title: Different Types of Urinary Steroid Profiling Obtained by High-Performance Liquid Chromatography and Gas Chromatography-Mass Spectrometry in Patients with Adrenocortical Carcinoma.
abstract: Urinary steroid profiling (USP) was studied using high-performance liquid chromatography (HPLC) and gas chromatography-mass spectrometry (GC-MS) methods in 108 patients with adrenocortical adenoma (ACA) and in 31 patients with adrenocortical carcinoma (ACC). Thirteen ACC and Cushing's syndrome (ACC-CS) patients had two types of USP as well as 18 ACC patients without hypercortisolism. These four types differed by androgen and glucocorticoid secretion of the adrenal cortex. Fifteen main ACC features were observed by GC-MS. Urinary excretion of dehydroepiandrosterone (DHEA) was increased in 67.7 % of ACC patients and tetrahydro-11-deoxycortisol (THS) in 74.2 %. By combination of the following parameters: THS >900 μg/24 h and/or DHEA >1500 μg/24 h with ratios of 3α,16,20-pregnentriol/3β,16,20-pregnentriol (3α,16,20dP3/3β,16,20dP3) less than 6.0 and 3α,17,20dP3/3β,17,20dP3 less than 9.0 and the detection of "non-classical" 5-en-pregnens, not found in ACA and healthy persons, 100 % sensitivity and specificity of ACC and ACA differential diagnosis were achieved. Features of 21-hydroxylase and 11β-hydroxylase deficiency were observed by GC-MS in 32.2 and 61.3 % of the ACC patients, respectively. Additional features for ACC-CS diagnostic were increased urinary excretion of 6β-hydroxycortisol, 18-hydroxycorticosterone, the sum (UFF + UFE) obtained by HPLC, tetrahydrocorticosterone, and the sum (THF + THE + allo-THF) obtained by GC-MS.
authors.affiliation: Federal State Budget Institution of Higher Education "North-Western State Medical University named after I.I Mechnikov" under the Ministry of Public Health of the Russian Federation, Saint Petersburg, Russian Federation. velikanovali@hotbox.ru.
authors.forename: L I
authors.initials: LI
authors.lastname: Velikanova
authors.affiliation: Federal State Budget Institution of Higher Education "North-Western State Medical University named after I.I Mechnikov" under the Ministry of Public Health of the Russian Federation, Saint Petersburg, Russian Federation.
authors.forename: Z R
authors.initials: ZR
authors.lastname: Shafigullina
authors.affiliation: Federal State Budget Institution of Higher Education "North-Western State Medical University named after I.I Mechnikov" under the Ministry of Public Health of the Russian Federation, Saint Petersburg, Russian Federation.
authors.forename: A A
authors.initials: AA
authors.lastname: Lisitsin
authors.affiliation: Federal State Budget Institution of Higher Education "North-Western State Medical University named after I.I Mechnikov" under the Ministry of Public Health of the Russian Federation, Saint Petersburg, Russian Federation.
authors.forename: N V
authors.initials: NV
authors.lastname: Vorokhobina
authors.affiliation: Federal State Budget Institution of Higher Education "North-Western State Medical University named after I.I Mechnikov" under the Ministry of Public Health of the Russian Federation, Saint Petersburg, Russian Federation.
authors.forename: K
authors.initials: K
authors.lastname: Grigoryan
authors.affiliation: Federal State Budget Institution of Higher Education "North-Western State Medical University named after I.I Mechnikov" under the Ministry of Public Health of the Russian Federation, Saint Petersburg, Russian Federation.
authors.forename: E A
authors.initials: EA
authors.lastname: Kukhianidze
authors.affiliation: Federal State Budget Institution of Higher Education "North-Western State Medical University named after I.I Mechnikov" under the Ministry of Public Health of the Russian Federation, Saint Petersburg, Russian Federation.
authors.forename: E G
authors.initials: EG
authors.lastname: Strelnikova
authors.affiliation: Federal State Budget Institution of Higher Education "North-Western State Medical University named after I.I Mechnikov" under the Ministry of Public Health of the Russian Federation, Saint Petersburg, Russian Federation.
authors.forename: N S
authors.initials: NS
authors.lastname: Krivokhizhina
authors.affiliation: Saint Petersburg Multiprofile Centre of Ministry of Healthcare of Russian Federation, Saint Petersburg, Russian Federation.
authors.forename: L M
authors.initials: LM
authors.lastname: Krasnov
authors.affiliation: Saint Petersburg Multiprofile Centre of Ministry of Healthcare of Russian Federation, Saint Petersburg, Russian Federation.
authors.forename: E A
authors.initials: EA
authors.lastname: Fedorov
authors.affiliation: Saint Petersburg Multiprofile Centre of Ministry of Healthcare of Russian Federation, Saint Petersburg, Russian Federation.
authors.forename: I V
authors.initials: IV
authors.lastname: Sablin
authors.affiliation: Saint Petersburg State University, Saint Petersburg, Russian Federation.
authors.forename: A L
authors.initials: AL
authors.lastname: Moskvin
authors.affiliation: Saint Petersburg State University, Saint Petersburg, Russian Federation.
authors.forename: E A
authors.initials: EA
authors.lastname: Bessonova
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000175:diagnosis / Q000652:urine*; D018246:Adrenocortical Adenoma / Q000175:diagnosis / Q000652:urine*; D018268:Adrenocortical Carcinoma / Q000175:diagnosis / Q000652:urine*; D000328:Adult; D002851:Chromatography, High Pressure Liquid / Q000379:methods*; D003350:Cortodoxone / Q000031:analogs & derivatives / Q000652:urine; D003480:Cushing Syndrome / Q000652:urine; D003687:Dehydroepiandrosterone / Q000652:urine; D003937:Diagnosis, Differential; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013252:Steroid 11-beta-Hydroxylase / Q000378:metabolism; D013255:Steroid 21-Hydroxylase / Q000378:metabolism; D013256:Steroids / Q000652:urine*; D055815:Young Adult
chemical_list: D013256:Steroids; D003687:Dehydroepiandrosterone; C009412:tetrahydro-11-deoxycortisol; D013255:Steroid 21-Hydroxylase; D013252:Steroid 11-beta-Hydroxylase; D003350:Cortodoxone