Tirovola E B, Biassoni L, Britton K E, Kaleva N, Kouykin V, Malpas J S
ICRF Department of Medical Oncology, St Bartholomew's Hospital, London, UK.
Br J Cancer. 1996 Dec;74(11):1815-20. doi: 10.1038/bjc.1996.636.
Tc-99m 2 methoxy-isobutyl-isonitrile (99mTc-MIBI), also called Sestamibi, is a safe and effective scanning agent in solid tumours. Its use in imaging lesions in multiple myeloma has been studied in 21 patients with either multiple myeloma (19/21) or monoclonal gammopathy of undetermined significance (MGUS) (2/ 21). 99mTc-MIBI scanning was positive in 14 patients, 13 with active myeloma and one patient with MGUS showing possible transformation to a more accelerated phase. In seven patients 99mTc-MIBI scanning was negative. In four of them, the result was unexpected, as they had the features of active myeloma. All four were either primarily or secondarily resistant to chemotherapy, with high total cumulative doses of doxorubicin. Overexpression of P-glycoprotein associated with multidrug resistance could be a factor, as it has been shown that 99mTc-MIBI is actively eliminated from the cell by P-glycoprotein. With this assumption, sensitivity of the scanning technique in this series is 100%, and the specificity 88%. No toxicity was experienced by any patient. 99mTc-MIBI scanning is a useful adjunct to the investigation of multiple myeloma, and may have potential as an in vivo test for multidrug resistance.
锝-99m 甲氧基异丁基异腈（99mTc-MIBI），也称为司他比，是一种用于实体肿瘤的安全有效的扫描剂。对21例患有多发性骨髓瘤（19/21）或意义未明的单克隆丙种球蛋白病（MGUS）（2/21）的患者进行了其在骨髓瘤病灶成像中的应用研究。14例患者的99mTc-MIBI扫描呈阳性，其中13例为活动性骨髓瘤，1例MGUS患者显示可能转变为加速期。7例患者的99mTc-MIBI扫描为阴性。其中4例结果出乎意料，因为他们具有活动性骨髓瘤的特征。这4例患者均对化疗原发或继发耐药，阿霉素总累积剂量较高。与多药耐药相关的P-糖蛋白过表达可能是一个因素，因为已表明99mTc-MIBI可被P-糖蛋白从细胞中主动清除。基于这一假设，本系列扫描技术的敏感性为100%，特异性为88%。所有患者均未出现毒性反应。99mTc-MIBI扫描是骨髓瘤检查的有用辅助手段，可能具有作为多药耐药体内检测的潜力。
