PDF(Pubmed)
Abstract：
Somatostatin receptor type 2 (SSTR2) and thyroid-stimulating hormone receptor (TSHR) display variable expression in primary thyroid tumors and have been implicated as theranostic targets. This study was designed to explore the differential expression of SSTR2 and TSHR in oncocytic (Hurthle cell) carcinoma (OC) vs oncocytic adenoma (OA). We performed a retrospective review for oncocytic neoplasms treated at our institution from 2012 to 2019. Formalin-fixed paraffin-embedded tissue blocks were used for tissue microarray construction. Tissue microarray blocks were cut into 5-μm sections and stained with anti-SSTR2 and anti-TSHR antibodies. Immunostains were analyzed by 3 independent pathologists. χ2 and logistic regression analysis were used to analyze clinical and pathologic variables. Sixty-seven specimens were analyzed with 15 OA and 52 OC. The mean age was 57 years, 61.2% were women, and 70% were White. SSTR2 positivity was noted in 2 OA (13%) and 15 OC (28%; 10 primary, 4 recurrent, and 1 metastatic) (P = .22). TSHR positivity was noted in 11 OA (73%) and 32 OC (62%; 31 primary and 1 metastatic) (P = .40). Those who presented with or developed clinical recurrence/metastasis were more likely to be SSTR2-positive (50% vs 21%; P = .04) and TSHR-negative (64.3% vs 28.9%; P = .02) than primary OC patients. Widely invasive OC was more likely to be SSTR2-positive compared to all other OC subtypes (minimally invasive and angioinvasive) (P = .003). For all patients with OC, TSHR positivity was inversely correlated with SSTR2 positivity (odds ratio, 0.12; CI, 0.03-0.43; P = .006). This relationship was not seen in the patients with OA (odds ratio, 0.30; CI, 0.01-9.14; P = .440). Our results show that recurrent/metastatic OC was more likely to be SSTR2-positive and TSHR-negative than primary OC. Patients with OC displayed a significant inverse relationship between SSTR2 and TSHR expression that was not seen in patients with OA. This may be a key relationship that can be used to prognosticate and treat OCs.
摘要：
生长抑素受体2型（SSTR2）和促甲状腺激素受体（TSHR）在原发性甲状腺肿瘤中显示出可变的表达，并被认为是治疗诊断靶标。本研究旨在探讨SSTR2和TSHR在嗜酸细胞（Hurthle细胞）癌（OC）和嗜酸细胞腺瘤（OA）中的差异表达。我们对2012年至2019年在我们机构治疗的嗜酸细胞肿瘤进行了回顾性审查。将福尔马林固定的石蜡包埋(FFPE)组织块用于组织微阵列(TMA)构建。在5微米切片处切割TMA块并用抗SSTR2和抗TSHR抗体染色。免疫染色由3名独立的病理学家进行分析。卡方和logistic回归分析用于分析临床和病理变量。用15个OA和52个OC分析67个标本。平均年龄是57岁,61.2%是女性，70%是白人。在2OA（13%）和15OC（28%，10主要，4经常性的，1转移)(p=0.22)。在11OA（73%）和32OC（62%，31小学，1转移)(p=0.40)。那些出现或发展为临床复发/转移的人更可能是SSTR2阳性（50％vs21％，p=0.04）和TSHR阴性（64.3%对28.9%，p=0.02）比原发性OC患者高。与所有其他OC亚型相比，广泛侵入性OC更可能是SSTR2阳性（微创，血管侵入性）（p=0.003）。对于所有OC患者，TSHR阳性与SSTR2阳性呈负相关(OR：0.12，CI[0.03-0.43]，p=0.006)。在OA患者中未发现这种关系（OR：0.30，CI[0.01-9.14，p=0.440）。我们的结果表明，复发性/转移性OC比原发性OC更可能是SSTR2阳性和TSHR阴性。OC患者在SSTR2和TSHR表达之间显示出显着的负相关关系，这在OA患者中未见过。这可能是可用于预测和治疗OC的关键关系。
