Suh Insoo, Guerrero Marlon A, Kebebew Electron
Department of Surgery, University of California, San Francisco, CA 94143, USA
Expert Rev Mol Diagn. 2009 May;9(4):343-51. doi: 10.1586/erm.09.13.
Adrenocortical carcinoma (ACC) is a rare malignancy of the adrenal cortex, associated with a generally dismal prognosis owing to its aggressive behavior. The clinical management of ACC is complicated by the inadequacy of current diagnostic modalities to accurately distinguish benign from malignant adrenocortical tumors. In addition, efforts to better predict clinical tumor behavior are limited by the lack of a better understanding of the molecular mechanisms of adrenocortical carcinogenesis. There have been no significant improvements in the treatment of ACC. Thus, there is a pressing need for the development of new therapeutic approaches for patients with ACC, as most patients present with advanced locoregional and metastatic disease. The prospects of identifying diagnostic and prognostic markers or gene profiles for ACC have significantly improved with the development of genome-wide gene-expression analysis. Since 2003, several studies have reported distinct gene-expression profiles between benign and malignant adrenocortical tumors that may have diagnostic and prognostic clinical utility. In this article, we discuss the limitations of the clinical management of ACC, and the gene-expression profile studies that have attempted to address these limitations.
肾上腺皮质癌（ACC）是一种罕见的肾上腺皮质恶性肿瘤，因其侵袭性的行为，通常预后较差。目前的诊断方法不足以准确区分良性和恶性肾上腺皮质肿瘤，这使得ACC的临床管理变得复杂。此外，由于对肾上腺皮质癌发生的分子机制缺乏更深入的了解，更好地预测临床肿瘤行为的努力受到限制。ACC的治疗一直没有显著进展。因此，迫切需要为ACC患者开发新的治疗方法，因为大多数患者就诊时已出现局部晚期和转移性疾病。随着全基因组基因表达分析的发展，识别ACC诊断和预后标志物或基因谱的前景有了显著改善。自2003年以来，多项研究报告了良性和恶性肾上腺皮质肿瘤之间不同的基因表达谱，这些谱可能具有诊断和预后的临床应用价值。在本文中，我们讨论了ACC临床管理的局限性，以及试图解决这些局限性的基因表达谱研究。
