RT Journal
A1 Fernandez-Ranvier GG, Weng J, Yeh R, et al
T1 IDentification of biomarkers of adrenocortical carcinoma using genomewide gene expression profiling
JF Archives of Surgery
JO Archives of Surgery
YR 2008
FD September 15
VO 143
IS 9
SP 841
OP 846
DO 10.1001/archsurg.143.9.841
UL http://dx.doi.org/10.1001/archsurg.143.9.841
AB Hypothesis 
    The gene expression profiles of benign and malignant adrenocortical tumors are different.Design 
    Genomewide gene expression profiling and validation.Setting 
    Tertiary medical center.Patients 
    Eighty-five patients with benign adrenocortical tumors (n = 74) and adrenocortical carcinoma (n = 11).Intervention 
    Real-time quantitative reverse transcription–polymerase chain reaction (RT-PCR) in 89 adrenocortical tissue samples (11 malignant and 78 benign). The criteria for differentially expressed genes between benign and malignant adrenocortical tumors were a false discovery rate of less than 5% and an adjusted P < .01. Genes differentially expressed by 8-fold higher or lower were validated by RT-PCR.Main Outcome Measures 
    The diagnostic accuracy of differentially expressed genes as determined by the area under the receiver operating characteristic curve (AUC).Results 
    We found 37 genes differentially expressed by 8-fold higher or lower. Fifteen genes were downregulated and 22 were upregulated in adrenocortical carcinoma. Of the 37 genes, 29 differentially expressed by microarray correlated with the gene expression levels by quantitative RT-PCR (P ≤ .01). Of the 37 genes validated by RT-PCR, 22 were significantly differentially expressed between benign and malignant adrenocortical tumors (P < .05). Five of these 22 genes had an AUC of 0.80 or greater (the AUC for IL13RA2 was 0.90; HTR2B, 0.87; CCNB2, 0.86; RARRES2, 0.86; and SLC16A9, 0.80), indicating high diagnostic accuracy for distinguishing benign from malignant adrenocortical tumors.Conclusion 
    We identified 37 genes that are dysregulated in adrenocortical carcinoma, and several of the differentially expressed genes have excellent diagnostic accuracy for distinguishing benign from malignant adrenocortical tumors.