微波消融和131^I-肿瘤细胞核人鼠嵌合单克隆抗体联合治疗肺癌

Combination of microwave ablation and 131^I labeled tumor necrosis therapy chimeric antibody in the treatment of lung cancer

微波消融（MWA）被认为是一种肺癌局部控制的新型微创治疗方法，它通过超声、CT或MRI引导经皮穿刺导入微波天线，利用微波产热机制，高温原位灭活肿瘤细胞，对原发性周围型肺癌或转移性肺癌局部控制率较高，但对于瘤体负荷较大的肿瘤病灶（如肿瘤直径在3cm以上）或近肺门的中心型肺癌、多发转移性肺癌的治疗风险大、疗效欠佳。以变性和（或）坏死的肿瘤细胞核作为抗原，将131^I标记的肿瘤细胞核人鼠嵌合单克隆抗体（131^I-chTNT）与该抗原结合，导致肿瘤坏死，这是一种新型放射免疫治疗法。该方法为肺癌的治疗提供了又一新的方法，然而其治疗肺癌的完全缓解率低。MWA扩大了肿瘤坏死区而有效地增加了131^I-chTNT治疗结合抗原的靶点，故MWA联合131^I-chTNT治疗可望明显提高对肺癌的治疗效果。

Microwave ablation（MWA） has been considered as an advanced, minimally invasive tech- nique in the treatment of lung cancer with a high local efficiency. MWA can inactivate tumor cells based on microwave heating mechanisms. It has a high local control rate of primary peripheral lung cancer and metastatic lung cancer result from percutaneous microwave antennas injection under ultrasound, CT and MRI guidance. However, for the lesions those are greater than 3.0 cm in diameter or abutting the hilars and the dif- fuse lesions there is less effective.131^I labeled tumor necrosis therapy chimeric antibody （131^I-chTNT）, a novel radioimmunotherapy which uses cell of degeneration or necrotic tumor cell nuclear antigen as target provides a new therapeutic approach for lung cancer, but the complete response is low. MWA can induce a mass tumor necrosis under the action of microwave thermal effect which greatly increases the targeting area for 131^I-chTNT radioimmunotherapy. Therefore, combination of MWA and 131^I-chTNT will enhance the treatment efficacy of lung cancer.