A 13-steroid serum panel based on LC-MS/MS: use in detection of adrenocortical carcinoma
Open accessAbstract
BACKGROUND: Adrenocortical carcinoma (ACC) is a rare malignancy, with an annual incidence of 1 or 2 cases per million. Biochemical diagnosis is challenging because up to two-thirds of the carcinomas are biochemically silent, resulting from de facto enzyme deficiencies in steroid hormone biosynthesis. Urine steroid profiling by GC-MS is an effective diagnostic test for ACC because of its capacity to detect and quantify the increased metabolites of steroid pathway synthetic intermediates. Corresponding serum assays for most steroid pathway intermediates are usually unavailable because of low demand or lack of immunoassay specificity. Serum steroid analysis by LC-MS/MS is increasingly replacing immunoassay, in particular for steroids most subject to cross-reaction. METHODS: We developed an LC-MS/MS method for the measurement of serum androstenedione, corticosterone, cortisol, cortisone, 11-deoxycorticosterone, 11-deoxycortisol, 21-deoxycortisol, dehydroepiandrosterone sulfate, pregnenolone, 17-hydroxypregnenolone, progesterone, 17-hydroxyprogesterone, and testosterone. Assay value in discriminating ACC from other adrenal lesions (phaeochromocytoma/paraganglioma, cortisol-producing adenoma, and lesions demonstrating no hormonal excess) was then investigated. RESULTS: In ACC cases, between 4 and 7 steroids were increased (median = 6), and in the non-ACC groups, up to 2 steroids were increased. 11-Deoxycortisol was markedly increased in all cases of ACC. All steroids except testosterone in males and corticosterone and cortisone in both sexes were of use in discriminating ACC from non-ACC adrenal lesions. CONCLUSIONS: Serum steroid paneling by LC-MS/MS is useful for diagnosing ACC by combining the measurement of steroid hormones and their precursors in a single analysis.
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In recent years, LC-MS/MS has also been used on serum samples to differentiate between benign and malignant adrenal disease.
“In recent years, LC-MS/MS has also been used on serum samples to differentiate between benign and malignant adrenal disease (352,353).”
From Adrenal incidentaloma (2020) · cites this paper as [353]
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Self-citation
- Authors
- Taylor, D. R., Ghataore, L., Couchman, L., Vincent, R. P., Whitelaw, B., Lewis, D., Diaz-Cano, S., Galata, G., Schulte, K.-M., Aylwin, S., & Taylor, N. F.
- Affiliations
- King's College Hospital NHS Foundation Trust (GB)
- Department of Histopathology, King's College Hospital NHS Foundation Trust, London, UK
- Department of Surgery, King's College Hospital NHS Foundation Trust, London, UK
- Corresponding author
- Taylor, David R
- Venue
- Clinical Chemistry
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-12-01
- Volume
- 63
- Issue
- 12
- Pages
- 1836-1846
- ISSN
- 0009-9147 (ISSN-L)
- 1530-8561
- OpenAlex
- W2755592887
- Cited by
- 109
- References
- 38
- Citations by year
- 2026: 9 · 2025: 7 · 2024: 7 · 2023: 16 · 2022: 16 · 2021: 11 · 2020: 12 · 2019: 18 · 2018: 11 · 2017: 2
- FWCI
- 12.04
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Chemistry (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Figshare (submittedVersion, cc-by)
- Figshare (cc-by)
- Funders
- King's College London
- Topics
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Keywords
- adrenocortical carcinoma, 11-deoxycortisol, adrenal mass, pheochromocytoma, paraganglioma, cortisol-producing adenoma, biochemical diagnosis, diagnostic discrimination
- MeSH terms
- Adrenal Cortex Neoplasms, Adult, Aged, Chromatography, Liquid, Female, Humans, Male, Middle Aged, Steroids, Adrenocortical Carcinoma, Tandem Mass Spectrometry, Limit of Detection
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