Prognostic significance of immunohistochemical markers in adrenocortical carcinoma

Acta Chir Belg. 2020 Feb;120(1):23-29. doi: 10.1080/00015458.2018.1543822. Epub 2018 Nov 30.


Background: To present basic demographic and clinical characteristics of patients with adrenocortical carcinoma (ACC), to determine the overall survival rate and to analyze the results of immunohistochemical staining and its correlation with the length of survival.Material and methods: The study was conducted during the period between 1996 and 2010 and included 30 patients with ACC. Immunohistochemical staining (MMP9, melan A, inhibin, caltretinin, D2-40, synaptophysin and Ki-67) was performed.Results: ACC was diagnosed in 19 females and 11 men (1.7:1). The average age was 50.1 years. The median tumor size was 10 cm, the median weight 400 g. Majority of subjects had positive immunohistochemical staining for the markers of interest. Patients with any negative staining had shorter cancer-specific survival than ones with positive staining. According to the log-rank test results as well as according to the results of the univariate Cox analysis, negative staining for inhibin, D2-40 and synaptophysin and Ki-67 expression ≥7% were associated with poorer prognosis.Conclusions: The results of our study suggest that the absence of staining for some immunohistochemical markers and increased expression of Ki-67 are associated with a poorer prognosis and shorter survival of patients with ACC. Immunohistochemical markers may serve as a prognostic factor for ACC.

Keywords: Adrenal gland; calretinin; inhibin; melan A; survival; synaptophysin.

MeSH terms

  • Adrenal Cortex Neoplasms / metabolism*
  • Adrenal Cortex Neoplasms / mortality*
  • Adrenal Cortex Neoplasms / surgery
  • Adrenocortical Carcinoma / metabolism*
  • Adrenocortical Carcinoma / mortality*
  • Adrenocortical Carcinoma / surgery
  • Adult
  • Aged
  • Antibodies, Monoclonal, Murine-Derived / metabolism
  • Biomarkers, Tumor / metabolism
  • Female
  • Humans
  • Inhibins / metabolism
  • Ki-67 Antigen / metabolism
  • MART-1 Antigen / metabolism
  • Male
  • Matrix Metalloproteinase 9 / metabolism
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Synaptophysin / metabolism
  • Young Adult


  • Antibodies, Monoclonal, Murine-Derived
  • Biomarkers, Tumor
  • Ki-67 Antigen
  • MART-1 Antigen
  • Synaptophysin
  • monoclonal antibody D2-40
  • Inhibins
  • MMP9 protein, human
  • Matrix Metalloproteinase 9