Endocrine Abstract 2015 - 10.1530:endoabs.38.P398.pdf (198.27 kB)
Discrimination of adrenocortical carcinoma from other adrenal lesions: use of a new 13 steroid serum panel based on LC–MS/MS
journal contribution
posted on 2016-04-07, 15:22 authored by Salvador J. Diaz-CanoSalvador J. Diaz-CanoAdrenocortical
carcinoma (ACC) is a rare malignancy, accounting for up to 11% of
adrenal masses investigated in referral centres. Diagnosis remains a
challenge. Up to two-thirds are biochemically inactive, resulting from
de facto enzyme deficiencies in the steroid hormone biosynthetic
pathways, as shown by urine steroid profiling by gas chromatography-mass
spectrometry. Increased metabolites of pathway intermediates in ACC
discriminate it from benign adrenal lesions and provide markers for
follow-up. Serum assays for most intermediates (e.g.
17-hydroxypregnenolone) are unavailable, due to low demand or lack of
immunoassay specificity. Serum steroid analysis by liquid
chromatography–tandem mass spectrometry (LC–MS/MS) is increasingly
replacing immunoassay, especially for those most subject to
cross-reverse-phase C18 column with the MS operated in positive APCI
ionisation mode. In the ACC cases, between four and 10 steroids were
increased (mean=6), whilst in the non-ACC group up to two steroids were
increased. 11-Deoxycortisol was markedly increased in all ACC cases,
whilst increases were also seen for androstenedione (five cases), 17-hydroxyprogesterone
(four cases) and pregnenolone, 17-hydroxypregnenolone,
11-deoxycorticosterone, and DHEAS (three cases each). The
cortisol:11-deoxycortisol ratio best discriminated between ACC
(mean=14.9), non-ACC (335.9), and healthy controls (324.9, P=0.003). In
conclusion, serum steroid panelling by LC–MS offers a promising
diagnostic test for ACC by combining the measurement of steroid hormones
and their precursors in a single analysis.
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- Cancer cell biology
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- Cell metabolism
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