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Distinguishing adrenal cortical carcinomas and adenomas: a study of clinicopathological features and biomarkers
Author(s) -
Wang Cuiping,
Sun Yang,
Wu Huanwen,
Zhao Dachun,
Chen Jie
Publication year - 2014
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.12283
Subject(s) - immunohistochemistry , adrenocortical carcinoma , pathological , immunochemistry , pathology , adenoma , medicine , histology , antibody , immunology
Aims To determine clinicopathological criteria and molecular markers helpful in distinguishing adrenocortical carcinomas ( ACC s) from adrenocortical adenomas ( ACA s). Methods and results We analysed retrospectively the clinical and pathological features of 50 adrenal cortical tumours, and tested the expression of mi R 483‐3p by in‐situ hybridization as well as the expression of IGF 2 and S mad4 by immunohistochemistry. We found that tumour size, tumour weight, hormonal function and the W eiss system are all high‐efficacy criteria for differentiating malignant from benign tumours ( P < 0.001). Mi R 483‐3p was overexpressed in 68% (17 of 25) of ACC s compared to 12% (three of 25) of ACA s ( P < 0.05). Using a combination of mi R 483‐3p and S mad4 improved diagnostic accuracy. Molecular markers were then tested in an independent set of 15 borderline tumours. We confirmed that the combined use of mi R 483‐3p and Smad4 immunochemistry can complement the Weiss score in the diagnosis of ACC in cases that display borderline histology. Conclusions Tumour size, tumour weight, hormonal function and the Weiss system are useful clinicopathological criteria that can result in accurate diagnosis of most ACC s and ACA s. In challenging cases, mi R 483‐3p and S mad4 expression may help in distinguishing these two entities.