Expression of Different Proliferation Biomarkers in Adreno-cortical Tumors

Study Overview
=================
Brief Summary
-----------------
In adrenal tumors, the investigators will examine if there is any correlation between WIESS criteria, prognosis of the tumor, and the different labeling index of the following proliferation biomarkers: MCM3, MCM2, KI-67, P53, NEUROPILIN -1, METALLOTHIONEIN, SEMAPHORIN-3A.

Detailed Description
-----------------
One of the problems in managing adrenocortical tumors is the ability to distinguish between benign and malignant tumors, while needle biopsy is unable to distinguish between the two situations. Therefore, when imaging tests demonstrate a suspected malignant adrenal tumor, surgical excision of the tumor is needed. Usually, the histological WIESS criteria are used in order to determine malignancy. However, there are cases when adrenal tumors were defined by WIESS criteria as benign but metastasized later. Moreover, there is no reliable test than can determine prognosis. KI-67 labeling index is a proliferation biomarker which is used to tell more about the malignant potential and prognosis of adrenal carcinoma. In various types of tumors, proliferation biomarkers are used in attempt to tell about prognosis. In this study, the investigators will examine whether some biomarkers can differentiate between adrenal carcinoma and adenoma and if the degree of expression of these markers is correlated with prognosis. The investigators will retrospectively collect 30 cases of adrenal carcinoma, 30 cases of adrenal adenoma and 10 cases of normal adrenals. All specimens are preserved with formalin. The investigators will re-review the WIESS criteria and all samples will be analyzed for the index labeling of the following proliferation biomarkers: MCM3, MCM2, KI-67, P53, NEUROPILIN -1, METALLOTHIONEIN, SEMAPHORIN-3A. The investigators will examine if there is any correlation between the labeling index of each biomarker, WIESS criteria and prognosis of the tumor.

Official Title
-----------------
Expression of Different Proliferation Biomarkers in Adreno-cortical Tumors

Conditions
-----------------
Adrenal Cortex Neoplasms, Adrenal Cortex Diseases

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: adrenal carcinoma adrenal adenoma normal adrenal tissue Exclusion Criteria: NA

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------
What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| MCM3 expression | Difference in MCM3 labeling index between adrenal cortical adenoma versus adrenocortical carcinoma | 1 year | 
| MCM2 expression | Difference in MCM2 labeling index between adrenal cortical adenoma versus adrenocortical carcinoma | 1 year | 
| P53 expression | Difference in P53 labeling index between adrenal cortical adenoma versus adrenocortical carcinoma | 1 year | 
| NEUROPILIN -1 expression | Difference in NEUROPILIN -1 labeling index between adrenal cortical adenoma versus adrenocortical carcinoma | 1 year | 
| METALLOTHIONEIN expression | Difference in METALLOTHIONEIN labeling index between adrenal cortical adenoma versus adrenocortical carcinoma | 1 year | 
| SEMAPHORIN-3A expression | Difference in SEMAPHORIN-3A labeling index between adrenal cortical adenoma versus adrenocortical carcinoma | 1 year | 
| E-caderein expression | Difference in E-caderein labeling index between adrenal cortical adenoma versus adrenocortical carcinoma | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| KI67 | Difference in Ki67 labeling index between adrenal cortical adenoma versus adrenocortical carcinoma | 1 year | 
| Prognosis | Correlation between the labeling index of each biomarker, WIESS criteria and prognosis of the tumor. | 1 year |