多体位放射免疫显像诊断膀胱癌

目的　评价膀胱灌注99mTc BDI 1多体位放射免疫显像诊断膀胱癌的临床价值。　方法　采用99mTc BDI 1111～ 2 2 2MBq对 39例膀胱癌患者和 8例其他患者进行膀胱灌注多体位放射免疫显像 ,计算肿瘤组织与非肿瘤组织放射性计数之比 (T/NT值 )。　结果　膀胱癌患者不同体位γ显像在肿瘤部位有明显放射性浓聚 ,膀胱癌显像阳性率 (灵敏度 )为 94.1% ,特异性为 87.5 %。多体位放射免疫显像可显示直径 <1.0cm(0 .5～ 0 .8cm)的肿瘤 ,T/NT值与膀胱移行细胞癌的形态 (乳头状 /非乳头状 )有关。　结论　多体位放射免疫显像有利于肿瘤的早期诊断 ,可测定肿瘤体积 ,判断肿瘤位置和预后     

基因工程人-鼠嵌合抗体ch-BDI在荷瘤鼠体内外功能的研究

目的　鉴定抗人膀胱癌人 鼠嵌合抗体ch BDI在荷瘤鼠体内外功能 ,探讨其临床应用价值。　方法　通过超滤浓缩和亲合层析 ,得到较高纯度的ch BDI,用还原法标记99mTc,体外测定了其对人膀胱癌细胞的结合能力 ,应用放射免疫显像观察了其在荷瘤鼠体内的分布。　结果　99mTc标记的ch BDI的免疫活性分数约为 76% ,体外的亲合常数约为 3 5 6× 10 9M-1,在荷瘤鼠体内能够迅速浓缩聚集于肿瘤部位。　结论　抗人膀胱癌人 鼠嵌合抗体ch BDI在体内、体外均具有良好的与人膀胱癌组织的结合活性 ,有较理想的临床应用前景     

99mTc-BDI-1导向诊断膀胱癌的临床研究

目的：评价＾９９ｍＴｃ标记抗人膀胱癌单克隆抗体（ＢＤＩ－１）用于膀胱癌放射免疫显像（ＲＩＩ）诊断的临床价值。方法：采用２－巯基乙醇直接还原法将＾９９ｍＴｃ与ＢＤＩ－１进行标记,制备＾９９ｍＴｃ－ＢＤＩ－１。将其灌入１２例非膀胱癌及３２例膀胱癌患者的膀胱内,用γ－照相机采集图像,根据放射性异常浓聚作诊断。结果：１２例非膀胱癌患者均为阴性显像。３２例膀胱癌患者３０例（９４％）显像。先于膀胱镜检３个月发     

甲状腺髓样癌^99mTc（V）-DMSA的临床显象研究

目的：评价放射性枝素五价锝标记的二巯基丁二酸[^99mTc(V)-DMSA显像对甲状腺髓样癌(MTC)的临床价值。方法：43例各种甲状腺肿瘤术前患者、12例MTC术后拟进一步治疔的患者和8例MTC根治术后患者接受了1～3次^99mTc(V)-DMSA显像研究。结果：^99mTc(V)-DMSA能被MTC高度摄取，图像清晰，正常甲状腺组织及其它甲状腺良恶性肿瘤不摄取放射性，^99mTc(V)-DMSA对MTC诊断是敏度为81.8％(18／22)，特异性为100％(41／41)，准确性为93．7％(69／631。^99mTc(V)-DMSA能特异性寻找术后残留或复发、转移灶能发现小至1cm、B超和CT不易识别、临床难于扪及的MTC病灶，与血降钙素水平一起检测．可望早期发现亚临床病灶。结论：^99mTc(V)-DMSA显像是MTC的一个特异性检查手段，对于MTC的诊断、定位、监测疗效和随访有一重要的临床价值。     

抗人膀胱癌单克隆抗体188Re标记及荷瘤裸鼠体内放射性分布

目的　制备放射免疫导向药物用以诊断和治疗膀胱癌。　方法　通过 2 巯基直接还原标记法将放射性核素188Re(188铼 )标记抗人膀胱癌单克隆抗体BDI 1,标记产物188Re BDI 1经尾静脉注入荷人膀胱癌裸鼠体内 ,检测其在裸鼠体内的放射性分布。　结果　188Re BDI 1的标记率为30 % ,放射化学纯度为 90 % ,免疫活性分数为 5 8.6 8%。在裸鼠体内 ,肿瘤对188Re BDI 1的摄取率在2 3h达到高峰 ,以后随时间推移 ,逐步下降。 2 3h时T/NT比值 (肿瘤与正常组织的放射性计数之比 )明显增加 ,平均T/NT为 4.42 ,最大为 16 .19(肿瘤 /肌肉 ) ,随时间推移T/NT比值有所下降 ,48h时T/NT比值仍保持在高水平 10 .41(肿瘤 /肌肉 )、70h时T/NT比值 3.41(肿瘤 /肌肉 )。结论　188Re BDI 1在裸鼠体内对膀胱癌移植瘤有靶向定位作用。188Re BDI 1有可能成为膀胱癌放射免疫显像和治疗的导向药物。     

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生长抑素受体显像应用于乳腺癌的诊断 ,文献虽有报道 ,但较少见。现就本组 2 3例乳腺疾病应用锝标记的生长抑素类似物 ( 99mTc OCT)受体显像的临床研究结果做如下报道。1　资料和方法　　本组病人为本院 2 0 0 2年 3～ 10月收治的病例 ,年龄2 9～ 75岁。女性 2 2例 ,男性 1例。均为乳房肿块怀疑乳腺癌的病人 ,术前行临床检查 ,乳房B超 ,99mTc OCT显像 ,肿块局部切除者行病理切片检查。　　在乳腺肿块病人的健侧上肢前臂的表浅静脉注入99mTc OCT显像剂 (剂量为每人次 370MBq)。 10min后 ,病人俯卧于专用的乳腺显像装置上 ,显像范围包括…     

乳腺肿物~(99m)Tc甲氧基异丁基异腈显像的临床价值

目的　评价99mTc甲氧基异丁基异腈 (MIBI)乳腺显像对乳腺癌诊断的价值。方法　对 195例 2 0 4处乳腺肿物患者分 3组进行99mTc MIBI显像 ,并与病理对照 ,另选择无乳腺疾病者 2 0例作对照组。99mTc MIBI在乳腺中有异常浓聚且阈值数大于健侧相对应区 10 %时为阳性。结果　本研究中乳腺癌病变 10 0处 ,阳性显像 92处 ;乳腺良性病变 70处 ,阳性显像 12处 ;隐匿性病变 34处 ,阳性显像 6处 ,3处为乳腺癌 ;对照组 2 0例显像均阴性。99mTc MIBI对乳腺疾病的诊断准确率为 92 0 %、灵敏度为 91 8%、特异度为 92 %、阳性预测值为 86 %、阴性预测值为 92 %。结论　 99mTc MIBI对乳腺癌的诊断及良恶性病变的鉴别有较高的敏感性和准确性。     

^99mTc标记单克隆抗体膀胱内灌注诊断膀胱癌

目的 使放射免疫显像诊断膀胱癌更加简便，安全，可靠。方法 采用抗人膀胱癌单克隆抗体ＢＤＩ－１通过２－巯基乙醇直接还原法标记＾９９ｍＴｃ（＾９９ｍＴｃ）制备了＾９９ｍＴｃ－ＢＤＩ－１。结果 标记率为６９．９％，放化纯度大于９５％，３３例患者接受了通过膀胱内灌注的放射免疫显像诊断，其中４例非膀胱癌患者均未见显像，２９例膀胱癌患者肿瘤显像阳性率为８８．５％，原发和复发肿瘤可获得清晰的显像，显像肿瘤最小为     

放射免疫显像中T／NT与膀胱癌的相关性研究

目的：探讨^99mTc-BDI-1膀胱灌注放射免疫显像(RII)中肿瘤组织与非肿瘤组织放射性计数之比（T／NT值）与膀胱癌之间的相关性。方法：采用^99mTc-BDI-1 111-222MBq对38例膀胱癌患者及其他非膀胱肿瘤患者进行膀胱灌注,在RII的同时测定并计算T／NT值。结果：当T／NT值≥1．40时,膀胱灌注法RII具有较高的灵敏度（91．4％）及特异性（87．5％）,以此为阳性判断标准,对于肿瘤直径为＜1c膀胱肿瘤诊断及灵敏度与大的肿瘤无差异,T／NT值与膀胱移行细胞癌的恶性程度有关;随着肿瘤分期和分级的增高、肿瘤直径的增大和肿瘤形态的变化,T／NT值有增高的趋势。结论：在膀胱癌RII中,通过定量方法判断诊断结果可提高对较小肿瘤诊断灵敏度,可判断膀胱瘤的恶性程度,有助于肿瘤的早期诊断和治疗方案的选择及预后的评价。     

~(99m)Tc-奥曲肽和~(99m)Tc-MIBI显像在乳腺癌临床的应用价值

目的　探讨99mTc 奥曲肽和99mTc MIBI显像在乳腺癌中的应用价值。方法　对我院住院手术治疗的2 6例怀疑为乳腺癌的乳腺肿块患者术前行99mTc 奥曲肽和99mTc MIBI显像。以术后病理检查结果作为金标准 ,分析比较两种显像的灵敏度、特异性和准确性。结果　乳腺肿块99mTc 奥曲肽显像的灵敏度、特异性和准确性分别是94 .4 %、87.5 %和 92 .3% ,99mTc MIBI显像分别是 88.9%、75 .0 %和 84 .6 % ,两者相比特异性和准确性间差异有显著性意义 (P<0 .0 5 ,P<0 .0 1) ;对于腋窝淋巴结转移的探测 ,99mTc 奥曲肽显像的灵敏度、特异性和准确性分别是6 6 .7%、92 .9%和 80 .8% ,99mTc MIBI分别是 5 8.3%、85 .7%和 73.1% ,两者相比特异性的差异有显著性意义 (P<0 .0 1)。结论　乳腺癌99mTc 奥曲肽显像优于99mTc MIBI显像 ,术前99mTc 奥曲肽显像有助于乳腺癌手术方式的选择。     

Targeted diagnosis of bladder and ureteral carcinoma using radiolabelled BDI-1

The aim of this study is to investigate the possibility of radioimmunoimaging (RII) by radiolabelled anti-bladder carcinoma monoclonal antibody BDI-1 applied to diagnosis of bladder cancer and ureteral cancer. BDI-1 was labelled with ¹³¹I and ^99mTc. The immunoreactivity, pharmacokinetics and biodistribution in mice were studied. RII was performed in 46 patients.The results showed that ¹³¹I, ^99mTc-BDI-1 have satisfactory immunoreactivity and excellent tumor-locating properties. The blood clearance half-life T_1/2 and T_1/2 were 35 h in the first phase and 151 h in the second phase, respectively. Thirty-nine patients were studied by an intravesical administration method; the sensitivity was 90.5%. Seven patients were studied by an intravenous administration method. The RII results of three cases with primary or recurrent bladder cancer and three cases with ureteral cancer were confirmed histologically. RII was negative in one patient with suspected lung metastasis that was shown on radiography. The investigation revealed that RII can be used as an auxiliary method for the detection of bladder cancer and may be valuable for the diagnosis of ureteral cancer. Received: 21 January 1997 / Accepted: 2 March 1998     

Intravesical administration of EGF- dextran conjugates in patients with superficial bladder cancer

OBJECTIVES: Overexpression of the epidermal growth factor receptor (EGFR) has been reported in bladder cancer and is a potential target for therapy with radionuclides. In this study, we investigated the binding of EGF-dextran-(99m)Tc to the EGFR. The aim of this study was to determine if intravesically administered EGF-dextran conjungate selectively accumulated in the tumor tissue and to correlate the uptake to tumor characteristics. METHODS: Eight patients received the conjugate intravesically for about 30 min followed by bladder irrigation and then transurethral resection. Radioactivity of the biopsy specimens from normal urothelium and tumor areas was measured in a gamma counter. RESULTS: Five patients received EGF-dextran-(99m)Tc, three received dextran-(99m)Tc and one received only (99m)Tc. The 5 patients who received the complete conjugate had a mean ratio of radioactivity between tumor and normal urothelium of 664:1 (range: 2.4-1,710). The dextran-(99m)Tc showed a slightly increased ratio and (99m)Tc did not bind at all. CONCLUSION: The results are encouraging and further studies are warranted to investigate if EGF-dextran could be effective as intravesical therapy, either conjugated with cystostatic drugs or labeled with suitable radionuclides.     

免疫毒素膀胱灌注预防膀胱癌复发的临床研究

目的 评价免疫毒素在预防膀胱癌复发中的价值。方法 用免疫组化ＳＰ法检测抗人膀胱癌单克隆抗体（ＢＤＩ－Ｉ）与蓖麻毒素（ＲＴ）偶联制备的免疫毒素（ＢＤＩ－１－ＲＴ）与３８例不同分级分期膀胱移行细胞癌组织标本的结合活性。膀胱移行细胞癌患者术后３１例膀胱灌注ＢＤ－１－ＲＴ为实验组,３６例使用丝裂霉素Ｃ为对照组,观察二组疗效及副作用。以ＥＬＩＳＡ法检测实验组７例人抗鼠抗体（ＨＡＭＡ）。结果 ３１例（８２％）     

Radioimmunoguided surgery using iodine 125 B72.3 in patients with colorectal cancer

Preliminary data using B72.3 murine monoclonal antibody labeled with iodine 125 suggested that both clinically apparent as well as occult sites of colorectal cancer could be identified intraoperatively using a hand-held gamma detecting probe. We report the preliminary data of a multicenter trial of this approach in patients with primary or recurrent colorectal cancer. One hundred four patients with primary, suspected, or known recurrent colorectal cancer received an intravenous infusion of 1 mg of B72.3 monoclonal antibody radiolabeled with 7.4 x 10 Bq of iodine 125. Twenty-six patients with primary colorectal cancer and 72 patients with recurrent colorectal cancer were examined. Using the gamma detecting probe, 78% of the patients had localization of the antibody in their tumor; this included 75% of primary tumor sites and 63% of all recurrent tumor sites; 9.2% of all tumor sites identified represented occult sites detected only with the gamma detecting probe. The overall sensitivity was 77% and a predictive value of a positive detection was 78%. A total of 30 occult sites in 26 patients were identified. In patients with recurrent cancer, the antibody study provided unique data that precluded resection in 10 patients, and in another eight patients it extended the potentially curative procedure.     

Radioimmunoguided surgery benefits for recurrent colorectal cancer

Background: Despite new adjuvant therapy, 50% of patients with colon cancer will have recurrent disease. This study investigated the use of a radiolabeled monoclonal antibody in locating occult tumor during surgery for recurrent colorectal cancer. Methods: Twenty-two patients with recurrent colorectal cancer underwent surgery using the radioimmunoguided surgery (RIGS) system. All patients were subjected to abdominal and chest computed tomography (CT). Before surgery, patients were injected with the CC49 monoclonal antibody (MoAb), anti-TAG antibody labeled with¹²⁵I. Ten patients with elevated carcinoembryonic antigen (CEA) levels and no CT findings had a scintigraphy scan with an anti-CEA MoAb labeled with⁹⁹Tc. Human antimouse antibody levels of these patients were within normal limits. Surgical exploration including liver ultrasound examination was followed by survey with a gamma-detecting probe (GDP). Results: There was MoAb tumor localization in 100% of the patients. CT found nine tumor sites, traditional surgical exploration 30, and the GDP 51, with 44 confirmed by pathology (hematoxylin and eosin). The RIGS system found occult tumor in 10 patients (45.4%) and resulted in major changes in surgical procedure in 11 patients. In the 10 patients who had scintigraphy scans, 10 tumor sites were identified, whereas RIGS found an additional eight sites. Conclusion: RIGS technology offers a substantial benefit for patients undergoing surgery for recurrent colorectal cancer and a better chance of finding recurrent tumor intraoperatively in patients who have elevated CEA levels with no other CT findings. Presented at the Annual Cancer Symposium of The Society of Surgical Oncology, Atlanta, Georgia, March 21–24, 1996.     

乳腺癌前哨淋巴结活检

目的 评价前哨淋巴结活检预测腋窝淋巴结有无肿瘤转移的准确性及其临床意义。方法 用^99m锝－硫胶体作为示踪剂,用γ探测仪导向,对70例临床分期为T1－2N0M0的乳腺癌患者进行前哨淋巴结活检,所有的患者均同时行腋窝淋巴结清扫,HE染色阴性的前哨淋巴结再切片,用CK8、CK19、KP－1行免疫组织化学染色。结果 70例患者中成功发现前哨淋巴结的有67例,发现率为95.7%（67／70）。前哨淋巴结的数量为1－5枚,平均每例1.6枚。非前哨淋巴结5－20枚,平均例12.3枚。67例前哨淋巴结活检成功的患者中,29例患者（43.3%）有腋窝淋巴结转移,其中前哨淋巴结有转移者24例（35.8%）,前哨淋巴结未发现转移而非前哨淋巴结有转移者5例（7.5%）。7例患者（10.4%）只有有淋巴结为阳性淋巴结,前哨淋巴结活检的准确性为100％。43例患者的65枚HE染色阴性一的前哨淋巴结,CK8及CK19免疫组织化学染色均为阴性。结论 前哨淋巴结检能较准确地预测腋窝淋巴结转移情况,对原发灶为T1的乳腺癌,前哨淋巴结活检的准确性为100％。同一层面切片行免疫组织化学染色并不能提高淋巴结微转移癌的发现率。