^(131)Ⅰ-美罗华显像在B细胞淋巴瘤中的初步临床应用研究  

The primary clinical study on radioimmunoscintigraphy with ^(131)Ⅰ-rituximab for B cell lymphoma

作　　者：李囡[1] 朱军[2] 林保和[1] 杨志[1] 许小宝[1] 张运涛[2] 郑文[2] 王小沛[1] 郭军[2] 

机构地区：[1]北京大学临床肿瘤学院,北京肿瘤医院核医学科,100036 [2]北京大学临床肿瘤学院,北京肿瘤医院淋巴血液肿瘤科,100036

出　　处：《白血病．淋巴瘤》2006年第1期20-23,共4页Journal of Leukemia & Lymphoma

摘　　要：目的通过131Ⅰ-美罗华显像监测CD20阳性B细胞淋巴瘤(NHL)病灶摄取美罗华情况,为准确分期和美罗华合理应用提供依据。方法准备充分后静脉滴注131Ⅰ-美罗华370MBq/人次,于给药后即刻及第1,3,5天行全身平面显像,第5天或第7天行头-盆部断层显像,观察阳性病灶部位及数目。结果经由临床医生核实14例CD20阳性B细胞NHL患者已知病灶数目总计109个,131Ⅰ-美罗华显像发现阳性病灶46个,其中有37个阳性病灶在已知病灶范围内,故131Ⅰ-美罗华显像总的阳性检出率为33.94%(37/109)。不同部位病灶的阳性检出率不同,131Ⅰ-美罗华显像对浅表淋巴结、深层淋巴结及脏器的阳性检出率分别为为23.52%,58.33%,44.00%(P<0.01)。另有9个阳性病灶被其他检查所遗漏,其中脾脏阳性病灶后经病理证实。结论131Ⅰ-美罗华显像对CD20阳性B细胞NHL的诊断分期有一定帮助,并可为美罗华免疫治疗提供依据。Objective Monitoring the ^131Ⅰ-rituximab uptake of whole-body lymphoma lesions in CD20 positive B cell non-Hodgkin lymphoma patients by plane scans and SPECT scans, in order to stage accurately and apply rituximab reasonably. Methods Whole-body plane scans are made ＂after infusion 370 MBq ^131Ⅰ-rituximab at four time points： immediately after injection; and on the first, third and fifth day, respectively. And whole- body SPECT scans are performed five or seven days after infusion. It is aimed at observing the uptake of ^131Ⅰ-rituximab in different lesions and recording the locations and ranges of the positive focuses. Results There are total 109 known lymphoma lesions in fourteen patients with CD20 positive B cell NHL, which are all verified by physicians, and forty-six positive lesions are revealed by ^131Ⅰ-rituximab radioimmunoscintigraphy. Of the 109 known lesions that were documented , ^131Ⅰ-rituximab radioimmunoscintigraphy detected 33.94 % （37 out of 109）, while lesions in different locations have different positive rate, in detail, positive rate of superficial lymph node, deep-seated lymph node and organ was 23.52 %, 58.33 %, 44.00 %, respectively（P 〈0.01）. In addition, ^131Ⅰ- rituximab radioimmunoscintigraphy uncovered nine sites not evident by other examinations, in which lesions in spleen are approved by pathology suhsequently. Conclusion ^131Ⅰ-rituximab radioimmunoscintigraphy is useful for the diagnosis and stage of CD20 positive B-cell NHL, and it is also the basis of immunotherapy with rituximab.

关 键 词：^131Ⅰ-美罗华显像 B细胞淋巴瘤 

分 类 号：R733.1[医药卫生—肿瘤]