Annals of nuclear medicine · 2026
Protein expression of glucose metabolism and somatostatin receptor between primary tumor and distant metastasis in differentiated thyroid cancer.
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Choi Joon Ho, Myung Jae Kyung, Moon Ji Eun, Kong Joon-Seog, Byun Byung Hyun, Kim Byung Il, Lim Ilhan
Аннотация
OBJECTIVE: This study evaluated differences in the expression of proteins related to glucose metabolism and somatostatin receptors (SSTRs) between primary tumors and distant metastatic lesions in differentiated thyroid cancer (DTC).
METHODS: We retrospectively analyzed 18 patients with DTC (mean age 56 ± 10 years) who had bone or soft tissue metastasis. Immunohistochemical staining of surgical specimens was performed to assess the expression of glucose transporter 1 (GLUT-1), hexokinase-2 (HK-2), and somatostatin receptor subtype 2 (SSTR-2). Protein expression was classified as negative, weakly positive, or strongly positive. Correlations between primary and metastatic lesions were evaluated using Spearman analysis. FDG SUVmax values were compared according to protein expression using the Mann-Whitney U test, and the association between iodine avidity and SSTR-2 expression was assessed using Fisher's exact test.
RESULTS: GLUT-1 expression was more frequent in metastatic lesions than in primary tumors (65% vs. 50%). HK-2 expression was high in both primary and metastatic lesions (94% each). SSTR-2 expression was similar between primary (50%) and metastatic lesions (41%). GLUT-1 expression demonstrated a marginal positive correlation between primary tumors and bone metastasis (r = 0.462, p = 0.062). After excluding primary tumors smaller than 1 cm, significant correlations were observed for both GLUT-1 (r = 0.624, p = 0.023) and HK-2 (r = 0.695, p = 0.008), whereas SSTR-2 showed no significant correlation. Among patients who underwent surgery and 18F-FDG PET/CT within one year, GLUT-1-positive metastatic lesions demonstrated significantly higher FDG SUVmax values than GLUT-1-negative lesions (p = 0.046). Among a small subset of evaluable iodine-non-avid metastatic lesions, preserved SSTR-2 expression was observed, although the association was not statistically significant.
CONCLUSION: GLUT-1 expression showed partial concordance between primary and metastatic DTC lesions and was associated with higher FDG uptake, which may reflect altered glucose metabolic activity. Although SSTR-2 expression was not associated with iodine avidity, its retention in a subset of iodine-refractory metastatic lesions may indicate a possible avenue for future investigation of SSTR-targeted imaging or radionuclide therapy in selected patients with advanced DTC.
METHODS: We retrospectively analyzed 18 patients with DTC (mean age 56 ± 10 years) who had bone or soft tissue metastasis. Immunohistochemical staining of surgical specimens was performed to assess the expression of glucose transporter 1 (GLUT-1), hexokinase-2 (HK-2), and somatostatin receptor subtype 2 (SSTR-2). Protein expression was classified as negative, weakly positive, or strongly positive. Correlations between primary and metastatic lesions were evaluated using Spearman analysis. FDG SUVmax values were compared according to protein expression using the Mann-Whitney U test, and the association between iodine avidity and SSTR-2 expression was assessed using Fisher's exact test.
RESULTS: GLUT-1 expression was more frequent in metastatic lesions than in primary tumors (65% vs. 50%). HK-2 expression was high in both primary and metastatic lesions (94% each). SSTR-2 expression was similar between primary (50%) and metastatic lesions (41%). GLUT-1 expression demonstrated a marginal positive correlation between primary tumors and bone metastasis (r = 0.462, p = 0.062). After excluding primary tumors smaller than 1 cm, significant correlations were observed for both GLUT-1 (r = 0.624, p = 0.023) and HK-2 (r = 0.695, p = 0.008), whereas SSTR-2 showed no significant correlation. Among patients who underwent surgery and 18F-FDG PET/CT within one year, GLUT-1-positive metastatic lesions demonstrated significantly higher FDG SUVmax values than GLUT-1-negative lesions (p = 0.046). Among a small subset of evaluable iodine-non-avid metastatic lesions, preserved SSTR-2 expression was observed, although the association was not statistically significant.
CONCLUSION: GLUT-1 expression showed partial concordance between primary and metastatic DTC lesions and was associated with higher FDG uptake, which may reflect altered glucose metabolic activity. Although SSTR-2 expression was not associated with iodine avidity, its retention in a subset of iodine-refractory metastatic lesions may indicate a possible avenue for future investigation of SSTR-targeted imaging or radionuclide therapy in selected patients with advanced DTC.