Detection and Staging of Small Cell Lung Carcinoma with a Technetiumhyphen;labeled Monoclonal Antibody A Comparison with Standard Staging Methods

摘要

Tumor-associated radiolabeled monoclonal antibodies (MoAb) can detect neoplasms in a variety of settings. The authors conducted a study comparing the ability to detect and stage small cell lung carcinoma by using a Tc-99m labeled monoclonal antibody (NR-LU-10 Fab) (NeoRx Corp, Seattle, WA) with standard staging methods. Standard staging included a physical examination, chest x-ray, a battery of radionuclide scans and/or computerized tomographic studies (head, abdomen, and bone), and bone marrow examination. A total of 22 comparisons were performed in 17 patients (five patients had revaluations after therapy). Fifty-four (74percnt;) of the 73 lesions defined by standard staging were detected by the radiolabeled MoAb. Seven of eight patients (88percnt;) classified by standard staging as having ldquo;limited stagerdquo; disease on presentation were concordantly ldquo;limited stagerdquo; by radio-immunoimaging. One patient deemed ldquo;limited stagerdquo; by standard staging was correctly upstaged (bone marrow involvement) as a result of the radiolabeled MoAb. Two patients found to have extensive disease at diagnosis were characterized as ldquo;limited stagerdquo; by the MoAb, for an overall staging accuracy of 0.88. Thirteen of 19 missed lesions were smaller than 2 cm (10 were smaller than 1 cm; 3 measured 1 to 2 cm). This comparative study shows that radioimmunoimaging by Tc-99m labeled NR-LU-10 Fab antibody is capable of complementing standard staging methods used in the evaluation of small cell lung carcinoma.