PURPOSE: This prospective study was performed to evaluate the usefulness of preoperative radioimmu-noscintigraphy and intraoperative scintimetric examination (radioimmunoguided surgery: RIGS) using (99m)Tc-anti-CEA F(ab')(2), fragment. MATERIALS AND METHODS: Nineteen patients with rectal cancer underwent preoperative whole body planar scintigraphy at 4 hours after injection of (99m)Tc-anti-CEA F(ab')(2), fragment and SPECT imaging at 18 hours. Surgical operation was performed at 24 hours after injection. During laparotomy, radioactivities from intraabdominal viscera were measured by gamma probe. The radioac-tivities from excised tumor and lymph nodes were also measured and compared with pathology. RESULTS: All nineteen patients were confirmed to have adenocarcinomas in the rectum. Twenty-seven of 97 excised lymph node groups had metastasis and 2 patients had liver metastasis in pathology. Preoperative radioim- munoscintigraphy detected primary tumors in 11 patients (sensitivity 55%) and it couId not detect any lymph nodes or liver metastasis. All patients showed high radioactivity in the kidneys, liver, spleen, and major vessels in intraoperative measurement by gamma probe, and tumor activity was not discriminated from background activity. However, ra4ioactivity from excised tumor was higher than normal rectum (T/B ratio; 3.47+/-2.25). When excised lymph node activity/background activity ratio > 1,5 was considered as positive criteria of metastasis, sensitivity, specificity, positive and negative predictive values were 78.6%, 73.9%, 55.0% and 89.5%, respectively. CONCLUSION: Radioimmunoscintigraphy using (99m)Tc-anti-CEA F(ab')(2). has no additional value for preoperative staging and use of early RIGS using (99m)Tc-anti-CEA F(ab')(2)is inappropriate. For early RIGS using (99m)Tc labeled antibodies in rectal cancer patients, further development of more specific antibodies and methods to reduce background activity are needed.
Adenocarcinoma ; Antibodies ; Humans ; Kidney ; Laparotomy ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Pathology ; Pilot Projects* ; Prospective Studies ; Radioactivity ; Radioimmunodetection* ; Radionuclide Imaging ; Rectal Neoplasms* ; Rectum ; Sensitivity and Specificity ; Spleen ; Tomography, Emission-Computed, Single-Photon ; Viscera

PURPOSE: Breast cancer results from the progressive accumulation of a series of genetic alterations leading to neoplastic transformation. Recent studies have shown that a) HMGI proteins play an important role in the regulation of chromatin structure and function and b) the expression of aberrant HMGI [HMGI(Y) and HMGI-C] proteins is generally correlated with malignant tumors. We tried to define the function of HMGI in carcinogenesis and we compare the expression of HMGI with known clinicopathologic parameters. MATERIALS AND METHODS: Using Reverse transcriptase-polymerase chain reaction (RT-PCR), we determined the expression of HMGI mRNA in 60 primary malignant tumors, 20 normal tissue, 13 benign tumors, and four ductal carcinoma in situ. Immunohistochemical staining of p53, ER, PR, and clinicopathological parameters were evaluated. RESULTS: The expression of the HMGI(Y) mRNA increased more in malignant tissue (90%, 54 of 60) than in benign (76.9%) and normal (65%) tissues (p=0.031). The expression of HMGI-C mRNA was visible only in malignant (48.4%, 29 of 60) and benign (23.1%, 3 of 13) tumors. The expression of HMGI-C mRNA increased more in malignant tumors than in benign tumors (p<0.001). In invasive ductal tumors (n=50), the expression of HMGI-C mRNA was observed more in high grade tumors (grade 3~81.3%, grade 1, 2~32.4%) (p=0.005). Among the prognostic parameters, only the number of mitotic figures was related to the expression of HMGI-C mRNA (p=0.046). CONCLUSION: These results suggest that a) HMGI-C gene may be correlated with the formation of breast tumors and b) the expression of HMGI-C gene may be of pathogenetic and prognostic importance in human breast cancer.
Breast Neoplasms* ; Breast* ; Carcinogenesis ; Carcinoma, Intraductal, Noninfiltrating ; Chromatin ; HMGA1a Protein ; Humans ; Humans* ; RNA, Messenger