Pathologic features and expression of insulin-like growth factor-2 in adrenocortical neoplasms |
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Authors: | Lori A Erickson MD Long Jin MD Thomas J Sebo MD PhD Christine Lohse BS V Shane Pankratz PhD Michael L Kendrick MD Jon A van Heerden MD Geoffrey B Thompson MD Clive S Grant MD Dr Ricardo V Lloyd MD PhD |
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Affiliation: | (1) Department of Laboratory Medicine and Pathology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota;(2) Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota;(3) Department of Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota |
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Abstract: | We analyzed a series of adrenocortical neoplasms to compare the clinicopathologic features and the expression of insulin-like
growth factor-2 (IGF-2) in adrenocortical adenomas and carcinomas. IGF-2 is a growth factor commonly expressed in many tumors
including adrenal cortical and medullary neoplasms. Formalin-fixed paraffin-embedded tissues from 64 adrenocortical adenomas
and 67 adrenocortical carcinomas were analyzed. The carcinomas were histologically graded from 1 to 4 based on mitotic activity
and necrosis. Tumor weight, size, and follow-up information were obtained by chart review. Expression of IGF-2 was detected
by immunohistochemistry with the avidin-biotin-peroxidase complex method and a monoclonal antibody against IGF-2. Adrenocortical
carcinomas were larger (mean: 13.1 cm, 787 g) than adenomas (mean: 4.2 cm, 52 g) (p<0.001). In patients with adrenocortical carcinomas, high tumor grade (3 or 4) (p=0.01) was associated with decreased survival. Expression of IGF-2 was higher in adrenocortical carcinomas than in adenomas
(p<0.001). These results show that tumor size and weight along with expression of IGF-2 protein are useful features to assist
in distinguishing between adrenocortical adenomas and carcinomas, and that high tumor grade is a predictor of survival in
adrenocortical carcinomas. However, single immunohistochemical markers such as IGF-2 or single histopathologic features cannot
by themselves separate adrenocortical adenomas from carcinomas, and a combination of clinical, gross, and microscopic features
are needed to establish the diagnosis in difficult cases. |
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Keywords: | Adrenocortical adenoma adrenocortical carcinoma insulin-like growth factor-2 |
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