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Updated: Feb 20, 2026
Quantitative Immunohistochemistry of the Cellular Microenvironment in Patient Glioblastoma Resections
Published on: July 31, 2017
Immunohistochemical evaluation of molecular radiotherapy target expression in neuroblastoma tissue
Jennifer E Gains1, Neil J Sebire2, Veronica Moroz3
1Department of Oncology, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London, NW1 2PG, UK.
Purpose:
Neuroblastoma may be treated with molecular radiotherapy, 131I meta-Iodobenzylguanidine and 177Lu Lutetium DOTATATE, directed at distinct molecular targets: Noradrenaline Transporter Molecule (NAT) and Somatostatin Receptor (SSTR2), respectively. This study used immunohistochemistry to evaluate target expression in archival neuroblastoma tissue, to determine whether it might facilitate clinical use of molecular radiotherapy.
Methods:
Tissue bank samples of formalin fixed paraffin embedded neuroblastoma tissue from patients for whom clinical outcome data were available were sectioned and stained with haematoxylin and eosin, and monoclonal antibodies directed against NAT and SSTR2. Sections were examined blinded to clinical information and scored for the percentage and intensity of tumour cells stained. These data were analysed in conjunction with clinical data.
Results:
Tissue from 75 patients was examined. Target expression scores varied widely between patients: NAT median 45%, inter-quartile range 25% - 65%; and SSTR2 median 55%, interquartile range 30% - 80%; and in some cases heterogeneity of expression between different parts of a tumour was observed. A weak positive correlation was observed between the expression scores of the different targets: correlation coefficient = 0.23, p = 0.05. MYCN amplified tumours had lower SSTR2 scores: mean difference 23% confidence interval 8% - 39%, p < 0.01. Survival did not differ by scores.
Conclusions:
As expression of both targets is variable and heterogeneous, imaging assessment of both may yield more clinical information than either alone. The clinical value of immunohistochemical assessment of target expression requires prospective evaluation. Variable target expression within a patient may contribute to treatment failure.
Insights
Molecular radiotherapy for neuroblastoma targets Noradrenaline Transporter Molecule (NAT) and Somatostatin Receptor (SSTR2). Target expression varies significantly, suggesting combined imaging may improve treatment efficacy.
Area of Science:
- Oncology
- Radiochemistry
- Molecular Imaging
Background:
- Neuroblastoma treatment can involve molecular radiotherapy targeting specific molecules.
- Key targets include Noradrenaline Transporter Molecule (NAT) and Somatostatin Receptor (SSTR2).
- Assessing target expression is crucial for guiding molecular radiotherapy use.
Purpose of the Study:
- To evaluate the expression of NAT and SSTR2 in neuroblastoma tissue.
- To determine if immunohistochemistry can facilitate the clinical application of molecular radiotherapy.
- To correlate target expression with clinical outcome data.
Main Methods:
- Archival neuroblastoma tissue samples were analyzed using immunohistochemistry.
- Monoclonal antibodies against NAT and SSTR2 were used for staining.
- Tumor sections were scored for target expression intensity and percentage, blinded to clinical data.
Main Results:
- Seventy-five neuroblastoma tissue samples were evaluated.
- Significant variability and heterogeneity in NAT and SSTR2 expression were observed.
- MYCN amplified tumors showed lower SSTR2 expression (p < 0.01).
Conclusions:
- Variable and heterogeneous target expression necessitates further investigation.
- Combined imaging assessment of both NAT and SSTR2 may provide more clinical information.
- Prospective evaluation of immunohistochemical assessment is required to confirm clinical utility.
