Study of urine steroid profiles by gas chromatography-mass spectrometry in patients with adrenocortical cancer in the course of treatment

Background : Adrenocortical carcinoma (ACC) is a rare and aggressive disease. There are only few studies evaluating the diagnostic value of gas chromatography-mass spectrometry (GC-MS) for detection ACC recurrence after surgery. It necessary to conduct an in-depth study search most informative markers disease relapse. Aim To urine steroid metabolism by GC-MS during treatment identify early signs metastatic Materials methods Thirty nine (39) patients were examined before surgery, in postoperative period (< 1 year) late (at 2 5 years). Ten (10) disease-free at less than year Twenty (29) had metastases lungs other organs: 14, within 15, years. The control group included 25 with nonfunctioning adrenocortical adenomas (NAA) without malignant characteristics histological examination. Urine profiles assessed chromatograph-mass spectrometer Shimadzu GCMS-QP2020. Results As GC-MS, 16 major biomarkers found including etiocholanolone, dehydroepiandrosterone (DHEA) its metabolites, pregnanediol, pregnanetriol, 5-ene-pregnenes, tetrahydro-11-deoxycortisol (THS). Their excretion was increased compared that NAA (р < 0.002). A non-classic 5-ene-pregnene, 3β,16,20-pregnenetriol (3β,16,20-dP3), identified, > 500 mcg/day typical patients. After decreased urinary THS 0.0001) 3β,16,20-dP3 0.0001), 3α,16,20-dP3/3β,16,20-dP3 ratio = 0.003), those indicative absence any metastases. No difference 3α,16,20-dP3/3e,16,20-dP3 from corresponding values surgery (p 0.05) sign diseases relapse years, chemotherapy. In addition, progestogen found. DHEA metabolites chemotherapy not different 0.05). Conclusion Determination THS, 3β,16,20-dP3, utmost importance monitoring diagnosis progression.