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Nuklearmedizin 1992; 31(01): 16-23
DOI: 10.1055/s-0038-1629594
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Schattauer GmbH

Stellenwert der Radioimmunszintigraphie in der Diagnostik und Verlaufskontrolle des Ovarialkarzinoms im Vergleich zur Computertomographie und Second Look-Operation

Value of Radioimmunoscintigraphy in the Diagnosis and Follow-Up of Ovarial Cancer in Comparison with Computer Tomography and “Second Look” Surgery
G. Barzen
3   Aus der Strahlenklinik und Poliklinik (Dir.: Prof. Dr. R. Felix)]
,
W. Friedmann
1   Frauenklinik und Poliklinik (Dir.: Prof. Dr. W. Lichtenegger) und der
,
W. Richter
3   Aus der Strahlenklinik und Poliklinik (Dir.: Prof. Dr. R. Felix)]
,
W. Schönegg
1   Frauenklinik und Poliklinik (Dir.: Prof. Dr. W. Lichtenegger) und der
,
H. Rieß
2   Medizinischen Klinik und Poliklinik, Abt. Hämatologie und Onkologie (Dir.: Prof. Dr. D. Huhn), Klinikum Rudolf Virchow, Freie Universität Berlin, FRG
,
H. Eichstädt
2   Medizinischen Klinik und Poliklinik, Abt. Hämatologie und Onkologie (Dir.: Prof. Dr. D. Huhn), Klinikum Rudolf Virchow, Freie Universität Berlin, FRG
,
W. Lichtenegger
3   Aus der Strahlenklinik und Poliklinik (Dir.: Prof. Dr. R. Felix)]
,
R. Felix
3   Aus der Strahlenklinik und Poliklinik (Dir.: Prof. Dr. R. Felix)]
› Author Affiliations
Further Information

Publication History

Eingegangen: 24 June 1991

08 October 1991

Publication Date:
05 February 2018 (online)

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Zusammenfassung

Die Szintigraphie mit radioaktiv markierten Antikörpern findet zunehmend Anwendung bei verschiedenen Tumoren. In der vorliegenden prospektiven Studie werden die Grundzüge der Radioimmunoassay (RIS) und ihre Wertigkeit in der Diagnostik und Verlaufskontrolle des Ovarialkarzinoms im Vergleich zur Computertomographie (CT) und zur Second Look-Operation anhand von 27 Patientinnen (Primärdiagnostik) und 52 Patientinnen (Verlaufskontrolle und Re-Staging nach chirurgischer und Chemotherapie) dargestellt. Die Ergebnisse werden mit der Immunhistochemie und dem CA125-Serum-Spiegel verglichen. Wir fanden in der Primärdiagnostik eine Sensitivität für die RIS von 100% bei einer Spezifität von 60%, in der Rezidivdiagnostik von 75% bzw. 68%. Es zeigte sich, daß die RIS besonders zum Nachweis der Peritonealkarzinose gegenüber der CT eine höhere Sensitivität besitzt bei geringerer Sensitivität für Organmetastasen. Dennoch können CT und RIS die »Second Look«-Operation nicht ersetzen.

Summary

In this prospective study the diagnostic capability of radioimmunoscintigraphy (RIS) was compared with that of computed tomography (CT) and of “second look” surgery as primary diagnostic procedures in 27 patients and in the follow- up of 52 women suspected of suffering from ovarian cancer. The results were compared with immunohistochemical findings and CA125 serum levels. For primary diagnosis sensitivity, specificity and diagnostic accuracy of RIS was 100%, 60% and 90%, resp. In follow-up, sensitivity for local recurrencies was 75% and specificity 68%. Peritoneal carcinosis in the pelvis and lower abdominal region was better detectable by RIS, but for detection of liver metastases CT showed better results. CT and RIS could not replace “second look” surgery.

Schlüsselwörter

Radioimmunszintigraphie - OC125 - Ovarialkarzinom

Key words

Radioimmunoscintigraphy - OC125 - ovarial carcinoma
 

  • LITERATUR

  • 1 Aure JC, Hoeg K, Kolsted P. Clinical and histological studies in ovarian carcinoma. Long-term follow-up of 990 cases. Obst Gynecol 1977; 37: 1-9.
    Google Scholar
  • 2 Bagley CM, Young RC, Schein PS, Chabner BA, De Vita VT. Ovarian carcinoma metastatic to the diaphragm: frequently undiagnosed at laparatomy – a preliminary report. Am J Obst Gynecol 1973; 116: 397-400.
    CrossrefPubMedGoogle Scholar
  • 3 Barzen G, Mayr AC, Langer M. et al. Radioimmunoscintigraphy of ovarian cancer with 131iodine labeled OC-125 antibody fragments. Eur J Nucl Med 1989; 15: 42-8.
    PubMedGoogle Scholar
  • 4 Bast RC, Feeney M, Lazarus H. et al. Reactivity of a monoclonal antibody with human ovarian carcinoma. J Clin Invest 1981; 68: 1331-7.
    CrossrefPubMedGoogle Scholar
  • 5 Baum RP, Maul FD, Senekowitsch S. et al. Radioimmunoscintigraphy and radioimmunotherapy with monoclonal antibodies (19-9/anti-CEA and OC-125). In: Radioaktive Isotope in Klinik und Forschung. Höfer R, Bergmann H. Hrsg. 1986; 17: 443-7.
    PubMedGoogle Scholar
  • 6 Berek JS, Knapp RC, Malkasian GD. et al. CA125 serum levels correlated with second look operations among ovarian cancer patients. J Obst Gynecol 1986; 67: 685-9.
    Google Scholar
  • 7 Breit A, Rhode U. Computertomographie gynäkologischer Tumoren. Stuttgart - New York: Thieme; 1981: 54-7.
    Google Scholar
  • 8 Brenner DE, Shaff MI, Jones HW. et al. Abdominopelvic computed tomography: evaluation in patients undergoing second- look laparatomy for ovarian carcinoma. Obst Gynecol 1985; 65: 715-9.
    PubMedGoogle Scholar
  • 9 Buy JN, Moss AA, Ghossain A. et al. Peritoneal implants from ovarian tumors: CT findings. Radiology 1988; 169: 691-4.
    CrossrefPubMedGoogle Scholar
  • 10 Chatal JF, Saccavini JC, Fumoleau P. Immunoscintigraphy of gynecological carcinomas with 131I-OC-125-F(ab’)2 monoclonal antibody. J Nucl Med 1987; 28: 1807-19.
    PubMedGoogle Scholar
  • 11 Davis HM, Zurawsky VR, Bast RC, Klug TL. Characterization of the CA 125 antigen associated with human epithelial ovarian carcinomas. Cancer Res 1986; 46: 6143-8.
    PubMedGoogle Scholar
  • 12 Davis JO, Davis ER, Howe K. et al. Radionuclide imaging of ovarian tumours with 123I-labelled monoclonal antibody (NDOG2) directed against placental alkaline phosphatase. Br J Obst Gynaecol 1985; 92: 277-86.
    CrossrefPubMedGoogle Scholar
  • 13 Deland FH, Goldenberg DM. Diagnosis and treatment of neoplasms with radionuclide-labeled antibodies. Sem Nucl Med 1985; 15: 2-11.
    Google Scholar
  • 14 Dhokia B, Canney PA, Pectasides D. et al. A new immunoassay using monoclonal antibodies HMFG1 and HMFG2 together with an existing marker CA 125 for serological detection and management of epithelial ovarian cancer. Br J Cancer 1986; 54: 891-5.
    CrossrefPubMedGoogle Scholar
  • 15 Ebner F, Lahousen M, Steiner H, Kopp W. Abdominelle Computertomographie versus Second-Look-Operation bei chemotherapierten Ovarialkarzinomen. Tumor Diagn Ther 1986; 07: 145-9.
    Google Scholar
  • 16 Epenetos AA, Carr D, Johnson PM, Boder WF, Lavender JP. Antibody-guided radiolocalisation of tumours in patients with testicular or ovarian cancer using two radioiodinated monoclonal antibodies to placental alkaline phosphatase. Br J Radiol 1986; 59: 117-25.
    CrossrefPubMedGoogle Scholar
  • 17 Giwerc M, Massulot J, George M, Rochard F, Haie C. Intérët de l’examen tomodensitometrique dans la surveillance des cancers de l’ovaire. J Radiol 1986; 67: 769-74.
    PubMedGoogle Scholar
  • 18 Goldenberg DM, Kim EE, Deland FH, Bennet S, Primus FJ. Radioimmunodetection of cancer with radioactive antibodies to carcinoembryonic antigen. Cancer Res 1980; 40: 2984-91.
    PubMedGoogle Scholar
  • 19 Goldhirsch A, Triller JK, Greiner R, Dreher E, Davis BW. Computed tomography prior to second look operation in advanced ovarian cancer. Obst Gynecol 1983; 62: 630-4.
    PubMedGoogle Scholar
  • 20 Goldhirsch A, Joss R, Greiner R. Das Ovarialkarzinom: neue prognostische und therapeutische Gesichtspunkte. Schweiz Med Wschr 1981; 110: 1597-1601.
    Google Scholar
  • 21 Granowska M, Nommon CC, Britton KE. Immunoscintigraphy of ovarian cancer by means of HMFG2 monoclonal antibody. In: Nuclear medicine in clinical oncology - Current status and future aspects. Winkler C. ed. Berlin: Springer; 1986: 171-76.
    Google Scholar
  • 22 Griner PF, Mayewski RJ, Mushlin AS. Selection and interpretation of diagnostic tests and procedures. Ann Intern Med 1981; 94: 559-64.
    CrossrefGoogle Scholar
  • 23 Kivinen S, Kuoppala T, Leppilampi M, Vuori J, Kaupipila A. Tumor-associated antigen CA125 before and during the treatment of ovarian carcinoma. Obst Gynecol 1986; 67: 468-72.
    PubMedGoogle Scholar
  • 24 Kohler G, Mielstein C. Continuous cultures of fused cells secreting antibodies of predefined specifity. Nature 1975; 256: 495-7.
    CrossrefPubMedGoogle Scholar
  • 25 Pansini F, Bellinazi A, Rainaldi V. et al. Serum CA 125 in ovarian pathology and its variation in ovarian carcinoma after integrated therapy. Gynecol Obst Invest 1986; 21: 47-51.
    Google Scholar
  • 26 Pateisky N, Philipp K, Skolder WD. et al. Radioimmunodetection in patients with suspected ovarian cancer. J Nucl Med 1985; 26: 1369-75.
    PubMedGoogle Scholar
  • 27 Pressman D, Keighley G. The zone of activity of antibodies as determined by the use of radioactive tracers; the zone of nephrotoxic anti-kidney serum. J Immunol 1948; 59: 141-9.
    PubMedGoogle Scholar
  • 28 Rhode U, Steinbrich W, Friedmann G. Computertomographie der Ovarialtumoren - Fortschritte in der Diagnostik. Radiologe 1982; 22: 146-53.
    PubMedGoogle Scholar
  • 29 van Nagel JR, Kim E, Casper S. et al. Radioimmunodetection of primary and metastatic ovarian cancer using radiolabeled antibodies to carcinoembryonic antigen. Cancer Res 1980; 40: 502-6.
    PubMedGoogle Scholar
  • 30 Walsh JW, Rosenfield AT, Jaffe CC. et al. Prospective comparison of ultrasound and computed tomography in evaluation of gynecologic pelvic masses. Am J Roentgenol 1978; 131: 955-60.
    CrossrefPubMedGoogle Scholar
  • 31 Witebsky E. Desponsibilität und Spezifität alkohollöslicher Strukturen von Organen und bösartigen Geschwülsten. Z Immunitätsforsch Ext Ther 1929; 62: 35-73.
    Google Scholar
  • 32 Del Vechio S, Reynolds JC, Carrasquillo JA, Lora ME, Larson SM. Human antimurin antibody (HAMA) concentration and HAMA-murine antibody (antibody-antibody) complexes. J Nucl Med 1987; 28: 614 (Abst).
    Google Scholar