Journal of Medicine and Palliative Care

Öz

Aims: Technetium-99m-hexamethylpropylene amine oxime (99mTc-HMPAO) labeled leukocyte scintigraphy is frequently used for infection imaging. The systemic immune-inflammation index is a new marker. In this study, we aim to investigate the relationship between 99mTc-HMPAO-labeled leukocyte scintigraphy findings and systemic inflammatory markers such as Neutrophil/lymphocyte ratios (NLR) and Platelet lymphocyte ratio (PLR) and systemic immune-inflammation index (SII).
Methods: Patients who underwent 99mTc-HMPAO-labeled leukocyte scintigraphy between 2014 and 2020 due to suspected infection such as diabetic foot infection or prosthesis infection vs. in any part of the body were included in our study. In addition, a negative control group consisting of 19 normal subjects who had no leukocyte scintigraphy and had hemogram examination was added to the study. Cases with findings consistent with infection in labeled leukocyte scintigraphy and infectious symptoms in this area of involvement in the clinical examination were considered as the positive group. The data were evaluated with the SPSS 23.0 program.
Results: Our study included 36 patients (28 males,8 females, mean age: 59.7). The mean SII was 1526±787 x109 cells/L in patients with positive findings in leukocyte scintigraphy that might be compatible with infection, while it was 1025 ± 370 x109 cells/L in patients who did not (p=0.017). The mean PLR was 183.95±68.30 in patients with positive findings in leukocyte scintigraphy that might be compatible with infection, while it was 145.81±58.30 in patients who did not (p=0.102). The mean NLR was 4.82±1.91 in patients with positive findings on leukocyte scintigraphy that might be compatible with infection, while it was 4.15±1.40 in patients who did not (p=0.181). While the negative control group and the patients who were considered positive in leukocyte scintigraphy were compared; a statistically significant difference was found between SII, NLR and PLR values. When the relationship between SII was evaluated, the mean SII was 1526±787 x109 cells/L in patients with involvement that may be compatible with infection in leukocyte scintigraphy, while it was 762±224 x109 cells/L in the negative control group (p<0.05). While the relationship between PLR was evaluated, the mean PLR was 183.95±68.30 in patients with involvement that might be compatible with infection in leukocyte scintigraphy, while it was 100.67±26.18 in the negative control group (p<0.05). When the relationship between NLR was evaluated, the mean NLR was 4.82±1.91 in patients with involvement that might be compatible with infection in leukocyte scintigraphy, while it was 3.11±0.85 in the negative control group (p<0.05).
Conclusion: When labeled leukocyte scintigraphy and systemic inflammatory markers were compared, there was a statistically significant relationship between the presence of infection in scintigraphy and SII, but the relationship with NLR and PLR were not statistically significant. When the negative control group and the patients who were considered positive in leukocyte scintigraphy were compared; a statistically significant difference was found between SII, NLR and PLR values. For this reason, we think that SII, NLR and PLR may be useful markers for diagnosis confirmation in centers that can’t perform radiolabeled infection imaging.