Прогностическое значение экспрессии натрий-йодного симпортера для высокодифференцированного рака щитовидной железы

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Abstract


The clue function of thyroid follicular cells is iodide (I) uptake and thyroid hormones production. NIS mediates the active transport of I into the thyroid follicular cells. It is impossible to perform effective 131I radioablation (131I RA) up to 10% of all differentiated thyroid cancer (DTC) owing to dedifferentiation and lost ability to cumulate I. To distinguish this group of patient preoperatively is difficult.

Aim.

To assess the utility of using membrane located NIS detection as marker of unfavorable prognosis for DTC after 131I RA.

Materials and methods.

We enrolled in our study retrospectively sixty patients with DTC operated from 2005 to 2008. Based on postop routine histology examination we performed TNM staging. Forty-five patients received 131I RA postoperatively. During 60 month of follow up recurrence were detected in 20 cases. In all 60 patients' level of membrane located NIS expression were detected immunohistochemicaly (IHC) in primary thyroid tumor. All statistical analysis performed using PC program Statistica 7.0.

Results.

We found that mean level of membrane located NIS expression in DTC is 4.5%, with maximum up to 10%, whereas mean level of NIS expression in normal tissue is 30—40%. Least mean level of NIS expression was in patients group with recurrence of DTC after 131I RA (p=0.00083). We proved that crutial for recurrence of DTC after 131I RA were decreased level of membrane located NIS expression less than 1%. As well as we found statistically significant correlation between Recurrence Free Survival (RFS) and level of NIS expression (p <0.005).

Conclusion.

Membrane location of NIS determines its functional activity, and membrane located NIS amount decreases in DTC. Detection of membrane located NIS in DTC has prognostic value.


About the authors

Dmitriy Yur'evich Semenov

First Pavlov State Medical University of St. Petersburg

Email: semyonov_dyu@mail.com

Russian Federation MD, PhD, Professor, Chief of the General surgery chair

Marina Evgen'evna Boriskova

First Pavlov State Medical University of St. Petersburg

Email: boriskovam@gmail.com

Russian Federation MD, PhD, Assistant professor, Head of the oncology department #3 of the Research institute for surgery and emergency medicine

Ul'yana Valentinovna Farafonova

First Pavlov State Medical University of St. Petersburg

Author for correspondence.
Email: medici@yandex.ru

Russian Federation MD, PhD-student, phisician of the oncology department #3 of the Research institute for surgery and emergency medicine

Roman Viktorovich Grozov

First Pavlov State Medical University of St. Petersburg

Email: medici@yandex.ru

Russian Federation MD, PhD, assistant professor at the Pathology chair

Polina Aleksandrovna Pankova

First Pavlov State Medical University of St. Petersburg

Email: polipank@mail.ru

Russian Federation MD, PhD, assistant professor at the General surgery chair

Ekaterina Nikolaevna Smolina

First Pavlov State Medical University of St. Petersburg

Email: k_aka@yandex.ru

Russian Federation MD, PhD, lecturer at the General surgery chair

References

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  2. Dohan O, De la Vieja A, Paroder V, et al. The Sodium/Iodide Symporter (NIS): characterization, regulation, and medical significance. Endocr Rev. 2003;24(1):48-77. doi: 10.1210/er.2001-0029.
  3. Ryu K-Y, Senokozlieff ME, Smanik PA, et al. Development of reverse transcription-competitive polymerase chain reaction method to quantitate the expression levels of human sodium iodide symporter. Thyroid. 1999;9(4):405-409. doi: 10.1089/thy.1999.9.405.
  4. Liang J. Differential expression of the Na+/I- symporter protein in thyroid cancer and adjacent normal and nodular goiter tissues. Oncol Lett. 2012. doi: 10.3892/ol.2012.947.
  5. Mian C, Barollo S, Pennelli G, et al. Molecular characteristics in papillary thyroid cancers (PTCs) with no 131I uptake. Clin Endocrinol (Oxf). 2008;68(1):108-116. doi: 10.1111/j.1365-2265.2007.03008.x.
  6. Riesco-Eizaguirre G. The oncogene BRAFV600E is associated with a high risk of recurrence and less differentiated papillary thyroid carcinoma due to the impairment of Na+/I- targeting to the membrane. Endocrine-Related Cancer. 2006;13(1):257-269. doi: 10.1677/erc.1.01119.
  7. Castro MR, Bergert ER, Goellner JR, et al. Immunohistochemical analysis of sodium iodide symporter expression in metastatic differentiated thyroid cancer: correlation with radioiodine uptake. J Clin Endocrinol Metab. 2001;86(11):5627-5632. doi: 10.1210/jcem.86.11.8048.

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Copyright (c) 2015 Semenov D.Y., Boriskova M.E., Farafonova U.V., Grozov R.V., Pankova P.A., Smolina E.N.

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