Adrenocortical tumours in children and adults: a study of pathological and proliferation features.
OBJECTIVE
To demonstrate the correlation between morphological and proliferation parameters with the biological behaviour of adrenocortical tumours (ACTs) in different age groups.


METHODS
Seventy-six cases of ACT were evaluated comparing tumours of children (< or =15 years, n=24) and adults (>15 years, n=52) regarding morphological features and proliferation rates. These parameters were also compared in clinically benign (CB) and clinically malignant (CM) tumours. Tumours were analysed according to Weiss' histological parameters. Proliferation rates were assessed by MIB-1 labelling index and silver binding nucleolar organiser regions (AgNORs) were quantified by image analysis.


RESULTS
ACTs in children presented higher proliferative activity than in adults. In adult's ACTs, MIB-1 labelling index (cut-off, 10%) (P=0.037) and the AgNOR pattern (P<0.001) had influence over the disease-free survival (DFS). The AgNOR pattern type I was associated with CB-ACT and the AgNOR pattern type II with CM-ACT. The AgNOR pattern type III was characteristic of children's ACTs and type IV was characteristic of non-neoplasic adrenal glands.


CONCLUSIONS
ACTs in children had a different morphological spectrum and higher proliferative activity than those tumours in adults, which should be always analysed as a separate group. In adults, our findings reinforce that the morphological criteria proposed by Weiss are an efficient way of differentiating CB-ACT from CM-ACT.
Department of Pathology, The Cancer Hospital, Ludwig Institute for Cancer Research, University of São Paulo, Rua Emilio de Menezes 56, apt 21, Higienópolis, São Paulo, CEP:01231-020, Brazil. ssredni@ludwig.org.br
Simone Treiger
ST
Sredni
Venâncio Avancini Ferreira
VA
Alves
Maria Do Rosário
Mdo R
Latorre
Maria Claudia Nogueira
MC
Zerbini
D000293:Adolescent; D000302:Adrenal Cortex / Q000378:metabolism / Q000473:pathology; D000306:Adrenal Cortex Neoplasms / Q000737:chemistry / Q000378:metabolism / Q000473:pathology*; D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis / Q000378:metabolism; D002455:Cell Division; D002648:Child; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis / Q000378:metabolism; D009697:Nucleolus Organizer Region / Q000145:classification / Q000473:pathology; D016622:Silver Staining
D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen