Context: Adrenal incidentaloma (AI) is commonly discovered on cross-sectional imaging. Mild autonomous cortisol secretion is the most common functional disorder detected in AI.
Objective: To delineate the association between radiological characteristics of benign adrenocortical tumors and hypothalamus-pituitary-adrenal (HPA) axis.
Methods: In the study, 494 patients diagnosed with benign unilateral adrenocortical tumors were included. Mild autonomous cortisol secretion (MACS) was diagnosed when cortisol after 1mg-dexamethasone suppression test (1-mg DST) was in the range of 1.8-5ug/dl. Non-functional adrenocortical tumor (NFAT) was diagnosed as cortisol following 1-mg DST less than 1.8ug/dL. We performed Logistics regression and causal mediation analyses, looking for associations between radiological characteristics and the HPA axis.
Results: Of 494 patients, 352 (71.3%) with NFAT and 142 (28.7%) with MACS were included. Patients with MACS had a higher tumor diameter, thinner contralateral adrenal gland, and lower plasma ACTH and serum DHEAS than those with NFAT. ACTH (OR 0.978, 0.962-0.993) and tumor diameter (OR 1.857, 95%CI, 1.357-2.540) were independent factors associated with decreased serum DHEAS (all P<0.05). ACTH was also associated with decreased contralateral adrenal diameter significantly (OR 0.973, 95%CI, 0.957-0.988, P=0.001). Causal mediation analysis showed ACTH mediated the effect significantly for the association between 1-mg DST results and DHEAS level (P0.001, proportion=22.3%). Meanwhile, we found ACTH mediated 39.7% of the effects of 1-mg DST on contralateral adrenal diameter (P=0.012).
Conclusions: Patients with MACS had thinner contralateral adrenal glands and disturbed HPA axes compared with NFAT. ACTH may partially be involved in mediating the mild autonomous cortisol secretion to DHEAS and the contralateral adrenal gland.
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http://dx.doi.org/10.3389/fendo.2023.1199875 | DOI Listing |
Transl Cancer Res
November 2024
Department of Clinical Laboratory, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
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View Article and Find Full Text PDFCancers (Basel)
November 2024
Department of Public Health and Pediatrics, University of Torino, 10126 Torino, Italy.
Background/objectives: Adrenocortical tumors (ACTs), including adrenocortical adenoma (ACA) and carcinoma (ACC), represent 0.3-0.4% of pediatric tumors.
View Article and Find Full Text PDFJ Thorac Dis
November 2024
Department of Oncology, Zhongshan Hospital, Fudan University, Shanghai, China.
Background: Immune checkpoint inhibitors (ICIs) are emerging as important drugs for patients with locally advanced esophageal cancer (EC). Yet, immune-related adverse events (irAEs) may be a major obstacle for these population. Multidisciplinary team (MDT) is an efficient way to deal with such conditions.
View Article and Find Full Text PDFAm J Transl Res
November 2024
Department of General Practice, Pingjiang New Town Community Health Service Center Sujin Street, Gusu District, Suzhou 215000, Jiangsu, China.
Background: Cancer represents a highly intricate disease, characterized by the uncontrolled proliferation and invasion of aberrant cells, leading to widespread global morbidity and mortality. This study investigates the influence of CD19, a marker specific to B-cells, within the tumor microenvironment (TME) across a spectrum of cancer types.
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Am J Transl Res
November 2024
Lower Extremity Division, Orthopedic Trauma Department, Honghui Hospital, Xi'an Jiaotong University Youyi East Road No. 555, Beilin District, Xi'an, Shaanxi, China.
Purpose: The stromal cell protein metalloproteinase 9 (MMP9), associated with extracellular matrix degradation and remodeling, promotes tumor invasion and metastasis and regulates cell adhesion molecule and cytokine activity. This study evaluated MMP9 in pan-cancer and screened for compounds and drug candidates that can inhibit it.
Methods: MMP9 expression in pan-cancer tissues was evaluated in a pan-cancer dataset from the University of California Santa Cruz database, along with the correlation between MMP9 and the tumor microenvironment (TME), RNA modification genes, and tumor mutation burden.
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