Neovascular PSMA expression is a common feature in malignant neoplasms of the thyroid
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Birthe Heitkötter1,*, Konrad Steinestel2,*, Marcel Trautmann1, Inga Grünewald1, Peter Barth1, Heidrun Gevensleben3, Martin Bögemann4, Eva Wardelmann1, Wolfgang Hartmann1, Kambiz Rahbar5 and Sebastian Huss1
1Gerhard Domagk Institute of Pathology, University of Münster, Münster, Germany
2Institute of Pathology, Military Hospital Ulm, Ulm, Germany
3Institute of Pathology, Neuss, Germany
4Department of Urology, University Hospital Münster, University of Münster, Münster, Germany
5Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
*These authors contributed equally to this work
Sebastian Huss, email: firstname.lastname@example.org
Keywords: PSMA; thyroid cancer; tumor neoangiogenesis; prostate cancer
Received: July 26, 2017 Accepted: November 15, 2017 Published: January 04, 2018
Aim: PSMA (prostate-specific membrane antigen) is physiologically expressed in normal prostate tissue and over expressed in prostate cancer cells, therefore constituting a potential target for antibody-based radioligand therapy. Very recent imaging findings reported PSMA-PET/CT uptake in various thyroid lesions. We were therefore encouraged to systematically analyse PSMA expression in different benign and malignant thyroid lesions.
Methods: Immunohistochemistry was used to detect PSMA expression in 101 thyroid lesions, while neovasculature was identified by CD34 immunostaining.
Results: PSMA expression in the neovasculature was significantly more frequent in malignant tumors (36/63; 57.1%) compared to benign diseases (5/38; 13.2%; p = 0.0001). In addition, PSMA expression levels in the neovasculature of poorly and undifferentiated thyroid cancers were significantly higher compared to differentiated thyroid tumors (p = 0.021). However, one case with a strong expression in follicular adenoma was identified.
Conclusions: We conclude that neovascular PSMA expression is common in thyroid cancer but may also rarely be found in benign thyroid diseases, such as follicular adenoma. High expression in the tumor-associated neovasculature is predominantly found in poorly differentiated and undifferentiated (anaplastic) thyroid cancer. This knowledge is highly relevant when interpreting PSMA/PET-CT scans from patients with prostate cancer. In addition, our findings might provide a rationale for further evaluation of PSMA-targeted anti-neovascular or radioligand therapy in metastatic dedifferentiated thyroid cancer.
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