[Evaluation of the diagnostic usefulness of CA125 immunoscintigraphy for ovarian carcinoma follow-up after treatment: contribution of this technique in Grenoble University Medical Center].
Immunoscintigraphy using indium-111-labeled OC125 monoclonal antibody F(ab')2 fragments is a technic complementary of morphological imaging (i.e. ultrasonography and computed tomography). It allows early detection of recurrences of ovarian carcinomas. We performed immunoscintigraphy 30 times in 26 patients who previously underwent radical treatment for ovarian carcinoma, and were suspected to have a recurrence. Our purposes were appreciation of diagnostic accuracy of the method, and above all its impact on clinical decisions and evolution of the patients. There were, after reevaluation of the results, 18 true positives, 7 true negatives, 3 false negatives and 2 false positive cases (sensitivity 85.7%, specificity 77.8%). Bayesian analysis showed positive and negative predictive values of 86% and 87% when probability of recurrence a priori was 50%, and 80% and 58% when probability of recurrence a priori was 70%. The result of immunoscintigraphy contributed to clinical decisions in 24 cases out of 30, and led to a correct decision for the patient in 21 cases. Conversely, for the 6 cases in which the result has not been considered, to take this result into account would have been beneficial in 4 cases, but harmful in 2. Finally, survival tended to be longer when immunoscintigraphy was negative, which could be associated with a better prognosis. We conclude that OC125-immunoscintigraphy may be useful for ovarian carcinoma follow-up and may contribute to a better therapeutic strategy.
Vuillez
J P
JP
Service de biophysique et médecine nucléaire, UPRES associée au CNRS 5077, Hôpital A.-Michallon, CHU, Grenoble.
Levrot
E
E
Mousseau
M
M
Buffaz
P D
PD
Bolla
M
M
Payan
R
R
Comet
M
M
Schaerer
R
R
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000276:immunology / Q000627:therapeutic use*; D018394:CA-125 Antigen / Q000276:immunology*; D005260:Female; D005602:France; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D016719:Radioimmunodetection; D015996:Survival Rate
D000911:Antibodies, Monoclonal; D018394:CA-125 Antigen
Evaluation de l'utilité diagnostique de l'immunoscintigraphie au CA.125 dans le suivi des carcinomes du revêtement épithélial de l'ovaire après traitement: apport décisionnel de la technique au CHU de Grenoble.