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 Hu, Qifu Li

Research output: Contribution to journalArticleResearchpeer-review

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.

Original languageEnglish
Pages (from-to)683-691
Number of pages9
JournalEndocrine
Volume65
Issue number3
DOIs
Publication statusPublished - 1 Sep 2019
Externally publishedYes

Keywords

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

Cite this

Yang, Y., Xiao, M., Song, Y., Tang, Y., Luo, T., Yang, S., He, W., Cheng, Q., Ma, L., Zhang, Y., He, Y., Cao, Y., Yang, J., Peng, B., Hu, J., & Li, Q. (2019). H-score of 11β-hydroxylase and aldosterone synthase in the histopathological diagnosis of adrenocortical tumors. Endocrine, 65(3), 683-691. https://doi.org/10.1007/s12020-019-02022-8