[Diagnostic value of A103 and inhibin-alpha in adrenocortical tumors: an immunohistochemical study using tissue microarray techniques].
OBJECTIVE
To investigate the potential diagnostic value of A103 and inhibin-alpha in adrenocortical tumors and to evaluate the applicability of tissue microarray/tissue chip in pathological studies using immunohistochemistry.


METHODS
A tissue microarray/tissue chip was constructed to contain 179 formalin-fixed, paraffin-embedded adrenal tissue samples which include 3 normal adrenal cortex, 2 fetal adrenal cortex, 2 nodular adrenocortical hyperplasia samples, 72 adrenocortical adenomas, 39 adrenocortical carcinomas, 3 adrenal medulla, 13 metastatic carcinomas, 4 metastatic malignant melanomas and 44 pheochromocytomas. Additional 20 cases of normal adult adrenal gland were used as controls. Immunohistochemical markers, including A103, inhibin-alpha, calretinin and Ki-67 were used on the tissue array sections by EnVision immunohistochemical staining methods.


RESULTS
Positive staining of A103 was seen in all of the 23 (100%) adrenal cortex, 2 fetal adrenal cortex, 2 nodular adrenocortical hyperplasia samples, 60 of 66 (90.9%) adrenocortical adenomas samples, 35 of 37 (94.6%) adrenocortical carcinomas samples, 3 of 3 malignant melanomas, but in none of the adrenal medulla, pheochromocytomas or adrenal metastatic carcinoma samples. In all of the adrenal cortex, fetal adrenal cortex and nodular adrenocortical hyperplasia cases, inhibin-alpha immunoreactivity was limited to the zona reticularis and the innermost zona fasciculata. Fifty of the 66 (75.8%) adrenocortical adenomas, 28 of the 37 (75.7%) adrenocortical carcinomas were positive for inhibin-alpha. None of the adrenal medulla, pheochromocytoma, metastatic malignant melanoma or carcinoma samples showed a positive inhibin-alpha immunostain.


CONCLUSIONS
The tissue microarray/tissue chip technique provides a reliable method to investigate marker expression by offering a rapid, economic and accurate screening of tissue specimens on a large scale. The combined use of A103 and inhibin-alpha is valuable in distinguishing adrenocortical tumor from pheochromocytoma and other metastatic neoplasms.
Zhang
Hong-Ying
HY
Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, China. hongyingzh@yahoo.com
Wang
Xiao-Jie
XJ
Liu
Wei-Ping
WP
Jiang
Li-Li
LL
Li
Gan-Di
GD
Guo
Jia
J
Zhang
Yuan-Heng
YH
D000302:Adrenal Cortex / Q000378:metabolism; D000306:Adrenal Cortex Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000556:secondary; D018246:Adrenocortical Adenoma / Q000175:diagnosis / Q000378:metabolism; D000328:Adult; D000951:Antigens, Neoplasm / Q000096:biosynthesis / Q000235:genetics; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007265:Inhibins / Q000096:biosynthesis* / Q000235:genetics; D058965:MART-1 Antigen; D008297:Male; D009363:Neoplasm Proteins / Q000096:biosynthesis* / Q000235:genetics; D020411:Oligonucleotide Array Sequence Analysis; D010673:Pheochromocytoma / Q000175:diagnosis* / Q000378:metabolism
D000951:Antigens, Neoplasm; D058965:MART-1 Antigen; C548667:MLANA protein, human; D009363:Neoplasm Proteins; C094377:inhibin-alpha subunit; D007265:Inhibins