Intraoperative radioimmunodetection.
The radioimmunoguided surgery (RIGS) system employs a monoclonal antibody (CC49), a radionuclide (Iodine-125), and a hand-held gamma-detecting probe (the Neoprobe model 1000). The prototype cancer studied has been colorectal cancer. The antibody identifies a type of mucin, the by-product of the adenocarcinoma cancer cell. The RIGS system localizes up to 90% of colorectal cancers and finds additional RIGS-positive tissues in >50% of the patients. More than 90% of the RIGS-positive visceral tumors are identified by routine hematoxylin-and-eosin (H&E) light microscopy, but the RIGS-positive lymph nodes are H&E occult tissues in >70% of the cases. Enhanced, more time-consuming methods have been developed to confirm hidden cancer cells in these lymph node tissues. Survival data confirm the importance of RIGS-positive tissues. RIGS-positive tissues remaining at the completion of the surgical procedure portend a much poorer outcome than if the patient is deemed RIGS-negative at the completion of the surgical procedure (i.e., all RIGS-positive tissue was removed at surgery).
Martin
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The Arthur G. James Cancer Hospital and Research Institute, The Ohio State University, Columbus 43210, USA. emartin@surgery.medctr.ohio.state.edu
Thurston
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D000911:Antibodies, Monoclonal; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007432:Intraoperative Period; D007457:Iodine Radioisotopes; D008198:Lymph Nodes / Q000473:pathology; D009367:Neoplasm Staging; D016719:Radioimmunodetection
D000911:Antibodies, Monoclonal; D007457:Iodine Radioisotopes