TCF21/POD-1, a Transcritional Regulator of SF-1/NR5A1, as a Potential Prognosis Marker in Adult and Pediatric Adrenocortical Tumors.

With recent progress in understanding the pathogenesis of adrenocortical tumors (ACTs), identification of molecular markers to predict their prognosis has become possible. Transcription factor 21 (TCF21)/podocyte-expressed 1 (POD1) is a transcriptional regulatory protein expressed in mesenchymal cells at sites of epithelial-mesenchymal transition during the development of different systems. Adult carcinomas express less than adenomas, in addition, the KEGG pathway analysis has shown that , among others genes, is negatively correlated with expression. The difference between and PTEN-induced putative kinase 1 () expression has been described previously to be associated with survival in adult but not in pediatric carcinomas. Here, we analyzed the gene expression of , and in adult and pediatric ACTs. We found a negative correlation between the relative expression levels of and in adult ACTs, but the relative expression levels of , and were similar in childhood ACTs. In addition, we propose using the subtracted expression levels of the genes as a predictor of overall survival (OS) in adult carcinomas and as a predictor of malignancy for pediatric tumors in patients aged <5 years. These results require further validation in different cohorts of both adult and pediatric samples. Finally, we observed that the OS for patients aged <5 years was markedly favorable compared with that for patients >5 years as well as adult patients with carcinoma. In summary, we propose as a new prognostic marker in adult and pediatric ACTs.