Delineating Pediatric Adrenocortical Tumors by Gas Chromatography-mass Spectrometry (GC-MS) Urinary Steroid Metabolome Analysis: Observations From the MET Study
Authors' conclusion
Urinary GC-MS steroid metabolome analysis is noninvasive and allows good detection of ACTs from spot urine as well as good differentiation of pACCs from pACAs. The dominance of Δ5-steroids in pACTs points to the zona reticularis as a common site of origin. The parameters differentiating pACAs from pACCs differ from adults.
Study context
- Population
- Children with adrenocortical tumors at initial diagnosis from the German Society for Pediatric Oncology and Hematology MET study; median age 6.9 (range 0.7–17) years; 36 females
- Participants
- 46 pACT patients
- Comparison
- Pediatric adrenocortical carcinomas (pACCs) vs pediatric adrenocortical adenomas (pACAs); Pediatric adrenocortical tumors (pACTs) vs controls
- pACAsn = 21reference
- pACCsn = 25
- Outcome
- Urinary steroid metabolome: detection of pACTs and differentiation of pACCs from pACAs
- Follow-up
- Initial diagnosis
Methodological detailstargeted GC-MS, machine learning classifiers
- Targeted GC-MS
- Machine learning classifiers
Performance
As reported in the abstract
- Selected biomarkers discriminated pACTs from controls, and pACCs from pACAs, with high sensitivity and specificity
- pACTs vs Controls: P < 0.001
- pACCs vs pACAs: P < 0.05
Original publication
Delineating Pediatric Adrenocortical Tumors by GC-MS Urinary Steroid Metabolome Analysis: Observations From the MET Study. J Clin Endocrinol Metab. Published 12 November 2025. doi:10.
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