title: Distribution of Na+/I- symporter in thyroid cancers in an iodine-deficient population: an immunohistochemical study.
abstract: BACKGROUND
  There are significant differences in the prevalence and behavior of differentiated thyroid cancers (DTC) in the iodine-deficient areas (IDA) and iodine-sufficient areas (ISA) of the world. The sodium iodide symporter (NIS), mediates active transport of iodide across the basolateral aspect of the thyroid follicular cell. However, no study had specifically addressed the issue of expression of sodium iodide symporter (NIS) in thyroid cancer specimens from IDA. The aim of the present study was to find an expression pattern of NIS in DTC in an iodine-deficient population, and to correlate it with histological subtypes, i.e., papillary carcinoma (PTC), follicular carcinoma (FTC), poorly differentiated carcinoma (PDTC), as well as with clinicopathological risk factors and iodine ((131)I) uptake by distant metastases.
  
  
  METHODS
  Immunohistochemistry was carried out in 39 cases of thyroid cancer (41 samples) including PTC (15), FTC (10), PDTC (9), anaplastic cancer (5), and resected metastases (2). Expression was correlated with the patient's age, sex, tumor size, presence or absence of extrathyroidal invasion, distant and lymph node metastases, and whole body radioiodine scan.
  
  
  RESULTS
  Overall, 61.8% of DTC patients showed NIS expression. There was no significant difference in expression rate between PTC (73.3%) and FTC (70.0%). However, expression was significantly less in PDTC (33.3%). There was no correlation between NIS expression and any clinicopathological risk factor (p > .05). The results of NIS expression were not concordant with (131)I uptake by metastases in 4 of 10 cases. (131)I uptake was absent in one case despite the finding that a metastatic site itself showed NIS expression in that case, whereas in the remaining 9 cases (131)I uptake was present although three cases did not show NIS expression.
  
  
  CONCLUSIONS
  In our experience, overall expression of NIS was comparable to other studies from ISA. We conclude that expression may not accurately predict radioactive iodine (RAI) uptake by metastases.
authors.affiliation: Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India.
authors.forename: Anjali
authors.initials: A
authors.lastname: Mishra
authors.affiliation: Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India.
authors.forename: Lily
authors.initials: L
authors.lastname: Pal
authors.affiliation: Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India. skmishra@sgpgi.ac.in.
authors.forename: Saroj Kanta
authors.initials: SK
authors.lastname: Mishra
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000737:chemistry / Q000473:pathology; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D002277:Carcinoma / Q000737:chemistry* / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D002291:Carcinoma, Papillary / Q000737:chemistry / Q000473:pathology; D018265:Carcinoma, Papillary, Follicular / Q000737:chemistry / Q000473:pathology; D005260:Female; D006043:Goiter, Endemic / Q000453:epidemiology; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D007455:Iodine / Q000172:deficiency*; D007457:Iodine Radioisotopes; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D027981:Symporters / Q000032:analysis*; D013964:Thyroid Neoplasms / Q000737:chemistry* / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D000099209:Sodium-Iodide Symporters
chemical_list: D014408:Biomarkers, Tumor; D007455:Iodine; D007457:Iodine Radioisotopes; D027981:Symporters; D000099209:Sodium-Iodide Symporters