肺癌放射免疫导向手术的动物实验和临床初步应用

The experimental study of radioimmunoguided surgery for lung neoplasm and the preliminary clinical practice of radio guided surgery for lung neoplasm

目的 :用手持型γ探测仪 (Gamma detectingprobe ,GDP)对荷瘤小鼠肿瘤原发灶及微小转移灶行放射免疫探测 ,术中对肺癌的侵润范围及淋巴结转移进行了初步探测。方法 :采用抗肺腺癌单克隆抗体LC 1生物素化预定位技术 ,进行肺腺癌小鼠RIGS动物实验。应用培普利欧霉素 (peplomycin ,PPM )和甲氧基异丁基异腈(methoxy isobutylisonitrile,MIBI)为肿瘤示踪剂对肺肿瘤患者手术标本的放射性探测 ,以T/NT值判定探测标本的性质。结果 :荷瘤小鼠的原发肿瘤和转移肺组织均有较高的T/NT比值。GDP探测鼠肺肿瘤转移的灵敏度、特异性和准确率为 98%、96 %和 97%。临床应用GDP能准确地探测出肿瘤侵及范围和淋巴结转移 ,灵敏度、特异性和准确率为 91%、88%和 90 %。结论 :应用GDP可以探测出荷瘤小鼠体内肿瘤及其微小转移灶。PPM和MIBI用作肿瘤示踪剂可以有效地判别肺癌的侵润范围及淋巴结转移。

Objective:The tumors and the micrometastases of the mice model bearing pulmonary adenocacinoma were detected by means of hand held gamma detecting probe (GDP); the preliminary clinical practice of radio guided surgery (RGS) was underwent to detect the tumors and the micrometastases at the time of surgery Methods:Using biotin avidin pretargeting technique, the experimental study of RIGS on the mice bearing pulmonary adenocacinoma models was performed with antihuman lung adenocacinoma monoclonal antibody (LC 1) Using Peplomycin (PPM) or Methoxyisobutylisonitrile (MIBI) as tumor tracer, radioactivity of the specimens resected from the the patients were detected by means of GDP at time of surgery Tumor to normal tissue (T/NT) count ratio were obtained by comparing the radioactivity of the tumor tissue with the normal lung tissue Results: The T/NT ratio of the tumor and the metastatic lung of the mice were significantly high Based on the application of GDP to identify the metastases of lung, the sensitivity?the specificity and the accuracy was 98%?96% and 97% respectively Using GDP could accurately detect the tumors and the metastases of lymph node, the sensitivity?the specificity and the accuracy was 91%,88% and 90% respectively Conclusions: The tumors and the micrometastases of the lung could be detected in vivo by GDP PPM and MIBI as tumor tracer can be used in detecting tumor by means of GDP intraoperatively