Histochemical demonstration of thyroglobulin, thyroxine and triiodothyronine in thyroid carcinoma tissue, and its predictive value for radioiodine uptake ability of metastatic lesions

Research Project

Project/Area Number	60570606
Research Category	Grant-in-Aid for General Scientific Research (C)
Allocation Type	Single-year Grants
Research Field	General surgery
Research Institution	Tokyo Women's Medical College
Principal Investigator	KODAMA Takaya Department of Endocrine Surgery, Tokyo Women's Medical College, 医学部, 講師 (30161946)
Co-Investigator(Kenkyū-buntansha)	KUSAKABE Kiyoko Department of Radiology, Tokyo Women's Medical College, 学・放射線科, 助教授 (80075473) HIRAYAMA Akira Department of Surgical Pathology, Tokyo Women's Medical College, 学・病院病理科, 助教授 (80075217) FUJIMOTO Yoshihide Department of Endocrine Surgery, Tokyo Women's Medical College, 学・内分泌外科, 教授 (10010167)
Project Period (FY)	1985 – 1986
Project Status	Completed (Fiscal Year 1986)
Budget Amount *help	¥1,300,000 (Direct Cost: ¥1,300,000) Fiscal Year 1986: ¥500,000 (Direct Cost: ¥500,000) Fiscal Year 1985: ¥800,000 (Direct Cost: ¥800,000)
Keywords	Thyroid cancer / Hematogenous metastasis / Total thyroidectomy / Radioactive iodine therapy / Thyroglobulin / Triiodothyronine / Thyroxine / 免疫組織化学
Research Abstract	Although a total thyroidectomy followed by radioactive iodide (I-131) therapy is widely used for hematogenous metastatic lesions of thyroid carcinoma, they do not always take up enough I-131 for treatment. This work was undertaken to elucidate the predictive value of histochemical demonstration of thyroid hormones in carcinoma for its ability to take up I-131. A total of 27 patients with thyroid carcinoma (10 papillary and 17 follicular variants) underwent the above treatment during a 19-year period (1966-1984). Metastases to either the lung or the bone, or both were found 12, 9 and 6 patients, respectively. Twenty-four patients were followed up from 2 to 20 years, average 8 years. Three patients were lost to follow-up. Four patients died of thyroid cancer, 2, 4, 10 and 10 years later, all of whom were over 40 years of age and had shown accumulation of I-131. Of the 27 cases, absence of I-131 uptake in the metastatic lesions was demonstrated in only 4. Immunohistochemical studies were carried out on the primary lesions in all cases, and metastatic lesions were also available from the lymph node in 15 cases, the skin in one and the bone in one. Sectioned specimens were stained by the peroxidase anti-peroxidase method, using commercially available kits, for thyroglobulin (Tg), thyroxine ( <T_4> ) and triiodothyronine ( <T_3> ). The activities of these substances in the primary Iesion almost paralleled those in the metastasis. Of a total of 27 cases, the presence of Tg, <T_4> and <T_3> was demonstrated in 26, 15 and 10 cases, respectively. All of the <T_4> or <T_3> -positive cases showed the ability to take up I-131. The uptake was not shown in 4 of 12 <T_4> -negative or in 4 of 17 <T_3> -negative cases. From these results, it may be concluded that I-131 uptake ability is predictable when <T_4> or <T_3> is demonstrated immunohistochemically in the lesion. In the absence of <T_4> or <T_3> , however, nothing can be predicted.