甲状腺微小乳头状癌隐匿性颈转移淋巴结中钠碘同向转运体和促甲状腺激素受体的表达。

Expression of sodium-iodide symporter and TSH receptor in subclinical metastatic lymph nodes of papillary thyroid microcarcinoma.

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Inje University College of Medicine, Haeundae Paik Hospital, Pusan, Korea.

出版信息

Ann Surg Oncol. 2012 Mar;19(3):990-5. doi: 10.1245/s10434-011-2047-y. Epub 2011 Aug 31.

DOI:10.1245/s10434-011-2047-y

PMID:21879263

Abstract

BACKGROUND

The clinical significance of the subclinical lymph node (LN) metastasis in clinically node-negative (cN0) papillary thyroid microcarcinoma (PTMC) has been debated. We investigated the expression of sodium-iodide symporter (NIS) and thyroid-stimulating hormone receptor (TSHR) in the subclinical metastatic LNs of PTMC, which are crucial prerequisites for the response to radioactive iodine treatment.

METHODS

Among 149 consecutive patients who received total thyroidectomy in conjunction with prophylactic central neck dissection for cN0 PTMC from October 2005 to December 2007, 20 who had single PTMC and subclinical LN metastasis (cN0, pN1, single PTMC) were included. Immunohistochemical staining was performed with anti-human NIS antibody and anti-human TSHR antibody in 20 primary tumors and 52 metastatic LNs.

RESULTS

NIS and TSHR expression was detected in 19 (95%) and 18 (90%) of 20 PTMCs, respectively. NIS and TSHR expression were also detected in 50 (96.2%) and 39 (75%) of 52 metastatic LNs, respectively. In 85% of patients, the presence of NIS expression in primary PTMCs was concordant with that in corresponding metastatic LNs. Intensities of NIS and TSHR expression were diverse. In 6 of 12 cases of multiple metastatic LNs, the metastatic LNs showed heterogeneous intensities of NIS expression.

CONCLUSIONS

The presence of NIS and TSHR expression was observed with high frequency in both PTMCs and corresponding subclinical metastatic LNs. However, the intensity of NIS and TSHR expression was diverse. Multiple metastatic LNs from single primary tumor focus could have heterogeneous intensity of NIS expression.

摘要

背景

亚临床淋巴结（LN）转移在临床淋巴结阴性（cN0）甲状腺微小乳头状癌（PTMC）中的临床意义一直存在争议。我们研究了 cN0PTMC 亚临床转移性 LN 中钠碘转运体（NIS）和促甲状腺激素受体（TSHR）的表达，这是对放射性碘治疗产生反应的关键前提。

方法

2005 年 10 月至 2007 年 12 月，我们对 149 例连续接受全甲状腺切除术联合预防性中央颈部淋巴结清扫术治疗的 cN0PTMC 患者进行了研究，其中 20 例患者为单发 PTMC 和亚临床 LN 转移（cN0、pN1、单发 PTMC）。我们对 20 例原发肿瘤和 52 例转移性 LN 进行了抗人 NIS 抗体和抗人 TSHR 抗体的免疫组织化学染色。

结果

分别有 19（95%）和 18（90%）例 20 例 PTMC 检测到 NIS 和 TSHR 表达，分别有 50（96.2%）和 39（75%）例 52 例转移性 LN 检测到 NIS 和 TSHR 表达。在 85%的患者中，原发 PTMC 中 NIS 表达的存在与相应转移性 LN 中的表达一致。NIS 和 TSHR 表达的强度存在差异。在 12 例多个转移性 LN 中，6 例转移性 LN 中 NIS 表达存在异质性。