DeRubertis F, Yamashita K, Dekker A, Larsen P R, Field J B
J Clin Invest. 1972 May;51(5):1109-17. doi: 10.1172/JCI106903.
"Cold" thyroid nodules do not concentrate (131)I before or after thyrotropin (TSH) administration. In an attempt to elucidate the reason for this TSH unresponsiveness, the effect of TSH in vitro on several metabolic parameters was studied in 11 "cold" thyroid adenomas, 2 medullary carcinomas, and in the surrounding normal thyroid tissue. Basal adenyl cyclase activity, glucose-1-(14)C oxidation, and (32)P incorporation into phospholipids were significantly greater in the adenomas than in the adjacent normal thyroid; basal cyclic 3',5'-adenosine monophosphate (cyclic AMP) concentration and adenine-(3)H incorporation into (3)H-labeled cyclic AMP were not different. In adenomas as well as normal thyroid, all parameters responded significantly to in vitro TSH stimulation. The response to TSH of adenyl cyclase activity and (32)P incorporation was enhanced in adenomas compared with that of the adjacent normal thyroid. These differences were not explained by an increased cellularity of the adenomas. Medullary carcinomas did not respond to TSH in any of the above parameters. The studies demonstrate an intact, TSH-responsive adenyl cyclase-cyclic AMP system in the adenomas and, accordingly, imply the presence of receptor sites for TSH on the cells of the adenoma. The failure of such nodules to concentrate (131)I may be owing to a subsequent impairment in the expression of cyclic AMP action on iodine metabolism.
“冷”性甲状腺结节在给予促甲状腺素（TSH）前后均不摄取（131）I。为阐明这种对TSH无反应的原因，对11个“冷”性甲状腺腺瘤、2个髓样癌及周围正常甲状腺组织进行了体外TSH对若干代谢参数影响的研究。腺瘤中的基础腺苷酸环化酶活性、葡萄糖 -1-（14）C氧化及（32）P掺入磷脂的量均显著高于相邻正常甲状腺组织；基础环磷腺苷（cAMP）浓度及腺嘌呤 -（3）H掺入（3）H标记的cAMP的量则无差异。在腺瘤及正常甲状腺组织中，所有参数对体外TSH刺激均有显著反应。与相邻正常甲状腺组织相比，腺瘤中腺苷酸环化酶活性及（32）P掺入对TSH的反应增强。这些差异无法用腺瘤细胞增多来解释。髓样癌在上述任何参数中均对TSH无反应。这些研究表明腺瘤中存在完整的、对TSH有反应的腺苷酸环化酶 - cAMP系统，因此提示腺瘤细胞上存在TSH受体位点。此类结节不摄取（131）I可能是由于随后cAMP对碘代谢作用的表达受损。
