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探讨125I标记的抗胃癌单克隆抗体McAb 3H11在胃癌放射免疫导向手术(RIGS)中的应用价值。方法：McAb 3H11以Iodogen法标记125I(放射性比活度37kBq/μg蛋白)，胃镜直视下注射于15例胃癌患者癌周粘膜下，给药剂量7.4～18.5MBq/0.2～0.5mg蛋白；给药后4～11天手术，术中使用手持式γ探测仪对肿瘤、胃周淋巴结、手术切缘等靶部位(T)进行放射性检测，以正常大网膜或远离肿瘤边缘8cm以上的正常胃壁为对照本底(NT)，T/NT≥3.5为判别胃癌及浸润胃壁的标准，T/NT≥3.0为判定转移淋巴结的标准；探测结果与术后病理检验结果对照；对探测阳性而术后常规病理检验阴性的淋巴结重新连续切片，进行免疫组织化学染色。结果：RIGS判别切缘癌浸润的总特异性和准确率分别为96.5%和93.3%；注射125I-McAb 3H11后6～8天手术的患者RIGS结果较为满意(n＝7例)，判别区域淋巴结转移的敏感度、特异性及准确率分别为80.8%、96.8%和89.5%，免疫组化染色证实RIGS检出部分病例中常规病理检验未发现的淋巴结微小转移癌；实施RIGS对患者及术者均无明显不良影响。结论：应用125I标记抗胃癌单克隆抗体McAb 3H11进行胃癌放射免疫导向手术，可有效判别区域淋巴结转移，有助于指导胃癌根治性手术的实施。
To investigate the value of 125I labeled anti-gastric cancer monoclonal antibody McAb 3H11 in radioimmunoguided surgery for gastric cancer (RIGS). Methods: McAb 3H11 was labeled with 125I (37kBq / μg radioactivity) by Iodogen method. Gastroscopy was injected under the mucosa of periocular carcinoma in 15 patients with gastric cancer under direct gastroscope. The dose of McAb 3H11 was 7.4 ~ 18.5MBq / 0.2 ~ 0.5mg. 4 to 11 days after surgery, intraoperative use of handheld gamma detector on tumor, perigastric lymph nodes, surgical margin and other target sites (T) for radioactive detection to the normal omentum or away from the edge of the tumor more than 8cm of the normal stomach (NT), T / NT≥3.5 was the criterion for distinguishing between gastric cancer and gastric wall invasion. T / NT≥3.0 was the standard for determining lymph node metastasis. The detection results were compared with the postoperative pathological results. Routine pathological examination negative lymph nodes re-serial sections, immunohistochemical staining. Results: The total specificity and accuracy of RIGS in identifying the marginal carcinoma were 96.5% and 93.3%, respectively. The RIGS of patients who underwent surgery 6 to 8 days after 125I-McAb 3H11 were satisfied (n = 7) The sensitivity, specificity and accuracy of metastasis were 80.8%, 96.8% and 89.5% respectively. Immunohistochemical staining confirmed that RIGS detected some micrometastases in lymph nodes that were not detected by routine pathological examination in some cases. No obvious adverse effects. Conclusion: 125I-labeled anti-gastric cancer monoclonal antibody McAb 3H11 for gastric cancer radioimmunoassay can effectively distinguish regional lymph node metastasis and help guide the implementation of radical surgery for gastric cancer.