ｒ Ｉ Ｉ示放射性浓集，１个肝转移灶阴性。３例非癌性病变未见放射性浓集。注射抗体２周后病人血清中 Ｈ Ａ Ｍ Ａ 均未见阳性反应。结论：９９ｍ Ｔｃｃｃ Ｍ ４肺癌 Ｒ Ｉ Ｉ诊断原发性肺癌是一种可行的方法。

Objective:To evaluate the clinical application of radioimmunoscintigraphy (RII) with 99m Tc labelled human/mouse chimeric ccM4 antibody in detection of lung cancer and its metastatic foci.Methods:ccM4 was labelled with 99m Tc using Mather and Ellision′s method and with 125 Ⅰ, using Ch T method.The level of TAG 72 in patients′s blood serum was assayed with 125 Ⅰ ccM4 and the RII was performed in 17 cases suspected lung cancer.Results:The level of TAG 72 in lung cancer was 7.7±3.4 ng/ml,much higher than that in normal controls ( P <0 05).In contrast to the results of CT and pathology,13 out of 18 foci were found positive with RII at 12 hours after injection of 99m Tc ccM4,the overall sensitivity was 72.2% (13/18).The sensitivity of RII for primary lung carcinoma was 78.6%(11/14).Two foci out of 3 mediastinal metastases were detected metastasis was not detected.The HAMA was negative in all patients at two weeks after injection.Conclusion: 99m Tc ccM4 antibody was significant in diagnosis of primary lung cancer and its methastasis.