Published online Jan 6, 2021. doi: 10.12998/wjcc.v9.i1.71
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
Processing time: 105 Days and 20.9 Hours
A proportion of lung cancers has sodium/iodide symporter (NIS) expression.
Lung cancers with NIS expression may uptake radioiodine (RAI) and show RAI-avid lesions on RAI scan.
The present study aimed to evaluate the possibility of RAI uptake by lung cancers.
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.
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.
A proportion of lung cancers has NIS expression and demonstrates RAI avidity. These findings are significant for clinicians in the interpretation of RAI scintigraphy.
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.