Lu Yu-Ling, Chen Szu-Tah, Ho Tsung-Ying, Chan Wen-Hui, Wong Richard J, Hsueh Chuen, Lin Shu-Fu
Department of Internal Medicine, New Taipei Municipal TuCheng Hospital, New Taipei City 236, Taiwan.
Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.
World J Clin Cases. 2021 Jan 6;9(1):71-80. doi: 10.12998/wjcc.v9.i1.71.
A proportion of lung cancers show sodium/iodide symporter (NIS) expression. Lung cancers with NIS expression may uptake radioiodine (RAI) and show RAI-avid lesions on RAI scan for differentiated thyroid cancer (DTC) surveillance.
To investigate the possibility of RAI uptake by lung cancer in a cohort with thyroid cancer.
RAI-avid lung cancers were analyzed using a prospectively maintained database of patients with thyroid cancer who were registered at a medical center between December 1, 1976 and May 28, 2018. NIS expression in lung cancer was assessed using immunohistochemical staining.
Of the 5000 patients with thyroid cancer from the studied dataset, 4602 had DTC. During follow-up, 33 patients developed primary lung cancer. Of these patients, nine received an iodine-131 (I) scan within 1 year before the diagnosis of lung cancer. One of these nine lung cancers was RAI-avid. NIS expression was evaluated, and three of the eight available lung cancers revealed NIS expression. The proportions of lung cancer cells with NIS expression were 60%, 15%, and 10%. The RAI-avid lung cancer had the highest level of expression (60%). The RAI-avid lung cancer had a spiculated border upon single-photon emission computed tomography/computed tomography, which led to an accurate diagnosis.
A proportion of lung cancer demonstrates NIS expression and is RAI-avid. Clinicians should be aware of this possibility in the interpretation of RAI scintigraphy.
一部分肺癌表现出钠/碘同向转运体（NIS）表达。具有NIS表达的肺癌可能摄取放射性碘（RAI），并在用于分化型甲状腺癌（DTC）监测的RAI扫描中显示出RAI摄取性病变。
研究甲状腺癌队列中肺癌摄取RAI的可能性。
使用前瞻性维护的甲状腺癌患者数据库对RAI摄取性肺癌进行分析，这些患者于1976年12月1日至2018年5月28日在一家医疗中心登记。使用免疫组织化学染色评估肺癌中的NIS表达。
在所研究数据集中的5000例甲状腺癌患者中，4602例为DTC。在随访期间，33例患者发生了原发性肺癌。在这些患者中，9例在肺癌诊断前1年内接受了碘-131（I）扫描。这9例肺癌中有1例为RAI摄取性。评估了NIS表达，在8例可用的肺癌中有3例显示NIS表达。具有NIS表达的肺癌细胞比例分别为60%、15%和10%。RAI摄取性肺癌的表达水平最高（60%）。RAI摄取性肺癌在单光子发射计算机断层扫描/计算机断层扫描上有毛刺状边界，从而得以准确诊断。
一部分肺癌表现出NIS表达且为RAI摄取性。临床医生在解释RAI闪烁扫描时应意识到这种可能性。
