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- Title
PSMA Expression in Differentiated Thyroid Cancer: Association With Radioiodine, 18FDG Uptake, and Patient Outcome.
- Authors
Ciappuccini, Renaud; Saguet-Rysanek, Virginie; Giffard, Florence; Licaj, Idlir; Dorbeau, Marine; Clarisse, Bénédicte; Poulain, Laurent; Bardet, Stéphane
- Abstract
<bold>Context: </bold>Little is known about prostate-specific membrane antigen (PSMA) expression in patients with cervical involvement of differentiated thyroid cancer (DTC).<bold>Objective: </bold>We investigated PSMA expression in neck persistent/recurrent disease (PRD) using immunohistochemistry and the association with radioiodine (RAI) or 18-fluorodeoxyglucose (18FDG) uptake, and patient outcome.<bold>Design, Setting, and Patients: </bold>Data from 44 consecutive DTC patients who underwent neck reoperation from 2006 to 2018 in a comprehensive cancer center.<bold>Main Outcome Measure(s): </bold>Immunostaining was performed with vascular endothelial marker CD31 and PSMA. PSMA expression was quantified using the immunoreactive score (IRS). RAI and 18FDG uptake were assessed before surgery using posttherapeutic RAI scintigraphy and 18FDG positron emission tomography with computed tomography. Mean follow-up after reintervention was 6.5 ± 3.7 years.<bold>Results: </bold>Thirty patients (68%) showed at least 1 PSMA-positive lesion (IRS ≥ 2) with similar proportions in RAI-positive and RAI-negative patients (75% vs 66%). In RAI-negative patients, however, the proportion of PSMA-positive disease (79% vs 25%, P < 0.01) and the mean IRS (4.0 vs 1.0, P = 0.01) were higher in 18FDG-positive than in 18FDG-negative patients. Furthermore, mean IRS was higher in patients ≥ 55 years, large primary tumors (>40 mm) or aggressive subtypes, and was correlated with structural disease at last follow-up. Strong PSMA expression (IRS ≥ 9) was associated with shorter progression-free survival (PFS).<bold>Conclusions: </bold>Our findings show that PSMA expression was present in two-thirds of patients with neck PRD, that it was related to poor prognostic factors and that very high expression was associated with poorer PFS. This preliminary study may offer new perspectives for the management of RAI-refractory DTC.
- Subjects
THYROID cancer; IODINE isotopes; HEALTH outcome assessment; ADENOCARCINOMA; THYROID gland tumors; PROTEOLYTIC enzymes; CANCER relapse; PROGNOSIS; RETROSPECTIVE studies; IODINE radioisotopes; RADIOPHARMACEUTICALS; DEOXY sugars; ANTIGENS; LONGITUDINAL method
- Publication
Journal of Clinical Endocrinology & Metabolism, 2021, Vol 106, Issue 12, p3536
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/clinem/dgab563