Correlation of 18F-FDG uptake and thyroid cancer stem cells

Q J Nucl Med Mol Imaging. 2020 Dec;64(4):393-399. doi: 10.23736/S1824-4785.18.03088-1. Epub 2018 Aug 28.

Abstract

Background: 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography (18F-FDG PET) has the potential to detect various types of cancers, including thyroid cancer (TC), at a potentially curable stage. Increased uptake of 18F-FDG was observed in anaplastic and poorly differentiated thyroid cancer cells, and PET-positive tumors are more likely to be resistant to 131I treatment. As cancer stem cells (CSCs) possess a dedifferentiated phenotype and are resistant to many anticancer therapies, we hypothesized that the expression of CSC-related markers is correlated with the ability of tumor cells in TC to uptake FDG.

Methods: The present study cohort included 12 patients with TC, who underwent 18F-FDG PET/CT imaging before surgery. Quantitative polymerase chain reaction (QPCR) and immunohistochemical (IHC) staining were performed to analyze the expression patterns of gene markers related to embryonic stem (ES) cells and CSCs in TC.

Results: The mRNA expression levels of CSC- (CD133 and CD44) and ES-related genes (Oct4 and Nanog) were higher in TC tissue than in normal thyroid tissue, whereas the mRNA expression levels of thyroid-specific genes (Tg, TSHR, and TTF1) were higher in normal thyroid tissue than in TC tissue. There was a positive and statistically significant correlation between FDG uptake (SUV<inf>max</inf>) of tumor and relative mRNA levels of CD133, CD44, Oct4, and Nanog. The IHC results demonstrated that CD133 and Nanog were expressed in TC tissue but not in normal thyroid tissue, however, CD44 expression was observed in both TC and normal thyroid tissue. Comparisons of the clinicopathological parameters between TC tissues with low and high SUV<inf>max</inf> demonstrated significant differences in protein level of CD133 but not in that of Nanog.

Conclusions: The pre-therapeutic tumor SUV<inf>max</inf> obtained from 18F-FDG PET/CT may be a potential predictor for evaluating the proportion of CSC population in individual patients with TC.

MeSH terms

  • AC133 Antigen / metabolism
  • Biological Transport
  • Cell Differentiation / radiation effects
  • Dose-Response Relationship, Radiation
  • Fluorodeoxyglucose F18 / chemistry*
  • Fluorodeoxyglucose F18 / pharmacology
  • Humans
  • Hyaluronan Receptors / metabolism
  • Indium Radioisotopes / chemistry
  • Neoplastic Stem Cells / radiation effects*
  • Positron Emission Tomography Computed Tomography
  • RNA, Messenger
  • Radiopharmaceuticals / chemistry*
  • Receptors, Thyrotropin / metabolism
  • Thyroid Gland / cytology
  • Thyroid Neoplasms / diagnostic imaging*
  • Thyroid Neoplasms / drug therapy*
  • Tissue Distribution
  • Tomography, X-Ray Computed
  • Trefoil Factor-1 / metabolism

Substances

  • AC133 Antigen
  • CD44 protein, human
  • Hyaluronan Receptors
  • Indium Radioisotopes
  • Indium-131
  • PROM1 protein, human
  • RNA, Messenger
  • Radiopharmaceuticals
  • Receptors, Thyrotropin
  • TFF1 protein, human
  • TSHR protein, human
  • Trefoil Factor-1
  • Fluorodeoxyglucose F18