乳腺癌转移淋巴结的体外和体内放射免疫定位

The external and internal radioimmunodetection of metastatic lymph nodes in breast cancer

本文报告用抗乳癌单克隆抗体6C6对乳癌转移淋巴结进行体外和体内放射免疫定位的研究。用DTPA法标记^(111)铟,Iodogen法标记^(131)碘。经双侧指蹼注药对7例乳癌和1例良性乳腺肿瘤患者进行腋窝淋巴结的体外放射免疫显像。6例患侧腋窝显阳性影像,病理诊断证实其中5例有淋巴结的转移:2例显像阴性,病理结果均未见癌细胞转移。用小型季持式γ探测仪对6例患者的腋窝淋巴结进行了术中放射免疫探测。24个淋巴结的探测结果,假阳性率0/18,假阴性率1/6。对术后解剖出的60个淋巴结用井型γ幂测仪进行探测,假阳性率6/42,假阴性率2/18。

A radiolabeled monoclonal antibody (McAb) 6c6 was used to detect the metastatic lymph nodes of breast cancer externally and internally. In-111 was labeled to 6c6 by DTPA method. Iodogen method was used to label I-131. Hosted tumor in nude mouse model could be demonstrated by both isotopes labeled 6c6 with external gamma imaging. The radiolabeled 6c6 was injected into the web space of esch in seven women with breast cancer and one with benign breast tumor. The scans were positive in two axillae with palpable nodes and four with impalpable nodes. Pathologic examination later confirmed metastases in five of the axillae. Two axillae, one of which with palpable nodes, showed negative result, and here no tumor cells were found by pathologists. Intraoperative metastatic lymph node detection with a hand-held gamma probe was carried out in six patients. 24 lymph nodes were measured with 17%(1/6) false negative and no false positive result (0/18), indicating that the result detected by the hand-held gamma probe presents the real radioactivity of the tissues examined. There were 60 lymph nodes that were removed and detected again by well shape detector after operation. The false positive rate was 14%(6/42), and the false negative rate was 11%(2/18), indicating that the radiolabeled McAb 6c6 could spe- cifically combine with the metastatic lymph nodes of breast cancer in vivo.