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Endocrine

, Volume 65, Issue 3, pp 683–691 | Cite as

H-score of 11β-hydroxylase and aldosterone synthase in the histopathological diagnosis of adrenocortical tumors

  • Yi Yang
  • Ming Xiao
  • Ying Song
  • Yi Tang
  • Ting Luo
  • Shumin Yang
  • Wenwen He
  • Qingfeng Cheng
  • Linqiang Ma
  • Yao Zhang
  • Yunfeng He
  • Youde Cao
  • Jun Yang
  • Bin Peng
  • Jinbo HuEmail author
  • Qifu LiEmail author
Original Article
  • 77 Downloads

Abstract

Purpose

To assess the diagnostic performance of the H-score of 11β-hydroxylase (CYP11B1) and aldosterone synthase (CYP11B2) in the histopathological diagnosis of adrenocortical tumors (ACT).

Methods

We retrospectively evaluated 199 cases of ACT, of which 85 were diagnosed as aldosterone-producing adenoma (APA), 66 as cortisol-producing adenoma (CPA), 9 as aldosterone–cortisol co-secreting adenoma, 30 as nonhyperfunctioning adenoma, and 9 as adrenocortical carcinoma (ACC). Immunohistochemical staining was performed using anti-CYP11B1 and anti-CYP11B2 monoclonal antibodies. The staining was quantified by the McCarty’s H-score system. The diagnostic performance was assessed by the receiver operating characteristic curve (ROC).

Results

The H-score of CYP11B1 is highest in the CPA group and lowest in the ACC group. The H-score of CYP11B2 in the APA group is significantly higher than other ACT groups. The area under ROC (AUC) of an increased H-score of CYP11B2 (>65) for the diagnosis of APA was 0.971 (95%CI 0.937–0.990). The AUC of an increased H-score of CYP11B1 (>204) for the diagnosis of CPA was 0.725 (95%CI 0.658–0.786). The AUC of a decreased H-score of CYP11B1 (<85) for the diagnosis of ACC was 0.960 (95%CI 0.923–0.983).

Conclusions

H-score of CYP11B1 and CYP11B2 are reliable tools for the histopathological subtyping of functional benign ACT and may offer some value in the histopathological diagnosis of malignant ACT.

Keywords

Adrenocortical Tumors 11β-hydroxylase Aldosterone synthase H-score Histopathological diagnosis 

Notes

Acknowledgements

The authors thank Laboratory of Endocrine and Laboratory of Lipid & Glucose Metabolism, the First Affiliated Hospital of Chongqing Medical University. The authors also thank Chuan Peng, Rufei Gao, and Xiaoqiu Xiao (from Laboratory of Lipid & Glucose Metabolism, the First Affiliated Hospital of Chongqing Medical University) for suggestions of study design and revision.

Funding

This study was funded by National Key Clinical Specialties Construction Program of China to the Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University; and the National Natural Science Foundation of China (81670785) to Q.L.; and the National Natural Science Foundation of China (81800701) to Y.S.; and the Fundamental Science & Advanced Technology Research of Chongqing (Major Project, cstc2015jcyjBX0096) to Q.L.; and Chongqing Science and Technology Committee Innovation Project (Technology Development and Application of Precision Medicine, cstc2016shms-ztzx1003) to Q.L.; and the Joint Medical Research Project of Chongqing Science and Technology Commission and Chongqing Health and Family Planning Commission (Youth Project, 2018QNXM001) to J.H.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

A written informed consent was obtained from each participant enrolled.

Supplementary material

12020_2019_2022_MOESM1_ESM.doc (670 kb)
Supplementary Information

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Yi Yang
    • 1
  • Ming Xiao
    • 2
  • Ying Song
    • 1
  • Yi Tang
    • 2
  • Ting Luo
    • 1
  • Shumin Yang
    • 1
  • Wenwen He
    • 1
  • Qingfeng Cheng
    • 1
  • Linqiang Ma
    • 1
  • Yao Zhang
    • 3
  • Yunfeng He
    • 3
  • Youde Cao
    • 2
  • Jun Yang
    • 4
  • Bin Peng
    • 5
  • Jinbo Hu
    • 1
    Email author
  • Qifu Li
    • 1
    Email author
  1. 1.Department of Endocrinologythe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
  2. 2.Department of Pathology, College of Basic MedicineChongqing Medical UniversityChongqingChina
  3. 3.Department of Urologythe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
  4. 4.Cardiovascular Endocrinology LaboratoryHudson Institute of Medical ResearchClaytonAustralia
  5. 5.School of Public Health and ManagementChongqing Medical UniversityChongqingChina

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