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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Primary lung cancer with radioiodine avidity: A thyroid cancer cohort study
Yu-Ling Lu, Szu-Tah Chen, Tsung-Ying Ho, Wen-Hui Chan, Richard J Wong, Chuen Hsueh, Shu-Fu Lin
Yu-Ling Lu, Shu-Fu Lin, Department of Internal Medicine, New Taipei Municipal TuCheng Hospital, New Taipei City 236, Taiwan
Yu-Ling Lu, Szu-Tah Chen, Shu-Fu Lin, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
Szu-Tah Chen, Shu-Fu Lin, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
Tsung-Ying Ho, Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
Wen-Hui Chan, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
Wen-Hui Chan, Institute for Radiological Research, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
Richard J Wong, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, United States
Chuen Hsueh, Department of Pathology, Chang-Gung Memorial Hospital, Taoyuan 333, Taiwan
Author contributions: Lin SF designed the study; Hsueh C performed the immunohistochemical study; all authors analyzed and interpreted the data; Lu YL wrote the first draft of this manuscript; Chen ST, Ho TY, Chan WH, Wong RJ, Hsueh C and Lin SF reviewed and revised the manuscript.
Supported by Chang Gung Memorial Hospital, No. CMRPG3J0471; and US NIH/NCI Cancer Center Support Grant, No. P30 CA008748.
Institutional review board statement: The present study was approved by the Chang Gung Medical Foundation Institutional Review Board (No. 202000365B0) and was conducted in accordance with the ethical principles of the Helsinki Declaration.
Informed consent statement: Informed consent was waived by Chang Gung Medical Foundation Institutional Review Board.
Conflict-of-interest statement: The authors report no relevant conflicts of interest.
Data sharing statement: The authors confirm that the data supporting the findings of this study are available within the article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Shu-Fu Lin, MD, Doctor, Department of Internal Medicine, New Taipei Municipal TuCheng Hospital, No. 2 Jingcheng Road, New Taipei City 236, Taiwan. mmg@cgmh.org.tw
Received: September 17, 2020
Peer-review started: September 17, 2020
First decision: October 18, 2020
Revised: October 30, 2020
Accepted: November 13, 2020
Article in press: November 13, 2020
Published online: January 6, 2021
ARTICLE HIGHLIGHTS
Research background
A proportion of lung cancers has sodium/iodide symporter (NIS) expression.
Research motivation
Lung cancers with NIS expression may uptake radioiodine (RAI) and show RAI-avid lesions on RAI scan.
Research objectives
The present study aimed to evaluate the possibility of RAI uptake by lung cancers.
Research methods
A prospectively maintained database of patients with thyroid cancer at a medical center between December 1, 1976 and May 28, 2018, was analyzed. Immuno-histochemical staining was used to assess NIS expression in lung cancers.
Research results
There were 5000 patients with thyroid cancer diagnosed between December 1, 1976 and May 28, 2018, in this database; of these, 4602 patients had differentiated thyroid cancer (DTC). Among those with DTC, 33 patients developed primary lung cancers during follow-up until March 20, 2019. Nine of these patients had an iodine-131 scan within 1 year before the diagnosis of lung cancer. The histological types of lung cancer were adenocarcinoma in eight patients and non-small-cell lung carcinoma-not otherwise specified in one patient. One of these nine lung cancers was RAI-avid. Immunohistochemical staining revealed that three of the eight available lung cancers had NIS expression. The proportions of lung cancer cells with NIS expression in these three lung tumors were 60%, 15%, and 10%, respectively. The RAI-avid lung cancer had the highest level of NIS expression (60%). Of note, the RAI-avid lung cancer had a spiculated border on single-photon emission computed tomography/computed tomography imaging, which led to an accurate diagnosis of primary lung cancer.
Research conclusions
A proportion of lung cancers has NIS expression and demonstrates RAI avidity. These findings are significant for clinicians in the interpretation of RAI scintigraphy.
Research perspectives
Our data were mainly derived from lung adenocarcinoma. Further studies are mandatory to determine the potential of RAI avidity in the other histologic types of lung cancers.
