title: Diagnostic and prognostic role of steroidogenic factor 1 in adrenocortical carcinoma: a validation study focusing on clinical and pathologic correlates.
abstract: The pathologic characterization of adrenocortical cancer is still problematic for several reasons, including the identification of novel markers of diagnostic or prognostic relevance. Among them, steroidogenic factor 1 deserves major interest because of its potential usefulness as a marker of adrenocortical derivation and of biological aggressiveness. Our aim was to validate its prognostic relevance in a large series of adrenocortical cancer, comparing the performance of 2 different commercial antibodies and investigating its expression in adrenocortical cancer variants and in comparison with clinical and pathologic features. Seventy-five (including 53 classical, 10 myxoid, and 12 oncocytic) adrenocortical cancer cases were included in tissue microarrays and analyzed for the immunohistochemical expression of steroidogenic factor 1 using 2 commercial antibodies, 1 polyclonal and 1 monoclonal (N1665). Nuclear steroidogenic factor 1 staining was assessed using a semiquantitative score and correlated with adrenocortical cancer type and clinical pathologic characteristics. A weak but significant correlation was found comparing the 2 antibodies with a positive rate of 88% and 58% using the monoclonal and polyclonal antibodies, respectively. High steroidogenic factor 1 expression with the N1665 antibody was positively correlated with high mitotic count, high Ki-67 index, and high European Network for the Study of Adrenal Tumors (ENSAT) stage and negatively associated with loss of functionality and presence of oncocytic features. Moreover, high steroidogenic factor 1 expression with this same antibody was significantly associated at univariate analysis with a decreased survival, together with high Ki-67 and mitotic indexes, with a trend to significance confirmed by multivariate analysis, thus supporting the detection of steroidogenic factor 1 using the N1665 antibody as a novel prognostic marker in adrenocortical cancer.
authors.affiliation: Division of Pathology, University of Turin at San Luigi Hospital, 10043 Orbassano, Torino, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Duregon
authors.forename: Marco
authors.initials: M
authors.lastname: Volante
authors.forename: Jessica
authors.initials: J
authors.lastname: Giorcelli
authors.forename: Massimo
authors.initials: M
authors.lastname: Terzolo
authors.forename: Enzo
authors.initials: E
authors.lastname: Lalli
authors.forename: Mauro
authors.initials: M
authors.lastname: Papotti
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000175:diagnosis* / Q000473:pathology; D018268:Adrenocortical Carcinoma / Q000175:diagnosis* / Q000473:pathology; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D054339:Steroidogenic Factor 1 / Q000096:biosynthesis / Q000378:metabolism*
chemical_list: D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor; D054339:Steroidogenic Factor 1