Vanhagen P M, Krenning E P, Reubi J C, Kwekkeboom D J, Bakker W H, Mulder A H, Laissue I, Hoogstede H C, Lamberts S W
Department of Internal Medicine III, Dijkzigt University Hospital, Rotterdam, The Netherlands.
Eur J Nucl Med. 1994 Jun;21(6):497-502. doi: 10.1007/BF00173035.
Normal as well as activated lymphocytes and macrophages have previously been shown by radioreceptor analysis to express somatostatin receptors (SS-R). The somatostatin (SS) analogue [111In-DTPA-D-Phe1]octreotide (111In-octreotide) is already used successfully in the visualization of a variety of neuro-endocrine tumours and malignant lymphomas. In the present study 20 consecutive patients were investigated, 12 with sarcoidosis, one with both sarcoidosis and aspergillosis, four with tuberculosis and three with Wegener's granulomatosis. For in vivo SS-R imaging, total-body scintigraphy was performed 24 and 48 h after the administration of 111In-octreotide. Granuloma localizations could be visualized in all patients studied; additional sites were found in nine patients with sarcoidosis and in two patients with tuberculosis. In vitro autoradiography of fresh tissue biopsies, using the SS analogue [125I-Tyr3]octreotide, showed binding at sites that were microscopically identified as granulomatous inflammation. These observations demonstrate the expression of SS-R by human granulomas. This scintigraphy procedure may contribute to a more precise staging and evaluation of granulomatous diseases, but more importantly it may be a sensitive indicator of the efficacy of glucocorticoid and/or immunosuppressive therapy.
放射性受体分析先前已表明，正常以及活化的淋巴细胞和巨噬细胞均表达生长抑素受体（SS-R）。生长抑素（SS）类似物[111铟-DTPA-D-苯丙氨酸1]奥曲肽（111铟-奥曲肽）已成功用于多种神经内分泌肿瘤和恶性淋巴瘤的显像。在本研究中，对20例连续患者进行了调查，其中12例患有结节病，1例同时患有结节病和曲霉菌病，4例患有结核病，3例患有韦格纳肉芽肿病。为了进行体内SS-R成像，在注射111铟-奥曲肽后24小时和48小时进行了全身闪烁扫描。在所研究的所有患者中均可观察到肉芽肿定位；在9例结节病患者和2例结核病患者中发现了其他部位。使用SS类似物[125碘-酪氨酸3]奥曲肽对新鲜组织活检进行体外放射自显影，结果显示在显微镜下被鉴定为肉芽肿性炎症的部位有结合。这些观察结果证明了人类肉芽肿表达SS-R。这种闪烁扫描程序可能有助于更精确地分期和评估肉芽肿性疾病，但更重要的是，它可能是糖皮质激素和/或免疫抑制治疗疗效的敏感指标。
