Evaluating diagnostic and prognostic significance of steroidogenic factor-1(SF-1) and gherlin in differentiation between adrenocortical adenoma, adrenocortical carcinoma and pheochromocytoma ( immunohistochemical study)

Background: Adrenal masses are a common finding in the adrenal gland. Steroidogenic factor 1 (SF1) is a nuclear transcription factor that regulates genes involved in gonadal and adrenal steroidogenesis. Ghrelin is a ligand of growth hormone secretagogue receptor type 1 (GHS-R1). The principal role of ghrelin is to regulate energy homeostasis and secretion of growth hormone. Aim: to differentiate adrenocortical adenoma, carcinoma and pheochromocytoma immunohistochemically using stroidogenic factor-1 (SF-1) and gherlin expression and evaluate their diagnostic and prognostic significance in relation to various clinicopathologic parameters. Material and methods: This is retrospective study was carried upon 45 of different cases of adrenal gland lesions designated as, 20 cases of adrenocortical adenomas(ACA) and 10 cases of adrenocortical carcinomas(ACC) ,15 cases of pheochromocytoma . Immunohistochemical staining techniques were used to detect the role of SF-1 and gherlin in the forementioned adrenal gland lesions and evaluate their relations to different clinicopathological data and patient’s survival.Results: SF-1 and gherlin were sensitive and specific immunohistochemical markers in diagnosis adrenocortical carcinoma, but gherlin was more sensitive and SF-1 was more specific in diagnosing adrenocortical adenoma. On the other side SF-1 was more sensitive(100%) in diagnosing pheochromocytoma. SF-1 expression in adrenocortical carcinoma revealed that strong positive SF-1expression was associated with reduced overall survival .Conclusion:. SF1 and ghrelin immunoreactivity may be considered sensitive and specific markers for differentiating ACC from ACA and pheochromocytoma. However, further research is required to determine the causes of differential ghrelin expression in adrenal tumors.