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目的 评估放免显像在大肠癌诊断中的价值,同时探讨影响其阳性率的因素。方法 采用改良氯胺T法对抗CEA单抗进行131I标记,将碘标记后的单抗静注患者体内,48～72小时后行SPECT显像,图像采用免疫断层专用程序重建,检查前后检测血相关指标。结果 49例中47例经放免显像确诊,诊断符合率95.9%。假阳性、假阴性各1例,除5例病人有一过性发热外,余均无不良反应。显像阳性的44例中阳性或强阳性者占38例,弱阳性者有6例,前者除低分化腺癌2例,高分化腺癌5例外,其余均为中分化腺癌,后者低分化腺癌54例,高分化腺癌仅2例,大肿瘤中央区放射性分布少于边缘区;26例恶性肿瘤病人中血清CEA水平正常与升高者各13例,放免显像阳性率前后分别为92%和100%。结论 放免显像在大肠癌的诊断、分期以及术后监测上具有较高价值,且安全性好。肿瘤大小、病理类型以及血清CEA水平可能是影响放免显像结果的部分因素。
Objective To evaluate the value of RIA in the diagnosis of colorectal cancer and to explore the factors influencing its positive rate. Methods The modified chloramine T method was used to detect the anti-CEA mAb 131I, the iodine labeled monoclonal antibody was intravenously injected into the body and the SPECT imaging was performed after 48 to 72 hours. The images were reconstructed by immune-specific procedures. The blood levels were detected before and after the test index. Results Of 49 cases, 47 cases were diagnosed by RIA and the diagnostic coincidence rate was 95.9%. False positive, false negative in 1 case, in addition to 5 patients had transient fever, I have no adverse reactions. In 44 cases of positive imaging positive or strong positive accounted for 38 cases, weak positive in 6 cases, the former in addition to poorly differentiated adenocarcinoma in 2 cases, 5 cases of well-differentiated adenocarcinoma, the others were moderately differentiated adenocarcinoma, the latter low Differentiated adenocarcinoma in 54 cases, only 2 cases of well-differentiated adenocarcinoma, large tumor central area less than the marginal zone radioactive distribution; 26 cases of malignant tumor patients serum CEA levels were normal and elevated in 13 cases, before and after radiosurgery positive rate 92% and 100%. Conclusion Radiofrequency imaging in the diagnosis of colorectal cancer, staging and postoperative monitoring has high value, and good safety. Tumor size, pathological type, and serum CEA levels may be part of the factors that influence the results of RMA.