Radioimmunoguided surgery for colorectal cancer
Radioimmunoguided surgery for colorectal cancer
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DOI：
10.1007/bf02306288
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发表时间：
1996-05-01
影响因子：
3.7
通讯作者：
Martin, WE
中科院分区：
文献类型：
--
作者：
Bertsch, DJ;Burak, WE;Martin, WE
背景：结直肠癌患者的手术是基于历史经验建立的传统。放射免疫引导手术 (RIGS) 提供了挑战这些传统的新信息。方法：32 名原发性结直肠癌患者在注射碘 125 标记的抗 TAG-72 鼠单克隆抗体 CC49 后接受了 RIGS。其中 16 例患者将肉眼肿瘤和 RIGS 阳性组织全部切除（RIGS 阴性组），16 例患者因 RIGS 阳性组织过于弥漫而仅进行传统切除肿瘤（RIGS 阳性组）。 结果：在 16 例所有 RIGS 阳性组织切除的患者中，5 例进行传统区域整块切除，11 例额外切除区域外组织。区域外疾病的鉴定增加了 2 例肝脏切除术和 25 例淋巴结切除术：10 例胃肝韧带、5 例腹腔轴、6 例腹膜后淋巴结切除术和 4 例髂淋巴结切除术。中位随访时间为 37 个月，RIGS 阴性组的生存率为 100%。 16 名患者中有 14 名（87.5%）没有疾病证据。在 RIGS 阳性组中，随访显示 16 名患者中有 14 名死亡，两名患者存活（p < 0.0001）。结论：这些结果表明 RIGS 识别的疾病传播模式与传统分期技术识别的模式不同，去除非传统区域的额外 RIGS 阳性组织可能会提高生存率。
Background: Operations for patients with colorectal cancer are based on traditions established by historical experience. Radioimmunoguided surgery (RIGS) provides new information that challenges these traditions.Methods: Thirty-two patients with primary colorectal cancer underwent RIGS after being injected with anti-TAG-72 murine monoclonal antibody CC49 labeled with iodine-125. Sixteen of the patients had all gross tumor and RIGS-positive tissue removed (RIGS-negative group), and 16 had only traditional extirpation of the tumor because RIGS-positive tissue was too diffuse (RIGS-positive group).Results: In the 16 patients having all RIGS-positive tissue removed, five had traditional regional en bloc resections and 11 had additional extraregional tissues resected. Identification of extraregional disease added two liver resections and 25 lymphadenectomies: 10 of the gastrohepatic ligament, five celiac axis, six retroperitoneal, and four iliac. With a median follow-up of 37 months, survival in the RIGS-negative group is 100%. In 14 of 16 patients (87.5%) there is no evidence of disease. In the RIGS-positive group, follow-up shows 14 of 16 patients are dead and two are alive with disease (p < 0.0001).Conclusion: These results suggest that RIGS identifies patterns of disease dissemination different from those identified by traditional staging techniques, Removal of additional RIGS-positive tissues in nontraditional areas may improve survival.