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Urine Steroid Metabolomics as a Novel Tool for Detection of Recurrent Adrenocortical Carcinoma.
Chortis, Vasileios; Bancos, Irina; Nijman, Thomas; Gilligan, Lorna C; Taylor, Angela E; Ronchi, Cristina L; O'Reilly, Michael W; Schreiner, Jochen; Asia, Miriam; Riester, Anna; Perotti, Paola; Libé, Rosella; Quinkler, Marcus; Canu, Letizia; Paiva, Isabel; Bugalho, Maria J; Kastelan, Darko; Dennedy, M Conall; Sherlock, Mark; Ambroziak, Urszula; Vassiliadi, Dimitra; Bertherat, Jerome; Beuschlein, Felix; Fassnacht, Martin; Deeks, Jonathan J; Biehl, Michael; Arlt, Wiebke.
Afiliação
  • Chortis V; Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.
  • Bancos I; Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK.
  • Nijman T; Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Gilligan LC; Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.
  • Taylor AE; Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN.
  • Ronchi CL; Bernoulli Institute for Mathematics, Computer Science and Artificial Intelligence, University of Groningen, Groningen, The Netherlands.
  • O'Reilly MW; Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.
  • Schreiner J; Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.
  • Asia M; Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.
  • Riester A; Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK.
  • Perotti P; Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Libé R; Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany.
  • Quinkler M; Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.
  • Canu L; Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK.
  • Paiva I; Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Bugalho MJ; Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany.
  • Kastelan D; Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK.
  • Dennedy MC; Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Sherlock M; Medizinische Klinik and Poliklinik IV, Ludwig-Maximilians-Universität München, Munich, Germany.
  • Ambroziak U; Department of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Turin, Italy.
  • Vassiliadi D; INCa-COMETE, Cochin Hospital, Institut Cochin, Institut National de la Santé et de la Recherche Medicale Unite ́ 1016, René Descartes University, Paris.
  • Bertherat J; Endocrinology in Charlottenburg, University of Berlin, Berlin, Germany.
  • Beuschlein F; Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
  • Fassnacht M; Department of Endocrinology, University Hospital of Coimbra, Coimbra, Portugal.
  • Deeks JJ; Serviço de Endocrinologia Diabetes e Metabolismo, Hospital de Santa Maria, Lisbon, Portugal.
  • Biehl M; Department of Endocrinology, University Hospital Centre Zagreb, Zagreb, Croatia.
  • Arlt W; School of Medicine, National University of Ireland Galway (NUIG), Galway, Republic of Ireland.
J Clin Endocrinol Metab ; 105(3)2020 03 01.
Article em En | MEDLINE | ID: mdl-31665449
CONTEXT: Urine steroid metabolomics, combining mass spectrometry-based steroid profiling and machine learning, has been described as a novel diagnostic tool for detection of adrenocortical carcinoma (ACC). OBJECTIVE, DESIGN, SETTING: This proof-of-concept study evaluated the performance of urine steroid metabolomics as a tool for postoperative recurrence detection after microscopically complete (R0) resection of ACC. PATIENTS AND METHODS: 135 patients from 14 clinical centers provided postoperative urine samples, which were analyzed by gas chromatography-mass spectrometry. We assessed the utility of these urine steroid profiles in detecting ACC recurrence, either when interpreted by expert clinicians or when analyzed by random forest, a machine learning-based classifier. Radiological recurrence detection served as the reference standard. RESULTS: Imaging detected recurrent disease in 42 of 135 patients; 32 had provided pre- and post-recurrence urine samples. 39 patients remained disease-free for ≥3 years. The urine "steroid fingerprint" at recurrence resembled that observed before R0 resection in the majority of cases. Review of longitudinally collected urine steroid profiles by 3 blinded experts detected recurrence by the time of radiological diagnosis in 50% to 72% of cases, improving to 69% to 92%, if a preoperative urine steroid result was available. Recurrence detection by steroid profiling preceded detection by imaging by more than 2 months in 22% to 39% of patients. Specificities varied considerably, ranging from 61% to 97%. The computational classifier detected ACC recurrence with superior accuracy (sensitivity = specificity = 81%). CONCLUSION: Urine steroid metabolomics is a promising tool for postoperative recurrence detection in ACC; availability of a preoperative urine considerably improves the ability to detect ACC recurrence.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Esteroides / Biomarcadores Tumorais / Neoplasias do Córtex Suprarrenal / Carcinoma Adrenocortical / Recidiva Local de Neoplasia Tipo de estudo: Diagnostic_studies / Evaluation_studies / Observational_studies / Prognostic_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Clin Endocrinol Metab Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Esteroides / Biomarcadores Tumorais / Neoplasias do Córtex Suprarrenal / Carcinoma Adrenocortical / Recidiva Local de Neoplasia Tipo de estudo: Diagnostic_studies / Evaluation_studies / Observational_studies / Prognostic_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Clin Endocrinol Metab Ano de publicação: 2020 Tipo de documento: Article