放射免疫显像在食管癌分期中的应用  

Application of radioimmunoimaging in staging of esophageal carcinoma

作　　者：林鹏[1] 戎铁华[1] 刘长征[2] 樊卫[3] 刘乐和[4] 何军芳[2] 张昌卿[5] 肖锡宾[5] 

机构地区：[1]中山医科大学肿瘤防治中心胸科,广州510060 [2]中山医科大学核医学教研室,510060 [3]中山医科大学核医学科,510060 [4]中山医科大学病原生物学部,510060 [5]中山医科大学中心实验室,510060

出　　处：《中华胃肠外科杂志》2001年第3期153-156,共4页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的探讨放射免疫显像(RII)在食管癌分期的应用。方法1LSAB法测定组织切片和抗人食管鳞癌单抗G9的反应;2125I标记G9,在荷食管癌裸鼠腹腔注射125IG9后的连续3d内,测定各主要组织、器官的放射性;3食管鳞癌术前经纤维食管镜在原发灶周围黏膜下注射131IG9后行RII;4对清扫淋巴结行放射性测定。结果1LSAB显示癌原发灶和转移淋巴结呈阳性,正常食管和淋巴结阴性;2125IG9在裸鼠体内分布显示,肿瘤组织的放射性计数均明显高于其它器官/组织;3镜下注药48h时RII在食管旁纵隔、贲门旁、胃小弯旁出现散在的细点状放射性浓集,浓集区域所清扫的淋巴结中,包含有转移淋巴结;无浓集区域,未发现转移淋巴结;4全部有转移淋巴结的放射性比活度均比无转移者高,且均数高出两倍多。结论1单抗G9能选择性定位于食管鳞癌细胞膜;2125IG9在荷食管癌裸鼠有肿瘤组织导向作用,显像效果良好;3用131IG9在食管鳞癌行RII,对转移淋巴结有定位作用可作为cTNM分期的选择手段。Objective To investigate the clinical application of radioimmunoimaging(RII)in staging of esophageal carcinoma.Methods (1)McAb G9specific to cellular membran e antigen of esophageal carcinoma was prepared and identified,and immunohistochemistry(LSAB)was used to detect its reaction to frozen sections from surgical sampl es.(2) 125 I labeled G9was prepared by chlorami ne-T method.The uptake radioactivities of different organ s or tissues in 15tumor-bearing nude mice were measured at different time (24,48,and 72h )after peritoneal injection of 125 I-G9.(3) 131 I labeled McAb G9was injected into esophageal submucosa around the primary lesion via endoscopy in the patients with sq uamous cell carcinoma of thoracic esophagus before operation,and rad ioimmunoimaging(RII)was performed.(4)The dissected lymph nodes were counted for radioactivity.Results(1)LSAB revealed that G9reacted positively with the primary lesion and the metastatic lymph node,negatively with normal esophageal tissue and tumor-free lymph node.(2)The distributions of 125 I-G9in nude mice indicated that redi oactivity markedly accumulated in t umor tissue.(3)RII at 48hour after injection of 131 I-G9submucosally showed small dots accumulated in mediastinum and upper abdomen around esophagus,cardia an d gastric lesser curvature of stomac h,which were considered as metastatic lymph nodes.Pathological results r evealed positive lymph nodes in radi oactivity accumulating regions and negative nodes in radioactivity-fr ee regions.(4)Radioactivity counts of metastatic lymph nodes were significantly higher than that of non-metastatic lymph nodes.Conclusions (1)McAb G9is specific to cellular membrane antigen of esophageal carcinoma,either in the primary lesion and metastatic lymph node.(2)Because of considerable targeting a ctivity,125 I-G9could be potentially applied in RII for detecting lymph node metastasis in esophageal carcinoma.(3)RII with 131 I-G9could locate metastatic lymph n odes steadily and be used as an optional p

关 键 词：放射免疫显像 食管肿瘤 淋巴结转移 分期 

分 类 号：R735.1[医药卫生—肿瘤]