The Korean Journal of Nuclear Medicine (대한핵의학회지)

The Korean Society of Nuclear Medicine (대한핵의학회)
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Relationship between the Expression of Sodium Iodide Symporter and the Findings of $^{99m}Tc-MIBI$ Scintimammography in the Primary Breast Cancer

원발성 유방암에서 Sodium Iodide Symporter의 발현과 $^{99m}Tc-MIBI$ 유방스캔의 관계

  • Seok, Ju-Won (Department of Nuclear Medicine, College of Medicine, Pusan National University) ;
  • Kim, Seong-Jang (Department of Graduate School, Pusan National University) ;
  • Kwak, Hi-Suk (Department of General Surgery, College of Medicine, Pusan National University) ;
  • Lee, Chang-Hun (Department of Pathology, College of Medicine, Pusan National University) ;
  • Kim, In-Ju (Department of Nuclear Medicine, College of Medicine, Pusan National University) ;
  • Kim, Yong-Ki (Department of Nuclear Medicine, College of Medicine, Pusan National University) ;
  • Bae, Young-Tae (Department of General Surgery, College of Medicine, Pusan National University) ;
  • Kim, Dong-Soo (College of Medicine, Pusan National University)
  • 석주원 (부산대학교병원 핵의학과) ;
  • 김성장 (부산대학교 대학원) ;
  • 곽희숙 (부산대학교병원 일반외과) ;
  • 이창훈 (부산대학교병원 해부병리과) ;
  • 김인주 (부산대학교병원 핵의학과) ;
  • 김용기 (부산대학교병원 핵의학과) ;
  • 배영태 (부산대학교병원 일반외과) ;
  • 김동수 (부산대학교)
  • Published : 2002.12.30
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Abstract

Purpose: Human Na+/I- symporter (hNIS) is known to be expressed in many tissues other than thyroid gland. The breast cancer cells are one of them and the possibility of radioiodine therapy in treatment of the breast cancer may be suggested. We investigated the expression rate of hNIS and the relationship between the expression of hNIS and the finding of 99mTc-MIBI scintimammographv in the breast cancer Materials and Methods: Surgically proved 56 patients with breast cancer were the subjects of this study The expression of hNIS were evaluated by immunohistochemistry and the results were compared to the findings of 99m7c-MIBI scintimammography. Results: Overall expression rate of hNIS was 41.1% in 56 patients. According to the pathologic diagnosis, it was 42.9% in 49 patients with invasive ductal carcinoma and 28.6% in the 7 patients with ductal carcinoma in situ. The expression rate of hNIS in the 41 cases with a focal increased uptake at he breast lesion on 99m7c-MIBI sointimammogram was 31.7%. That in the 15 cases without any abnormal uptake on the scan was significantly higher(65.7%, p<0.05). Conclusion: The expression rate of hNIS in the patients with breast cancer was not so high. The rate was higher in the patients with no increased uptake at the breast lesion on 99m7c-MIBI scintimammography.

목적: hNIS는 갑상선 조직 외에 다른 조직들에서도 발현된다고 알려져 있다. 유방암 세포는 그런 조직들 중에 하나이며, 그에 의한 유방암의 방사성옥소치료의 가능성이 제시되고 있다. 본 연구에서는 유방암 조직에서 hNIS의 발현정도를 알아보고, $^{99m}Tc-MIBI$ 유방스캔과 hNIS의 발현 정도와의 관계를 조사하여 보았다. 대상 및 방법: 본 연구에서는 유방암으로 수술을 시행했던 56명의 환자를 대상으로 하였다. hNIS의 발현은 면역조직화학염색에 의해서 평가되었으며, 그 결과를 $^{99m}Tc-MIBI$ 유방스캔의 판정 결과와 비교하였다. 결과: 전체 56명의 환자에서 hNIS의 발현율은 41.1%였다. 병리학적 진단에 의해 침윤성관상피암종이었던 49명에서의 발현율은 42.9%, 관상피내암종이었던 7명에서의 발현율은 28.6%였다. $^{99m}Tc-MIBI$ 유방스캔에서 국소섭취 소견이 관찰되었던 41명에서의 hNIS의 발현율은 31.7%였다. 비정상적인 섭취 소견이 관찰되지 않았던 15명의 환자에서의 hNIS의 발현율이 의미있게 높게 관찰되었다(66.7%, p>0.05). 결론: 유방암 환자에서의 hNIS의 발현율은 그다지 높지 않았다. $^{99m}Tc-MIBI$ 유방스캔에서 섭취증가 소견이 없을 때 hNIS의 발현율이 더 높았다.

Keywords

References

  1. Carrasco N. Iodide transport in the thyroidgland. Biochem Biophys Acta 1993;1154:65-82.
  2. Kaminsky SM, Levy 0, Salvador C, Dai G.Carrasco N. Na+/I- symporter activity is presentin membrane vesicles from thyrotropin-deprivednon-I-transporting cultured thyroid cells. ProNatl Acad Sci 1994;91:3789-93.
  3. Filetti S, Bidart J M, Arturi F, Caillou B, RussoD, Schhunberger M. Sodium/iodide symporter: akey transport system in thyroid cancer cellmetabolism. Eur J Endocrinol 1999;141:443-57.
  4. Dai G, Levy 0, Carrasco N. Cloning andcharacterization of the thyroid iodide transporter.Nature 1996;379:458-60.
  5. Raspe E, Costagliola S, Ruf J, Mariotti S,Dumont JE, Ludgate M. Identification of the Na+/1 - cotransporter as a potential autoantigen in thyroid autoimmune disease. Eur J Endocrinol1995;132:399-405.
  6. Spitzweg C, Joba W, Eisenmenger W, HeufelderA. Analysis of human sodium iodide symportergene expression in extrathyroidal tissues andcloning of its complementary deoxyribonucleicacids from salivary gland, mammary gland, andgastric mucosa. J Clin Endocrinol Metab 1998;83:1746-51.
  7. Cancroft ET, Goldsmith SJ. Tc-99m-pertechnetatescintigraphy as an aid in the diagnosis of breastmasses. Radiology 1973;106:441-4.
  8. Kilban MT, Ajjan RA, Weetman AP, Dwyer R,McDermott EW, O'Higgins NJ, et al. Tissueiodine content and serum-mediated 1-125 uptakeblockingactivity in breast cancer. J ClinEndocrinol Metab 2000;85:1245-50.
  9. Cho JY, Leveille R, Kao R, Rousset B, ParlowAF, Burak WE Jr, et al. Hormonal regulation ofradioiodide uptake activity and Na+jl- symporterexpression in mammary glands. J Clin EndocrinolMetab 2000;85:2936-43.
  10. Nakamoto Y, Saga T, Misaki T, Kobayashi H,Sato N, Ishimori T, et al. Establishment andcharacterization of a breast cancer cell lineexpressing Na+jI- symporters for radioiodideconcentrator gene therapy. J Nucl Med 2000;41:1898-904.
  11. Dulgeroff AJ, Hershman JM, Medical therapy for differentiated thyroid carcinoma. EndocrineRev 1994; 15:500-15.
  12. Khalkhali I, tolmos J. Role of Tc-99m sestamibiscintimammography for the evaluation of breastlesions. In: Taillerfer R, Khalkhali I, WaxmannAD, et aI, editors. Radionuclide imaging of thebreast. New York: Marcel Dekker; 1998. p.371-96.
  13. Kim SJ, Kim IJ, Kim YK, Bae YT. Tc-99mtetrofosmin scintimammography in suspectedbreast cancer patients: a comparison with Tc-99m MIBI. Medical Principles and Practice2000;9:282-9.
  14. Mekhmandarov S, Sandbank J, Cohen M,Lelcuk S, Lubin E. Tc-99m MIBI scintimammographyin palpable and nonpalpable breastlesions. J Nucl Med 1998;39:86-91.
  15. Rao VV, Chiu ML, Krounage JF, PiwnicaWormsD. Expression of recombinant humanmultidrug resistance p-glycoprotein in insectcells confers decreased accumulation of technetium-99m sestamibi. J Nucl Med 1994;35:510-5.
  16. Cordobes MD, Starzec A, Delmon-Moingeon L,Blanchot C, Kouyoumdiian JC, Prevest G, et al.Technetium-99m-sestamibi uptake by humanbenign and malignant breast tumor cells: Correlationwith mdr gene expression. J Nucl Med1999;37:286-9.