Molecular biology reportsJun 1, 2019

Using tumor cell markers to predict and track radioactive iodine treatment in thyroid cancer

Circadian Biology Weekly Brief ↗PubMed ↗DOI ↗

Updated Mar 28, 2026

Abstract

Postoperative NIS high expression is independently correlated with a better response to first RAI therapy.

NIS high expression in circulating tumor cells (CTCs) may indicate improved treatment response after radioactive iodine-131 (RAI) therapy.
The presence of NIS-/epithelial-/mesenchymal+ CTCs is associated with a poorer response to initial RAI therapy.
Higher numbers of NIS+ CTCs and NIS+/epithelial+/mesenchymal+ CTCs after RAI therapy may correlate negatively with treatment response in univariate analyses.
A decrease or no change in total NIS+ CTCs following RAI therapy could suggest effective treatment outcomes.
These findings indicate that monitoring NIS expression and EMT phenotypes in CTCs may assist in evaluating RAI therapy effectiveness in differentiated thyroid cancer patients.

Simplified

Current methods, such as serum thyroglobulin measurement and medical imaging, have limitations in the routine monitoring of the disease status and treatment response of patients with differentiated thyroid cancers (DTCs), and additional methods remain to be explored. The aim of this study was to investigate the clinical value of the sodium/iodide symporter (NIS) expression and epithelial-mesenchymal transition (EMT) phenotypes of circulating tumor cells (CTCs) in monitoring the disease status and treatment response of DTC. Blood samples were obtained from DTC patients before (1 to 3 months after total thyroidectomy) and 4 to 6 months after radioactive iodine-131 (RAI) therapy for the CTC assessments. The number, NIS expression, and EMT phenotypes of CTCs were enumerated and characterized with CanPatrol™ CTC enrichment and mRNA in situ hybridization. Postoperative NIS high expression was independently correlated with a better response to first RAI therapy and good treatment efficacy. Postoperative NIS-/epithelial-/mesenchymal+ CTCs presence was independently correlated with a worse response to first RAI therapy. The numbers of total NIS+ CTCs and NIS+/epithelial+/mesenchymal+ CTCs after first RAI therapy were negatively correlated with a better response to RAI therapy only in univariate analyses. Univariate and multivariate analyses showed that a decreased or unchanged number of total NIS+ CTCs after RAI therapy may denote good efficacy and effective RAI therapy. These preliminary data suggest that assessment of the NIS expression and EMT phenotypes of CTCs may serve as potential adjuncts for predicting and monitoring the curative effect of RAI therapy in DTC patients and avoid ineffective treatment. Further validation is warranted.

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Using tumor cell markers to predict and track radioactive iodine treatment in thyroid cancer

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