不能摄取^131I的甲状腺癌转移灶的^131I-hTgMcAb显像及初步治疗

对不能摄取^131I的分化型、低分化型和未分化型甲状腺癌转移灶患者，采用^131I-hTgMcAb进行显像和初步治疗，观察诊断转移灶和治疗价值。动物实验取无菌、无致热源的^131I-hTgMcAb，18．5MBq(^131I)／50μg(hTgMcAb)／kg静脉注射于新西兰实验兔，观察一个月，了解^131I-hTgMcAb的稳定性、安全性及体内代谢。临床诊断26例上述各型甲状腺癌转移患者静脉滴注^131I-hTgMcAb稀释液。经多时相SPECT显像测定肿瘤与正常组织之比(T／N)。分析治疗后4个月的^131I显像、X片、^99mTc-MIBI显像等进行疗效对照及随访肝肾功能、血常规、血小板、出、凝血时间。实验兔在静脉注射后6h内显像，见心腔、大血管显影，隐见肝区显影，但未见甲状腺、胃显影。经显像及治疗的26例甲状腺癌转移者^131I-hTgMcAb不同程度地浓聚于X摄片或CT定位的转移灶部位，未感不良反应。^131I-hTgMcAb进入转移灶的最高峰时间在72h左右。有5例患者的转移灶轻度缩小，17例患者的转移灶未见增大或增多。动物试验提示：^131I-hTgMcAb稳定性较好，未见有明显的毒性反应。对了解甲状腺癌转移灶的存在与治疗有一定的临床应用价值。

Preliminary imaging and therapy study of ~(131)I-hTgMcAb in thyroid cancer metastasis which can not accumulate ~(131)I

Aim of this work is to evaluate the diagnostic and prospective value of 131I-hTgMcAb for the differential, low differential and other type of thyroid cancer which do not uptake 131I. New Zealand rabbits were IV with asepsis and pyrogen-free 131I-hTgMcAb (18.5 mBq/kg) in order to study the stability, safety and metabolism in vivo. 26 cases of thyroid cancer with metastasis were IV 131 I-hTgMcAb. Multiple-phase SPECT imaging was done and the radioactive ratios of T/N were determined. We compared the 131I imaging, X-ray photos, 99mTc -MIBI imaging before and after 4 month therapy to evaluate the therapy effect. The liver and kidney function was followed up. The animal experiment showed that the cardiac chambers and great blood vessels could be imaged in 6 h, the liver was faintly visualized, while thyroid and stomach were not displayed. 26 cases showed 131I-hTgMcAb accumulated in the metastasis lesions which were identified by X-ray films or CT studies. The peak uptake time is about 72 h, the T/N ratio is over 4. After 4 months follow-up, the lesions of 5 cases became smaller, no changes in 17 cases. It is concluded that the stability of131I-hTgMcAb is good, no obvious side effects are found, so 131I-hTgMcAb is helpful to localize and treat the thyroid cancer.