Thrombopoiesis and Androgen Biosynthesis in Patients with Adrenal Cortex Tumors

Abstract

The results of experimental and clinical studies indicate the involvement of platelets in the process of progression of malignant tumors of different localizations. Studying the effect of corticosteroids on thrombopoiesis in patients with adrenal cortex tumors will allow us to expand our understanding of the pathogenesis of adrenocortical cancer. Twenty two patients with adrenal cortex neoplasms were examined: 11 individuals with adrenocortical cancer (ACC) and 11 ones with adrenocortical adenoma (ACA). The diagnosis was confirmed based on the results of histological examination using the scale of L.M. Weiss. The age of patients was 58 (49–63) years, 5 (23%) of men were included in the study. No differences in the age, gender, or body mass index value between examined individuals with ACC and ACA were detected. In the preoperative period, all patients underwent clinical blood test with determination of leukocyte formula, calculation of systemic immune inflammation index (SII), urine steroid profiles were studied using gas chromatography/mass spectrometry. A larger number of platelets were obtained in ACC patients as compared with examined individuals with ACA: 282 (256‒310) × 10⁹ and 222 (194‒251) × 10⁹, р = 0.004. A lower SII value was detected in ACA patients as compared with ACC patients: 251 (186–354) and 618 (500–703), р = 0.002. Using gas chromatography/mass spectrometry method, higher urinary excretion of glucocorticoid metabolite tetrahydro-11-deoxycortisol, as well as androgens—dehydroepiandrosterone (DHEA) and etiocholanolone (Et) and 11β-OH-androsterone (androstenedione metabolites), progestogens—17-OH-pregnanolone, pregnanediol, pregnanetriol, pregnenediol, was demonstrated in ACC patients as compared with indices in ACA patients (p < 0.007). A linear dependence of the number of blood platelets on urinary excretion of Et (r = 0.81, p < 0.001) and DHEA (r = 0.94, p < 0.001), as well as SII on urinary excretion of DHEA (r = 0.90, p < 0.001), was demonstrated in all examined individuals.