The Expression and Clinical Features of 8 Immunohistochemistry Markers in Adrenal Cortical Adenomas and Pheochromocytomas.

Abstract

This study explores the potential relationship between 8 immunohistochemistry markers and 4 adrenal diseases-cushing syndrome, primary hyperaldosteronism, nonfunctioning adrenal adenoma, and hypercatecholamine-based on symptoms and laboratory findings. Understanding these associations can provide valuable insights into the diagnosis and management of adrenal tumors. We retrospectively analyzed cases of patients treated in the urology department of our hospital from April 2017 to May 2022, focusing on pathologic results of specimens that had undergone immunohistochemical staining following laparoscopic adrenalectomy. The statistical analysis was performed using the χ2 test with SPSS 25.0 software. A total of 124 cases were collected, including 71 men and 53 women. Among them, 21 cases were diagnosed with cushing syndrome, 49 with primary hyperaldosteronism, and 40 with nonfunctioning adrenal adenoma, all reported as adrenal cortical adenomas. In addition, 14 cases were diagnosed with hypercatecholamine, reported as pheochromocytoma. The expression of Melan-A, inhibin α, and vimentin was significantly higher in adrenal cortical adenomas compared with pheochromocytoma (P<0.05), while CgA and S100 were more noticeable in pheochromocytoma (P<0.05). However, there was no significant difference in the expression of Syn, β-catenin, and CK between these 2 groups. Further comparisons revealed no significant differences among cushing syndrome, primary hyperaldosteronism, nonfunctioning adrenal adenoma, and hypercatecholamine concerning these 8 markers. The same applied when comparing nonfunctioning adrenal adenoma and functional adrenal adenoma (cushing syndrome and primary hyperaldosteronism). Our findings suggest that the combination of Melan-A, inhibin α, vimentin, CgA, and S100 may be useful in distinguishing between adrenal cortical adenoma and pheochromocytoma. However, these markers are not reliable for distinguishing among cushing syndrome, primary hyperaldosteronism, hypercatecholamine, and nonfunctioning adrenal adenoma.