The value of immunoscintigraphy for the operative retreatment of colorectal cancer. Limitations of a new diagnostic method.
In 42 patients with suspected recurrent colorectal cancer, results of conventional diagnostic methods were compared with those of immunoscintigraphy. In 69% of all cases, the intraoperative findings of a second-look operation served for validation, whereas in 31% close follow-up was used. Recurrent tumors were successfully localized in 83% of patients by conventional methods, whereas immunoscintigraphy was expressive in 57% of cases. Immunoscintigraphy was disappointing especially because of its low sensitivity (23%) and low predictive value (positive, 33%; negative, 37%) with regard to successful diagnosis of extrahepatic tumors compared with the results of conventional methods (77% sensitivity; positive, 94%; negative, 79%). The rate of false-positive results was relatively high with immunoscintigraphy (n = 12), 83% of which were related to extrahepatic recurrent tumors. The value of immunoscintigraphy using an immunococktail of 131-J-labeled F(ab')2 fragments of monoclonal antibodies against CEA, with Ca 19-9 as an additional diagnostic tool for early detection of recurrent colorectal cancer, must therefore be viewed critically.
Hölting
T
T
Department of Surgery, University of Heidelberg, Federal Republic of Germany.
Schlag
P
P
Steinbächer
M
M
Kretzschmar
U
U
Georgi
P
P
Herfarth
C
C
D000911:Antibodies, Monoclonal; D002272:Carcinoembryonic Antigen / Q000032:analysis / Q000276:immunology; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D005189:False Positive Reactions; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes; D007813:Laparotomy; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000601:surgery; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012086:Reoperation
D000911:Antibodies, Monoclonal; D002272:Carcinoembryonic Antigen; D007457:Iodine Radioisotopes