Woelfl S, Bogner S, Huber H, Salaheddin-Nassr S, Hatzl M, Decristoforo C, Virgolini I, Gabriel M
Prof. Dr. Michael Gabriel, Department of Nuclear Medicine and Endocrinology General Hospital, Krankenhausstr. 9, 4021 Linz, Austria, Tel. +43/(0)732/78 06 61-41, Fax -65, E-mail:
Nuklearmedizin. 2014;53(5):179-85. doi: 10.3413/Nukmed-0646-14-02. Epub 2014 Jun 26.
To retrospectively analyse the expression of somatostatin receptor subtypes 2 (SSTR 2) and 5 (SSTR 5) in thyroid malignancies, possibly the most relevant subtypes for targeted therapy with somatostatin peptide radioligands. In addition, findings were also correlated with the course of disease.
PATIENTS, METHODS: 87 consecutive patients (59 women, 28 men) with thyroid malignancy were included; 52 had papillary carcinoma, 24 follicular carcinoma, six medullary carcinoma, two poorly differentiated carcinoma and three anaplastic carcinoma. After initial therapy 70 (80.5%) patients showed complete remission, 11 (12.6%) patients partial remission with clinical and biochemical signs of residual disease and six (6.9%) patients progressive disease. The immunohistochemical staining results of the primary malignancy for SSTR 2 and SSTR 5 were semiquantitatively assessed and correlated with various outcome parameters.
In 10 of 87 (11.49%) thyroid cancer samples SSTR 2 showed positive immunohistochemical expression as compared to 75 of 87 (86.20%) for SSTR 5. All SSTR 2-positive cases expressed SSTR 5. Persistent or recurrent disease was found in 17 of 87 cases (19.54%). Fifty percent (6 /12) of SSTR 5-negative patients showed persistent disease as compared to 14.7 % (11 / 75) of SSTR 5-positive patients: seven of these were exclusively SSTR 5-positive, 4 showed dual expression of SSTR 5 and SSTR 2 (p = 0.01). No case showed only SSTR 2 expression.
SSTR 5 was shown to be the main receptor subtype in the analysed differentiated or anaplastic thyroid malignancies, whereas SSTR 2 was found only in a small percentage. Deficient SSTR expression may indicate higher risk for persistent or recurrent disease after initial therapy. For this reason immunohistochemistry can be considered a prognostic marker which should be further validated in prospective studies.
回顾性分析甲状腺恶性肿瘤中生长抑素受体2型（SSTR 2）和5型（SSTR 5）的表达情况，这两种亚型可能是生长抑素肽放射性配体靶向治疗最相关的亚型。此外，研究结果还与疾病进程相关。
患者、方法：纳入87例连续性甲状腺恶性肿瘤患者（59例女性，28例男性）；其中52例为乳头状癌，24例为滤泡状癌，6例为髓样癌，2例为低分化癌，3例为未分化癌。初始治疗后，70例（80.5%）患者完全缓解，11例（12.6%）患者部分缓解，伴有残留疾病的临床和生化体征，6例（6.9%）患者疾病进展。对原发性恶性肿瘤的SSTR 2和SSTR 5免疫组化染色结果进行半定量评估，并与各种结局参数相关联。
87例甲状腺癌样本中，10例（11.49%）SSTR 2免疫组化表达呈阳性，而87例中有75例（86.20%）SSTR 5呈阳性。所有SSTR 2阳性病例均表达SSTR 5。87例中有17例（19.54%）出现持续性或复发性疾病。SSTR 5阴性患者中有50%（6/12）出现持续性疾病，而SSTR 5阳性患者中这一比例为14.7%（11/75）：其中7例仅为SSTR 5阳性，4例表现为SSTR 5和SSTR 2双重表达（p = 0.01）。无病例仅表现为SSTR 2表达。
在分析的分化型或未分化型甲状腺恶性肿瘤中，SSTR 5是主要的受体亚型，而SSTR 2仅在小部分病例中发现。SSTR表达缺陷可能表明初始治疗后持续性或复发性疾病的风险较高。因此，免疫组化可被视为一种预后标志物，应在前瞻性研究中进一步验证。
