双核素免疫显像诊断大肠癌的临床研究

The clinical study of radioimmunoimaging with ^(131)I labelled anti CEA McAB and ^(99m)Tc-MDP for the diagnosis of colorectal cancer

目的 探索大肠癌及其复发、转移灶的诊断方法。方法 采用改良氯胺T法进行抗癌胚抗原 (CEA)单抗 (C5 0 ) 13 1I标记 ,对 2 0例临床疑为大肠癌或其复发、转移的患者静注13 1I C5 0 370～5 5 5mBq后 48～ 72h进行放免显像 (RII) ,显像前 3h同时静注99mTc MDP(亚甲基二膦酸盐 ) 185～ 5 5 5mBq。手术时取不同组织行放射计数检测。显像结果与手术、病理诊断进行对照。结果 显像阳性18例 ,均经病检证实为癌 ,其中 4例为局部复发或远处转移。另有 2例显像阴性 ,病理证实为息肉。13 1I C5 0的组织分布显示肿瘤 /非肿瘤比值 (T/NT)为 1 45～ 18 6 ,其中瘤区以边缘放射性集聚更为显著。结论 采用13 1I C5 0和99mTc MDP进行双核素免疫显像对大肠癌及其复发、转移灶具有较高的诊断价值。

Objective [WT5”BZ] To evaluate the effectiveness of radioimmunoimaging (RII) with 131 I labelled anti CEA McAB (C50) followed by 99m Tc MDP infusion for detection of colorectal cancer,primary or recurrent, and metastatic foci. [WT5”HZ] Methods [WT5”BZ] C50 was labelled with 131 I using modified chloramine T method. The RII was performed in 20 cases suspected with colorectal cancer at 24 to 72 hours after intravenous injection of 131 I C50 and 99m Tc MDP. The tissue radioactivity distribution was determined in a well type scintillation counter. [WT5”HZ] Results [WT5”BZ] Eighteen patients with positive RII result were proved by pathology as suffering from colorectal cancer,among them 4 was found to have local recurrence or distal metastasis.The remaining two patients whose RII was negative were proved by pathological examination as of colonic polyps. The ratios of radiobabelled antibody of tumor over normal tissue (T/NT) was 1.45 to 18.6,most 131 I C50 was distributed in the peripheral zone of the tumors. [WT5”HZ] Conclusion [WT5”BZ] RII with 131 I C50 and 99m Tc MDP was very sensitive for the diagnosis of primary,recurrent and metastatic colorectal cancer. [WT5”HZ]