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Cited by 85Adrenal and Paraganglionic TumorsAdrenal Hormones and DisordersHormonal Regulation and Hypertension

Plasma steroid metabolome profiling for the diagnosis of adrenocortical carcinoma

Schweitzer, Sophie, Kunz, Meik, Kurlbaum, Max, Vey, Johannes, Kendl, Sabine, Deutschbein, Timo, Hahner, Stefanie, Fassnacht, Martin +2 more·2019·European Journal of Endocrinology
DOI 10.1530/eje-18-0782
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Abstract

Objective Current workup for the pre-operative distinction between frequent adrenocortical adenomas (ACAs) and rare but aggressive adrenocortical carcinomas (ACCs) combines imaging and biochemical testing. We here investigated the potential of plasma steroid hormone profiling by liquid chromatography tandem mass spectrometry (LC-MS/MS) for the diagnosis of malignancy in adrenocortical tumors. Design Retrospective cohort study of prospectively collected EDTA-plasma samples in a single tertiary reference center. Methods Steroid hormone profiling by liquid chromatography tandem mass spectrometry (LC-MS/MS) in random plasma samples and logistic regression modeling. Results Fifteen steroid hormones were quantified in 66 ACAs (29 males; M) and 42 ACC (15 M) plasma samples. Significantly higher abundances in ACC vs ACA were observed for 11-deoxycorticosterone, progesterone, 17-hydroxyprogesterone, 11-deoxycortisol, DHEA, DHEAS and estradiol (all P < 0.05). Maximal areas under the curve (AUC) for discrimination between ACA and ACC for single analytes were only 0.76 (estradiol) and 0.77 (progesterone), respectively. Logistic regression modeling enabled the discovery of diagnostic signatures composed of six specific steroids for male and female patients with AUC of 0.95 and 0.94, respectively. Positive predictive values in males and females were 92 and 96%, negative predictive values 90 and 86%, respectively. Conclusion This study in a large adrenal tumor patient cohort demonstrates the value of plasma steroid hormone profiling for diagnosis of ACC. Application of LC-MS/MS analysis and of our model may facilitate diagnosis of malignancy in non-expert centers. We propose to continuously evaluate and improve diagnostic accuracy of LC-MS/MS profiling by applying machine-learning algorithms to prospectively obtained steroid hormone profiles.

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Crossref · 10.1530/eje-18-0782

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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 [352]

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Authors
Schweitzer, S., Kunz, M., Kurlbaum, M., Vey, J., Kendl, S., Deutschbein, T., Hahner, S., Fassnacht, M., Dandekar, T., & Kroiss, M.
Affiliations
  • Universitätsklinikum Würzburg (DE)
  • Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
  • University of Würzburg (DE)
Corresponding author
  • Kunz, Meik
  • Kroiss, Matthias
ORCID
Venue
European Journal of Endocrinology
Publisher
Oxford University Press (OUP)
Published
2019-02
Volume
180
Issue
2
Pages
117-125
ISSN
  • 0804-4643 (ISSN-L)
  • 1479-683X
DOI
10.1530/eje-18-0782
OpenAlex
W2902019941
Cited by
85
References
26
Citations by year
2026: 9 · 2025: 6 · 2024: 9 · 2023: 11 · 2022: 11 · 2021: 15 · 2020: 14 · 2019: 10
FWCI
10.14
Type
journal article
Language
en
Open access
closed
Locations
  • European Journal of Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
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, adrenal adenoma, plasma steroids, diagnostic biomarkers, malignancy diagnosis, progesterone, estradiol, 17-hydroxyprogesterone, deoxycorticosterone, dehydroepiandrosterone, dehydroepiandrosterone sulfate, 11-deoxycortisol, adrenal tumors
MeSH terms
Adrenal Cortex Neoplasms, Adult, Aged, Aged, 80 and over, Chromatography, Liquid, Female, Humans, Male, Middle Aged, Steroids, Adrenocortical Carcinoma, Tandem Mass Spectrometry, Metabolomics, Metabolome, Young Adult

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