99mTc标记抗卵巢癌单克隆抗体放射免疫导向手术的实验研究

李小平　钱和年　冯捷　崔恒　刘玉英　杨飞雪　傅天云

　　【摘要】　目的：进行99mTc标记卵巢癌单抗放射免疫导向手术研究，为临床应用提供基础。方法：采用改进预锡法标记COC183B2-F(ab′)2和正常鼠IgG(NMIgG)，并分别向荷人卵巢癌裸鼠体内注入99mTc-COC183B2-F(ab′)2(单抗组)和99mTc-NMIgG(对照组)。首先在体外进行放射免疫显像(RII)初步决定探测时机，然后采用肿瘤探测仪(GDP)进行体内肿瘤及临近正常组织放射性测量，并计算肿瘤与非肿瘤放射性比值(T/NT)。结果：1.改进预锡法单抗99mTc标记率达95%以上，标记后免疫组化染色显示标记物保留较好免疫活性；2.GDP体内探测肿瘤最小为0.3cm×0.1cm，分辨瘤与正常组织间最小距离为0.2cm；T/NT(肝)为3.27±0.64、T/NT(脾)为2.23±0.47、T/NT(小肠)为3.33±0.84、T/NT(肌肉)为4.68±0.81，术中可以T/NT比值大于2为肿瘤阳性诊断标准；3.RII和GDP体内探测显示，18h后可进行99mTc标记单抗片段放射免疫导向手术。结论：99mTc标记单抗进行卵巢癌放射免疫导向手术可行，有望用于临床。
　　【关键词】　卵巢肿瘤；放射免疫导向手术；抗体，单克隆；锝99m
　　中图分类号　R737.31

Experimental study of radioimmunoguided surgery with99mTc labeling monoclonal antibody in ovarian carcinoma

Li Xiaoping,Qian Henian,FengJie
（Gynecologic Oncology Center,People s Hospital,Beijing Medical University,100044）

　　Abstract Objective:To study radioimmunoguided surgery (RIGS) system with99mTc labeling monoclonal antibody (McAb) for detection of ovarian carcinoma in nude mice bearing human ovarian carcinoma.Methods:McAb COC183 B2-F(ab′)2 and normal mice IgG labelled with99mTc were prepared according to improved pretining method and were injected respectively into two groups of nude mice bearing human ovarian carcinoma with ascites.Radioimmunoimaging(RII) were performed before operations to determine the correct time of operation.The radioactivity of tumor and their neighboring tissues were measured by GDP in vivo and compared with gamma well counts after dissection in vitro.Results:COC183B2-F(ab′)2 labelled with99mTc yielded a labeling rate of over 95% and a good immunoactivity.The detection of carcinoma tissue by GDP showed T/NT(liver) 3.27±0.64，T/NT(spleen) 2.23±0.47,T/NT(intestine)0.33±0.84,T/NT(muscle)4.68±0.81 and T/NT ratio of 2:1 was diagnosed positive for cancer.The smallest carcinoma detected was 0.3cm×0.1cm and the nearest dis

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