title: Detection of circulating tumor cells in patients with adrenocortical carcinoma: a monocentric preliminary study.
abstract: BACKGROUND
  Adrenocortical carcinoma (ACC) is a rare malignancy, the prognosis of which is mainly dependent on stage at diagnosis. The identification of disease-associated markers for early diagnosis and drug monitoring is mandatory. Circulating tumor cells (CTCs) are released into the bloodstream from primary tumor/metastasis. CTC detection in blood samples may have enormous potential for assisting in the diagnosis of malignancy, estimating prognosis, and monitoring the disease.
  
  
  OBJECTIVE
  The aim of the study was to investigate the presence of CTCs in blood samples of patients with ACC or benign adrenocortical adenoma (ACA).
  
  
  METHODS
  We conducted the study at a university hospital.
  
  
  METHODS
  CTC analysis was performed in blood samples from 14 ACC patients and 10 ACA patients. CTCs were isolated on the basis of cell size by filtration through ScreenCell devices, followed by identification according to validated morphometric criteria and immunocytochemistry.
  
  
  METHODS
  We measured the difference in CTC detection between ACC and ACA.
  
  
  RESULTS
  CTCs were detected in all ACC samples, but not in ACA samples. Immunocytochemistry confirmed the adrenocortical origin. When ACC patients were stratified according to the median value of tumor diameter and metastatic condition, a statistically significant difference was found in the number of CTCs detected after surgery. A significant correlation between the number of CTCs in postsurgical samples and clinical parameters was found for tumor diameter alone.
  
  
  CONCLUSIONS
  Our findings provide the first evidence for adrenocortical tumors that CTCs may represent a useful marker to support differential diagnosis between ACC and ACA. The correlation with some clinical parameters suggests a possible relevance of CTC analysis for prognosis and noninvasive monitoring of disease progression and drug response.
authors.affiliation: Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence 50139, Italy.
authors.forename: Pamela
authors.initials: P
authors.lastname: Pinzani
authors.forename: Cristian
authors.initials: C
authors.lastname: Scatena
authors.forename: Francesca
authors.initials: F
authors.lastname: Salvianti
authors.forename: Elisa
authors.initials: E
authors.lastname: Corsini
authors.forename: Letizia
authors.initials: L
authors.lastname: Canu
authors.forename: Giada
authors.initials: G
authors.lastname: Poli
authors.forename: Milena
authors.initials: M
authors.lastname: Paglierani
authors.forename: Valentina
authors.initials: V
authors.lastname: Piccini
authors.forename: Mario
authors.initials: M
authors.lastname: Pazzagli
authors.forename: Gabriella
authors.initials: G
authors.lastname: Nesi
authors.forename: Massimo
authors.initials: M
authors.lastname: Mannelli
authors.forename: Michaela
authors.initials: M
authors.lastname: Luconi
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000473:pathology*; D018268:Adrenocortical Carcinoma / Q000473:pathology*; D000328:Adult; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011379:Prognosis