Differentiated thyroid carcinoma that express sodium-iodide symporter have a lower risk of recurrence for children and adolescents.
The sodium-iodide symporter (NIS) is expressed by papillary (PTC) and follicular (FTC) thyroid carcinoma, and is essential for iodine uptake. We hypothesized that PTC and FTC with detectable NIS immunostaining would be more amenable to radioactive iodine ((131)I) treatment and follow a more benevolent course. To test this, we determined NIS expression by immunohistochemistry in 23 PTC, 9 FTC, and 12 benign thyroid lesions from children and adolescents. NIS expression was determined by two blinded examiners and graded as absent = 0, minimal = 1, moderate = 2, intense = 3, and very intense = 4. NIS was detected in 35% (eight of 23) of PTC, 44% (four of 9) of FTC, 25% (two of eight) of benign tumors, and 100% (four of four) of autoimmune lesions. The intensity of NIS expression was similar in PTC (0.61 +/- 0.24), FTC (0.56 +/- 0.24), and benign tumors (0.50 +/- 0.33) but was more intense in autoimmune lesions (3.0 +/- 0.7, p < 0.005). Distant metastases were found only among PTC with undetectable NIS (two of 15, 13%), and recurrence developed exclusively from PTC and FTC with undetectable NIS (four of 20, 20% versus zero of 12, p = 0.043). The dose of iodine 131 required to achieve remission in the five patients with PTC who had undetectable NIS (213.3 +/- 53 mCi) was greater than that required by patients with similar age and extent of disease for whom NIS expression is unknown (109 +/- 22 mCi, p = 0.06). We conclude that NIS expression is associated with a lower risk of recurrence for PTC and FTC of children and adolescents.
Patel
Aneeta
A
Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA.
Jhiang
Sissy
S
Dogra
Shalini
S
Terrell
Richard
R
Powers
Patricia A
PA
Fenton
Cydney
C
Dinauer
Catherine A
CA
Tuttle
R Michael
RM
Francis
Gary L
GL
D018263:Adenocarcinoma, Follicular / Q000737:chemistry* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D015415:Biomarkers; D002291:Carcinoma, Papillary / Q000737:chemistry* / Q000453:epidemiology / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D002454:Cell Differentiation; D002648:Child; D003131:Combined Modality Therapy; D006111:Graves Disease / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007457:Iodine Radioisotopes / Q000008:administration & dosage / Q000627:therapeutic use; D009362:Neoplasm Metastasis; D009363:Neoplasm Proteins / Q000032:analysis*; D011379:Prognosis; D012008:Recurrence; D012306:Risk; D016037:Single-Blind Method; D027981:Symporters / Q000032:analysis*; D013964:Thyroid Neoplasms / Q000737:chemistry* / Q000453:epidemiology / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D013965:Thyroidectomy; D013967:Thyroiditis, Autoimmune / Q000378:metabolism / Q000473:pathology; D000099209:Sodium-Iodide Symporters
D015415:Biomarkers; D007457:Iodine Radioisotopes; D009363:Neoplasm Proteins; D027981:Symporters; D000099209:Sodium-Iodide Symporters