Ralph J. Doerr

Radiolabeled antibody imaging in the management of colorectal cancer. Results of a multicenter clinical study.

Presurgical colorectal cancer patients (n = 116) received single intravenous infusions of 1 mg of CYT-103 (OncoScint CR103), an immunoconjugate of monoclonal antibody B72.3, radiolabeled with 111In. Following gamma camera imaging, 103 patients underwent an operative procedure: 92 had primary or recurrent colorectal carcinoma, 1 patient evaluated for recurrence of colorectal cancer had a second primary malignancy (small cell lung), and 10 patients had no demonstrable evidence of malignancy. 111In-CYT-103 immunoscintigraphic findings were consistent with the pathologic diagnoses for 70% of patients with colorectal cancer and 90% of disease-free patients. Antibody imaging contributed to surgical decision making through the detection of occult disease (12% of patients) and the confirmation of localized, potentially resectable disease without regional or metastatic spread. Seven patients (6%) experienced adverse effects, primarily fevers and itching, and 33% of patients developed antibodies to murine immunoglobulin after administration of 111In-CYT-103. The results of this study suggest that 111In-CYT-103 is a useful diagnostic tool for the presurgical evaluation of colorectal cancer patients.

Augmentation of the immune response of the murine liver by levamisole

Murine hepatic nonparenchymal cells (NPC) were studied following in vivo treatment with levamisole. This agent was found to increase the cytolytic action of these cells against YAC-1 and P815 target cells. An increase in the cytostatic activity against liver-derived murine colon adenocarcinoma 38 tumor cells was also observed. Treatment with levamisole also augmented the proliferation of the hepatic NPC. Supernatants generated by these cells contained an agent capable of stimulating the proliferation of bone marrow cells from the same mice. The effect of levamisole on different subsets of NPC derived from the liver in this model is discussed.

Mucocele of the appendix and colorectal neoplasms

To the Editor--The article by Fujiwara e t al. 1 raises interesting observations related to the histopathology of mucocele of the appendix and its management. Our interest in the subject stems from three patients we have been treating for the past two years. The first case involves a mucinous cystadenoma (MCA) in a 42-year-old female with known ulcerative proctocolitis. 2 The lesion was not appreciated on colonoscopy but was noted on a computerized tomographic scan and was treated with a hemicolectomy. The second case is a 57-year-old female who underwent laparoscopic appendectomy for chronic abdominal pain. The computed tomographic scan was suggestive of appendicitis. Following removal, the slightly thickened appendix proved to be a MCA with appendicitis. The third case is 58-year-old white male who underwent an appendectomy for acute appendicitis. The inflamed appendix proved to be a perforated MCA with adenomatous changes extending to the surgical margin. A postoperative colonoscope revealed a large villous lesion in the cecum (Fig. 1) and a sessile lesion in the transverse colon. At extended right colectomy, there was no mucinous ascites. The cecal lesion was a villous adenoma with invasive