Portal de investigação
The differential diagnosis of adrenocortical tumors: systematic review of Ki-67 and IGF2 and meta-analysis of Ki-67
Data de publicação:
Data Ahead of Print:
Autores da FMUP
Participantes de fora da FMUP
- Oliveira, SB
- Machado, MQ
- Sousa, D
- Pereira, SS
Unidades de investigação
Abstract
Distinguishing benign from malignant adrenocortical tumors (ACT) is not always easy, particularly for tumors with unclear malignant potential based on the histopathological features comprised of the Weiss score. Previous studies reported the potential utility of immunohistochemistry (IHC) markers to recognize malignancy, in particular the Insulin-like growth factor 2 (IGF2) and the proliferation marker, Ki-67. However, this information was not compiled before. Therefore, this review aimed to collect the evidence on the potential diagnosis utility of IGF2 and Ki-67 IHC staining. Additionally, a meta-analysis was performed to assess the Ki-67 accuracy to identify adrenocortical carcinoma. The systematic review and meta-analysis were conducted according to the PRISMA guidelines. From the 26 articles included in the systematic review, 21 articles provided individual data for IGF2 (n = 2) or for Ki-67 (n = 19), while 5 studies assessed both markers. IGF2 staining was positive in most carcinomas, in contrast to adenomas. However, the different immunostaining evaluation methods adopted among the studies impeded to perform a meta-analysis to assess IGF2 diagnostic accuracy. In contrast, for the most commonly used cut-off value of 5% stained cells, Ki-67 showed pooled specificity, sensitivity and log diagnostic odds ratio of 0.98 (95% CI 0.95 to 0.99), 0.82 (95% CI 0.65 to 0.92) and 4.26 (95% CI 3.40 to 5.12), respectively. At the 5% cut-off, Ki-67 demonstrated an excellent specificity to recognize malignant ACT. However. the moderate sensitivity observed indicates the need for further studies exploring alternative threshold values. Additionally, more studies using similar approaches are needed to assess the diagnostic accuracy of IGF2.Registration code in PROSPERO: CRD42022370389.
Dados da publicação
- ISSN/ISSNe:
- 1573-2606, 1389-9155
- Tipo:
- Review
- Páginas:
- -
REVIEWS IN ENDOCRINE & METABOLIC DISORDERS Springer Netherlands
Documentos
- Não há documentos
Filiações
Keywords
- Adrenocortical tumors; Diagnosis; Immunohistochemistry; IGF2; Ki-67; Meta-analysis
Financiamento
Proyectos asociados
Prevalence and biochemical characterization of hirsutism-associated syndromes in a cohort of Portuguese women
Investigador Principal: Duarte Luís Pignatelli Dias Almeida
Estudo Clínico Académico (Hirsutism syndrome) . 2023
Citar a publicação
Oliveira SB,Machado MQ,Sousa D,Pereira SS,Pignatelli D. The differential diagnosis of adrenocortical tumors: systematic review of Ki-67 and IGF2 and meta-analysis of Ki-67. Rev. Endocr. Metab. Disord. 2025. IF:8,200. (1).
