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Thyroid Cancer Diagnosis and Treatment / Thyroid Disorders and Treatments · Journal article
Endocrine Related Cancer · September 8, 2026
Encouraging direction, but not yet definitive.
This retrospective study of 31 patients with metastatic or recurrent thyroid cancer identifies high-risk histology combined with TPO, Tg, and cytoplasmic NIS expression as predictors of iodine avidity and radioiodine treatment response, explaining approximately half of inter-patient variation. The findings are biologically plausible and suggest potential utility for treatment stratification, but the small sample size and lack of independent validation limit confidence in clinical applicability.
Retrospective biomarker analysis. Patients with metastatic or recurrent differentiated thyroid cancer in whom iodine avidity in metastatic sites could be assessed by image-based analysis and for whom primary surgery tissue specimens were available.. Intervention: Radioiodine therapy (exposure); analysis of tissue biomarkers and mutational status. n = 31.
High-risk histology combined with TPO, Tg, and cytoplasmic NIS expression predicted iodine avidity and treatment response These variables explained approximately half of the variation between patients in treatment response TPO and Tg expression were identified as the largest contributors in prediction modelling
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
If validated in a prospective or independent cohort, this biomarker panel could enable pre-treatment prediction of radioiodine response and guide treatment intensification or alternative strategies in adjuvant and metastatic settings. At present, the findings support further investigation but do not yet justify routine clinical adoption.
A single-centre retrospective study with modest sample size identifying predictive biomarkers for radioiodine response using immunohistochemistry and mutation analysis; results are encouraging but require validation in an independent cohort before clinical adoption.
As stated by the source record.
Quoted from the source exactly as published.
If validated in a prospective or independent cohort, this biomarker panel could enable pre-treatment prediction of radioiodine response and guide treatment intensification or alternative strategies in adjuvant and metastatic settings. At present, the findings support further investigation but do not yet justify routine clinical adoption.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Radioiodine therapy of differentiated thyroid cancer is effective and possibly curative in patients with metastatic lesions that retain iodine avidity. However, in clinical practice, iodine avidity in any metastatic site is usually unknown at the point of initial treatment. Avidity prediction could enable more tailored initial radioiodine treatment. This work aimed to establish the best predictive factors for iodine avidity and subsequent treatment response. Thirty-one patients with metastatic or recurrent thyroid cancer sites in which iodine avidity could be assessed by image-based analysis were included. In tissue specimens from primary surgery, immunohistochemical expression of thyroglobulin (Tg), thyroid peroxidase (TPO), sodium-iodide symporter (NIS) and Ki67, and mutational status of BRAF, RAS and the TERT promoter was analyzed. Biochemical and structural response were assessed by serum Tg response and radiological evaluation. High-risk histology (widely invasive follicular, tall cell subtype papillary, differentiated high-grade or poorly differentiated thyroid carcinoma) combined with expression of TPO, Tg and cytoplasmic NIS performed well in predicting treatment response and iodine avidity. Approximately half of the variation between patients was explained by those variables, outperforming pT stage and mutational status. TPO and Tg expression were the largest contributors in prediction modelling. Radioiodine treatment response and iodine avidity in thyroid cancer can be predicted from histopathological analysis of the primary tumor. High-risk histology and expression of TPO, Tg and NIS were robust and informative predictors. This may be used to adapt treatment strategy in adjuvant and metastatic therapy settings.
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