Rubin R H, Fischman A J, Callahan R J, Khaw B A, Keech F, Ahmad M, Wilkinson R, Strauss H W
Infectious Disease Unit of the Medical Service, Massachusetts General Hospital, Boston 02114.
N Engl J Med. 1989 Oct 5;321(14):935-40. doi: 10.1056/NEJM198910053211404.
We performed radionuclide scanning after the intravenous injection of human IgG labeled with indium-111 in 128 patients with suspected focal sites of inflammation. Localization of 111In-labeled IgG correlated with clinical findings in 51 infected patients (21 with abdominal or pelvic infections, 11 with intravascular infections, 7 with pulmonary infections, and 12 with skeletal infections). Infecting organisms included gram-positive bacteria, gram-negative bacteria, Pneumocystis carinii, Mycoplasma pneumoniae, and Candida albicans. No focal localization of 111In-labeled IgG was observed in 63 patients without infection. There were five false negative results, and nine results were unusable. Serial scans were carried out in eight patients: continued localization correctly predicted relapse in six, and the absence of localization indicated resolution in two. To determine whether 111In-labeled IgG localization was specific for inflammation, we studied 16 patients with cancer. Focal localization occurred in 13 of these patients (5 with melanomas, 5 with gynecologic cancers, and 1 each with lymphoma, prostate cancer, and malignant fibrous histiocytoma). No localization was seen in patients with renal or colon cancer or metastatic medullary carcinoma of the thyroid. We conclude that 111In-labeled IgG imaging is effective for the detection of focal infection and that serial scans may be useful in assessing therapeutic efficacy. This technique may also be helpful in the evaluation of certain cancers.
我们对128例疑似局部炎症病灶的患者静脉注射铟-111标记的人免疫球蛋白后进行了放射性核素扫描。在51例感染患者（21例腹部或盆腔感染、11例血管内感染、7例肺部感染和12例骨骼感染）中，铟-111标记的免疫球蛋白的定位与临床发现相关。感染病原体包括革兰氏阳性菌、革兰氏阴性菌、卡氏肺孢子虫、肺炎支原体和白色念珠菌。在63例未感染的患者中未观察到铟-111标记的免疫球蛋白的局灶性定位。有5例假阴性结果，9个结果不可用。对8例患者进行了系列扫描：持续定位正确预测了6例复发，无定位表明2例病情缓解。为了确定铟-111标记的免疫球蛋白定位是否对炎症具有特异性，我们研究了16例癌症患者。其中13例患者出现局灶性定位（5例黑色素瘤、5例妇科癌症、1例淋巴瘤、1例前列腺癌和1例恶性纤维组织细胞瘤）。肾癌、结肠癌或甲状腺转移性髓样癌患者未见定位。我们得出结论，铟-111标记的免疫球蛋白成像对检测局灶性感染有效，系列扫描可能有助于评估治疗效果。该技术在某些癌症的评估中也可能有帮助。
