Serum Steroid Profiling in the Diagnosis of Adrenocortical Carcinoma: A Prospective Cohort Study
Authors' conclusion
We showed that measurements of 11-deoxycortisol, 17OH-progesterone, and 17OH-pregnenolone could be valuable in diagnosing ACC. After appropriate validation, serum steroid score could be integrated in clinical practice.
Study context
- Population
- Patients with adrenal masses evaluated 2015–2023, single centre; reference standard histopathology, imaging characteristics, imaging follow-up of 2 years or clinical follow-up of 5 years
- Participants
- 263 patients
- Comparison
- Serum 11-deoxycortisol, 17OH-progesterone and 17OH-pregnenolone (serum steroid score) for adrenocortical carcinoma (ACC) vs non-ACC
- ACCn = 44
- Adrenocortical adenomas (ACAs)n = 161
- Other adrenal malignanciesn = 27
- Othern = 31
- Outcome
- Accuracy of serum 11-deoxycortisol, 17OH-progesterone and 17OH-pregnenolone (LC-MS) in diagnosing ACC; serum steroid score assessed with AUC
Methodological detailsprospective, single-centre, cohort
- Prospective
- Single-centre
- Cohort
Performance
As reported in the abstract
Serum steroid score discriminating ACC vs non-ACC
- Mean threshold fixed AUC of serum steroid score (Localized Generalized Matrix Learning Vector Quantization)
- 0.823
- All 3 steroids higher in ACCs vs non-ACCs, incl. vs functioning ACAs and vs ACAs with Hounsfield unit ≥ 20
- P < .0001 for all
Further findings
- Hounsfield unit ≥ 20 — ACAs
- 31%
Hounsfield unit ≥ 20
- Hounsfield unit ≥ 20 in all ACCs and in all but 1 other adrenal malignancy
Original publication
Serum Steroid Profiling in the Diagnosis of Adrenocortical Carcinoma: A Prospective Cohort Study. J Clin Endocrinol Metab. Published 4 September 2024. doi:10.
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