Line B R, Hunninghake G W, Keogh B A, Jones A E, Johnston G S, Crystal R G
Am Rev Respir Dis. 1981 Apr;123(4 Pt 1):440-6. doi: 10.1164/arrd.1981.123.4.440.
Current concepts of the pathogenesis of sarcoidosis suggest that the alveolitis of this disorder is related to increased numbers of mononuclear phagocytes and activated T-lymphocytes within the lung. To determine if 67Ga scanning, a procedure commonly used in the evaluation of inflammation, would be useful in staging the alveolitis of sarcoidosis, we studied 41 patients with this disorder and correlated estimates of pulmonary 67Ga accumulation with clinical, roentgenographic, physiologic, and bronchoalveolar lavage studies in these patients. Although 65% of patients with sarcoidosis showed increased amounts of 67Ga accumulation in the lung compared with control subjects, only weak correlations (r less than +/- 0.42, all comparisons) were found between the degree of gallium uptake and the clinical, roentgenographic, or physiologic data. In contrast, there was a strong correlation of 67Ga uptake and the number of lymphocytes and T-lymphocytes recovered from the lungs of these patients by bronchoalveolar lavage (p less than 0.0001, r greater than or equal to 0.67, both comparisons). This data suggested that gallium uptake reflects the intensity of the T-lymphocytes mediated component of the alveolitis in sarcoidosis. Because 67Ga scans are noninvasive, simple to perform, and widely available, they should prove useful to stage the activity of sarcoidosis and to make decisions regarding therapy directed against the alveolitis of the disease.
结节病发病机制的当前概念表明，该疾病的肺泡炎与肺内单核吞噬细胞和活化T淋巴细胞数量增加有关。为了确定常用于评估炎症的67Ga扫描是否有助于对结节病的肺泡炎进行分期，我们研究了41例该疾病患者，并将肺部67Ga积聚的评估结果与这些患者的临床、放射学、生理学和支气管肺泡灌洗研究结果进行了关联分析。尽管与对照组相比，65%的结节病患者肺部67Ga积聚量增加，但在镓摄取程度与临床、放射学或生理学数据之间仅发现了微弱的相关性（所有比较中r均小于±0.42）。相比之下，67Ga摄取与通过支气管肺泡灌洗从这些患者肺部回收的淋巴细胞和T淋巴细胞数量之间存在很强的相关性（p小于0.0001，两次比较中r均大于或等于0.67）。这些数据表明，镓摄取反映了结节病肺泡炎中T淋巴细胞介导成分的强度。由于67Ga扫描是非侵入性的，操作简单且广泛可用，它们应被证明有助于对结节病的活动进行分期，并就针对该疾病肺泡炎的治疗做出决策。
