^(99m)Tc标记三种抗人肺癌细胞单抗肺放免显像的临床研究  

Radioimmunoimaging for detection of lung cancer using ^(99m)Tc labelled antihuman lung cancer cell monoclonal antibodies: clinical study

作　　者：孙晓春[1] 周前[1] 

机构地区：[1]中国医学科学院,中国协和医科大学北京协和医院核医学科,博士研究生100730

出　　处：《中华核医学杂志》1996年第2期77-80,共4页Chinese Journal of Nuclear Medicine

基　　金：国家"八五"科技攻关基金资助

摘　　要：为了解3种特异性抗人肺癌细胞单抗(McAb)用于人肺癌放射免疫显像(RII)的临床价值,采用^(99m)Tc标记3种McAb:抗人大细胞肺癌McAb(2E_3)、抗人肺鳞状细胞癌McAb(Sm-1)和抗人肺腺癌细胞McAb(Am-7),对53例患者进行肺RII。结果:53例中真阳性34例(肿瘤直径5.74±3.12cm),假阴性10例(肿瘤直径2.45±1.01cm)。2E_3的诊断灵敏度(83%)高于Sm-1(76%)和Am-7(50%),混合单抗(2E_3+Sm-1)为87%。混合抗体可明显提高非鳞状细胞肺癌的检出率(由41.6%升至80.0%,x^2=3.91,P<0.05)。断层显像检出率可由平面显像的72%升至92%。与其他方法比较,肺RII准确性(81%)高于支气管镜活检(75%)及痰瘤细胞检查(47%)。结果表明混合单抗的应用优于单一抗体;断层显像可明显提高RII的检出率。PURPOSE To study the clinical usefulness of pulmonary RII using 3 ^(99m)Tc labelled antihuman lung cancer cell McAbs. METHODS 53 patients were studied with 3 ^(99m)Tc labelled IgG antihuman lung cancer cell MeAbss: 2E_3 (antihuman lung large cell cancer McAb), Sm-1 (antihuman lung squamous cell carcinoma McAb), Am-7 (antihuman lung adenocarcinoma cell McAb) and 2E_3+Sin-1 mixture. RESULTS 1)53 cases were verified surgically and pathologically. Among them, 44 were primary lung cancers. 2)The average diameter of the tumors with true positive RⅡ(32/44) was 5.74±3.12cm, while that of the tumor with false negative RⅡ(10/44) was 2.45±1.01cm (P<0.05). 3) The sensitivity of RⅡ using 2E_3 (83%) was higher than that of using Sm-1 (76%) and Am-7(50%). But the highest was that of the RⅡ using a mixture of the 2E_3 + Sin-1 (87%). 4) The use of the mixture of McAbs may increase the detection rate of nonsquamous cell carcinoma (from 41.6% to 80.0% ). 5)The detection rate of SPECT imaging (92%) was higher than that of planar imaging (72%). 6)In comparison with other diagnostic modalities, the accuracy of lung RⅡ(81%) was higher than that of bronchoscopy (75%) and tumor cell detection in sputum (47%). CONCLUSIONS The use of the mixture of McAbs was better than the use of a single type of McAb. The detection rate of SPECT imaging was higher than that of planar imaging.

关 键 词：单克隆抗体 肺肿瘤 放射免疫法 锝99M 

分 类 号：R734.204[医药卫生—肿瘤]