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21.11.2020 | Review

Urine steroid profile as a new promising tool for the evaluation of adrenal tumors. Literature review

verfasst von: Marta Araujo-Castro, Pablo Valderrábano, Héctor F. Escobar-Morreale, Felicia A. Hanzu, Gregori Casals

Erschienen in: Endocrine | Ausgabe 1/2021

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Abstract

Purpose

To review the literature assessing the diagnostic performance of urinary steroid profiling (USP) by high-performance liquid chromatography (LC–MS) or gas chromatography (GC) coupled to mass spectrometry (MS) in the evaluation of adrenal lesions, both in terms of functionality and malignancy.

Results

The evaluation of adrenal incidentalomas (AI) aims to rule out malignancy and hormone excess. Current diagnostic protocols have several limitations and include time consuming and relatively complicated multi-step processes in most cases. On the contrary, USP by LC–MS/MS or LC-GC/MS offer an easy, comprehensive and non-invasive assessment of adrenal steroid secretion. USP complements current workups used in the evaluation of AIs by improving our ability to identify malignancy and/or autonomous hormone secretion.

Conclusions

Urine steroid profiling by LC–MS/MS and GC–MS allows a thorough, non-invasive, assessment of adrenal steroidogenesis as a whole which complement the current evaluation of AIs, and holds a promising role in the diagnosis of autonomous cortisol secretion, primary aldosteronism, and adrenal malignancy.

M. Araujo-Castro, M.A. Sampedro Núñez, M. Marazuela, Autonomous cortisol secretion in adrenal incidentalomas. Endocrine 64(1), 1–13 (2019). https://doi.org/10.1007/s12020-019-01888-yCrossRefPubMed

M. Araujo-Castro, M. Iturregui Guevara, M. Calatayud Gutiérrez, P. Parra Ramírez, P. Gracia Gimeno, F.A. Hanzu et al. Practical guide on the initial evaluation, follow-up, and treatment of adrenal incidentalomas Adrenal Diseases Group of the Spanish Society of Endocrinology and Nutrition. Endocrinol. Diabetes Nutr. 67(6), 408–419 (2020). https://doi.org/10.1016/j.endinu.2020.03.002CrossRefPubMed

M. Fassnacht, W. Arlt, I. Bancos, H. Dralle, J. Newell-Price, A. Sahdev et al. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur. J. Endocrinol. 175(2), G1–G34 (2016). https://doi.org/10.1530/EJE-16-0467CrossRefPubMed

J.M. Lee, M.K. Kim, S.H. Ko, J.M. Koh, B.Y. Kim, S.W. Kim et al. Clinical guidelines for the management of adrenal incidentaloma. Endocrinol Metab (Seoul). 32(2), 200–218 (2017). https://doi.org/10.3803/EnM.2017.32.2.200CrossRef

M.M. Grumbach, B.M.K. Biller, G.D. Braunstein, K.K. Campbell, J. Aidan Carney, P.A. Godley et al. Management of the clinically inapparent adrenal mass (“incidentaloma”). Ann. Intern. Med. 138(5), 424–429 (2003). https://doi.org/10.7326/0003-4819-138-5-200303040-00013CrossRefPubMed

A.H. Hamrahian, A.G. Ioachimescu, E.M. Remer, G. Motta-Ramirez, H. Bogabathina, H.S. Levin et al. Clinical utility of noncontrast computed tomography attenuation value (hounsfield units) to differentiate adrenal adenomas/hyperplasias from nonadenomas: Cleveland clinic experience. J. Clin. Endocrinol. Metab. 90(2), 871–877 (2005). https://doi.org/10.1210/jc.2004-1627CrossRefPubMed

T.J. Cawood, P.J. Hunt, D. O’Shea, D. Cole, S. Soule, Recommended evaluation of adrenal incidentalomas is costly, has high false-positive rates and confers a risk of fatal cancer that is similar to the risk of the adrenal lesion becoming malignant; time for a rethink?. Eur. J. Endocrinol. 161(4), 513–527 (2009). https://doi.org/10.1530/EJE-09-0234CrossRefPubMed

J.W. Funder, R.M. Carey, F. Mantero, M.H. Murad, M. Reincke, H. Shibata et al. The management of primary aldosteronism: Case detection, diagnosis, and treatment: An endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 101(5), 1889–1916 (2016). https://doi.org/10.1210/jc.2015-4061CrossRefPubMed

E. Fischer, F. Beuschlein, M. Bidlingmaier, M. Reincke, Commentary on the Endocrine Society Practice Guidelines: Consequences of adjustment of antihypertensive medication in screening of primary aldosteronism. Rev. Endocr. Metab. Disord. 12(1), 43–48 (2011). https://doi.org/10.1007/s11154-011-9163-7CrossRefPubMed

10.

I. Chiodini, Diagnosis and treatment of subclinical hypercortisolism. J. Clin. Endocrinol. Metab. 96(5), 1223–1236 (2011). https://doi.org/10.1210/jc.2010-2722CrossRefPubMed

11.

A.A. Gheorghisan-galateanu, M. Carsote, A. Valea, Incidentaloma: from general practice to specific endocrine frame. J. Pak. Med. Assoc. 67(6), 917–922 (2017)PubMed

12.

J.W. Funder, R.M. Carey, C. Fardella, C.E. Gomez-Sanchez, F. Mantero, M. Stowasser et al. Case detection, diagnosis, and treatment of patients with primary aldosteronism: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 93(9), 3266–3281 (2008). https://doi.org/10.1210/jc.2008-0104CrossRefPubMed

13.

M. Peppa, E. Boutati, C. Koliaki, N. Papaefstathiou, E. Garoflos, T. Economopoulos et al. Insulin resistance and metabolic syndrome in patients with nonfunctioning adrenal incidentalomas: a cause-effect relationship? Metabolism 59(10), 1435–1441 (2010). https://doi.org/10.1016/j.metabol.2010.01.007CrossRefPubMed

14.

T.M.A. Kerkhofs, M.N. Kerstens, I.P. Kema, T.P. Willems, H.R. Haak, Diagnostic value of urinary steroid profiling in the evaluation of adrenal tumors. Horm. Cancer 6(4), 168–175 (2015). https://doi.org/10.1007/s12672-015-0224-3CrossRefPubMedPubMedCentral

15.

W. Arlt, M. Biehl, A.E. Taylor, S. Hahner, R. Libé, B.A. Hughes et al. Urine steroid metabolomics as a biomarker tool for detecting malignancy in adrenal tumors. J. Clin. Endocrinol. Metab. 96(12), 3775–3784 (2011). https://doi.org/10.1210/jc.2011-1565CrossRefPubMedPubMedCentral

16.

L.I. Velikanova, Z.R. Shafigullina, A.A. Lisitsin, N.V. Vorokhobina, K. Grigoryan, E.A. Kukhianidze et al. Different types of urinary steroid profiling obtained by high-performance liquid chromatography and gas chromatography-mass spectrometry in patients with adrenocortical carcinoma. Horm. Cancer 7(5-6), 327–335 (2016). https://doi.org/10.1007/s12672-016-0267-0CrossRefPubMed

17.

Z.R. Shafigullina, L.I. Velikanova, N.V. Vorokhobina, S.B. Shustov, A.A. Lisitsin, E.V. Malevanaia et al. Urinary steroid profiling by gas chromatography mass spectrometry: Early features of malignancy in patients with adrenal incidentalomas. Steroids 135, 31–35 (2018). https://doi.org/10.1016/j.steroids.2018.04.006CrossRefPubMed

18.

V. Chortis, I. Bancos, T. Nijman, L.C. Gilligan, A.E. Taylor, C.L. Ronchi et al. Urine steroid metabolomics as a novel tool for detection of recurrent adrenocortical carcinoma. J. Clin. Endocrinol. Metab. 105(3), e307–e318 (2020). https://doi.org/10.1210/clinem/dgz141CrossRef

19.

A. Khorram-Manesh, H. Ahlman, S. Jansson, B. Wängberg, O. Nilsson, C.E. Jakobsson et al. Adrenocortical carcimona: surgery and mitotane for treatment and steroid profiles for follow-up. World J. Surg. 22(6), 605–611 (1998). https://doi.org/10.1007/s002689900442.CrossRefPubMed

20.

A. Kotłowska, E. Maliński, K. Sworczak, J. Kumirska, P. Stepnowski, The urinary steroid profile in patients diagnosed with adrenal incidentaloma. Clin. Biochem. 42(6), 448–454 (2009). https://doi.org/10.1016/j.clinbiochem.2008.12.027CrossRefPubMed

21.

A. Kotłowska, K. Sworczak, P. Stepnowski, Urine metabolomics analysis for adrenal incidentaloma activity detection and biomarker discovery. J. Chromatogr. B Anal. Technol. Biomed. Life Sci. 879(5–6), 359–363 (2011)CrossRef

22.

F. Holler, D.A. Heinrich, C. Adolf, B. Lechner, M. Bidlingmaier, G. Eisenhofer et al. Steroid profiling and immunohistochemistry for subtyping and outcome prediction in primary aldosteronism—a review. Curr. Hypertens. Rep. 21(10), 77 (2019). https://doi.org/10.1007/s11906-019-0985-0CrossRefPubMed

23.

W. Arlt, K. Lang, A.J. Sitch, A.S. Dietz, Y. Rhayem, I. Bancos et al. Steroid metabolome analysis reveals prevalent glucocorticoid excess in primary aldosteronism. JCI Insight 2(8), e93136 (2017). https://doi.org/10.1172/jci.insight.93136CrossRefPubMedCentral

24.

L.S. Meyer, X. Wang, E. Sušnik, J. Burrello, A. Burrello, I. Castellano et al. Immunohistopathology and steroid profiles associated with biochemical outcomes after adrenalectomy for unilateral primary aldosteronism. Hypertension 72(3), 650–657 (2018). https://doi.org/10.1161/HYPERTENSIONAHA.118.11465CrossRefPubMedPubMedCentral

25.

P. Mulatero, S.M. Di Cella, S. Monticone, D. Schiavone, M. Manzo, G. Mengozzi et al. 18-hydroxycorticosterone, 18-hydroxycortisol, and 18-oxocortisol in the diagnosis of primary aldosteronism and its subtypes. J. Clin. Endocrinol. Metab. 97(3), 881–889 (2012). https://doi.org/10.1210/jc.2011-2384CrossRefPubMed

26.

C. Rossi, I. Cicalini, S. Verrocchio, G. Di Dalmazi, L. Federici, I. Bucci, The potential of steroid profiling by mass spectrometry in the management of adrenocortical carcinoma. Biomedicines 8(9), 314 (2020). https://doi.org/10.3390/biomedicines8090314CrossRefPubMedCentral

27.

G. Casals, F.A. Hanzu, Cortisol measurements in Cushing’s syndrome: immunoassay or mass spectrometry? Ann. Lab. Med. 40(4), 285–296 (2020). https://doi.org/10.3343/alm.2020.40.4.285CrossRefPubMedPubMedCentral

28.

G. Aranda, M. Careaga, F.A. Hanzu, I. Patrascioiu, P. Ríos, M. Mora et al. Accuracy of immunoassay and mass spectrometry urinary free cortisol in the diagnosis of Cushing’s syndrome. Pituitary 19(5), 496–502 (2016). https://doi.org/10.1007/s11102-016-0730-5CrossRefPubMed

29.

P.C. White, Trastornos de la glándula suprarrenal suprarrenal. In: Nelson. Tratado de pediatría, pp. 2403–2420. (Elsevier, España, S.L.U. 2020)

30.

W. Arlt, P.M. Stewart, Adrenal corticosteroid biosynthesis, metabolism, and action. Endocrinol. Metab. Clin. N. Am. 34(2), 293–313 (2005). https://doi.org/10.1016/j.ecl.2005.01.002CrossRef

31.

C. Shackleton, O.J. Pozo, J. Marcos, GC/MS in recent years has defined the normal and clinically disordered steroidome: will it soon be surpassed by LC/tandem MS in this role? J. Endocr. Soc. 2(8), 974–996 (2018)CrossRef

32.

N. Krone, B.A. Hughes, G.G. Lavery, P.M. Stewart, W. Arlt, C.H.L. Shackleton, Gas chromatography/mass spectrometry (GC/MS) remains a pre-eminent discovery tool in clinical steroid investigations even in the era of fast liquid chromatography tandem mass spectrometry (LC/MS/MS). J. Steroid Biochem. Mol. Biol. 121(3–5), 496–504 (2010)CrossRef

33.

C.H.L. Shackleton, Profiling steroid hormones and urinary steroids. J. Chromatogr. 379, 91–156 (1986). https://doi.org/10.1016/s0378-4347(00)80683-0CrossRefPubMed

34.

C.H.L. Shackleton, Mass spectrometry in the diagnosis of steroid-related disorders and in hypertension research. J. Steroid Biochem. Mol. Biol. 45(1-3), 127–140 (1993). https://doi.org/10.1016/0960-0760(93)90132-gCrossRefPubMed

35.

K.-H. Storbeck, L. Schiffer, E.S. Baranowski, V. Chortis, A. Prete, L. Barnard et al. Steroid metabolome analysis in disorders of adrenal steroid biosynthesis and metabolism. Endocr. Rev. 40(6), 1605–1625 (2019). https://doi.org/10.1210/er.2018-00262CrossRefPubMedPubMedCentral

36.

J.W. Honour, E. Conway, R. Hodkinson, F. Lam, The evolution of methods for urinary steroid metabolomics in clinical investigations particularly in childhood. J. Steroid Biochem. Mol. Biol. 181, 28–51 (2018). https://doi.org/10.1016/j.jsbmb.2018.02.013CrossRefPubMed

37.

D.J. Handelsman, L. Wartofsky, Requirement for mass spectrometry sex steroid assays in the journal of clinical endocrinology and metabolism. J. Clin. Endocrinol. Metab. 98(10), 3971–3973 (2013). https://doi.org/10.1210/jc.2013-3375CrossRefPubMed

38.

D. Lopez, M.A. Luque-Fernandez, A. Steele, G.K. Adler, A. Turchin, A. Vaidya, “Nonfunctional” adrenal Tumors and the risk for incident diabetes and cardiovascular outcomes: a cohort study. Ann. Intern. Med. 165(8), 533–542 (2016). https://doi.org/10.7326/M16-0547CrossRefPubMedPubMedCentral

39.

L.K. Nieman, B.M.K.K. Biller, J.W. Findling, J. Newell-Price, M.O. Savage, P.M. Stewart et al. The diagnosis of Cushing’s Syndrome: an Endocrine Society Clinical Practice Guideline. J. Clin. Endocrinol. Metab. 93(5), 1526–1540 (2008). https://doi.org/10.1210/jc.2008-0125CrossRefPubMedPubMedCentral

40.

R. Gatti, G. Antonelli, M. Prearo, P. Spinella, E. Cappellin, E.F. De Palo, Cortisol assays and diagnostic laboratory procedures in human biological fluids. Clin. Biochem. 42(12), 1205–1217 (2009). https://doi.org/10.1016/j.clinbiochem.2009.04.011CrossRefPubMed

41.

A. Kotłowska, T. Puzyn, K. Sworczak, P. Stepnowski, P. Szefer, Metabolomic biomarkers in urine of cushing’s syndrome patients. Int. J. Mol. Sci. 18(2), 1–15. (2017)CrossRef

42.

J. Homoki, R. Holl, W.M. Teller, Urinary steroid profiles in Cushing’s syndrome and tumors of the adrenal cortex. Klin. Wochenschr. 65(15), 719–726 (1987). https://doi.org/10.1007/BF01736807CrossRefPubMed

43.

E. Kikuchi, H. Yanaihara, J. Nakashima, K. Homma, T. Ohigashi, H. Asakura et al. Urinary steroid profile in adrenocortical tumors. Biomed. Pharmacother. 54(1), 194s–197s (2000). https://doi.org/10.1016/s0753-3322(00)80043-8CrossRefPubMed

44.

P.M. Stewart, B.R. Walker, G. Holder, D. O’Halloran, C.H.L. Shackleton, 11 beta-Hydroxysteroid dehydrogenase activity in Cushing’s syndrome: explaining the mineralocorticoid excess state of the ectopic adrenocorticotropin syndrome. J. Clin. Endocrinol. Metab. 80(12), 3617–3620 (1995). https://doi.org/10.1210/jcem.80.12.8530609CrossRefPubMed

45.

J. Brossaud, D. Ducint, J.B. Corcuff, Urinary glucocorticoid metabolites: biomarkers to classify adrenal incidentalomas. Clin. Endocrinol. (Oxf.) 84(2), 236–43. (2016)CrossRef

46.

J.M. Hines, I. Bancos, C. Bancos, R.D. Singh, A.V. Avula, W.F. Young et al. High-resolution, accurate-mass (HRAM) mass spectrometry urine steroid profiling in the diagnosis of adrenal disorders. Clin. Chem. 63(12), 1824–1835 (2017). https://doi.org/10.1373/clinchem.2017.271106CrossRefPubMed

47.

F. Ceccato, G. Antonelli, M. Barbot, M. Zilio, L. Mazzai, R. Gatti et al. The diagnostic performance of urinary free cortisol is better than the cortisol: Cortisone ratio in detecting de novo Cushing’s Syndrome: The use of a LC-MS/MS method in routine clinical practice. Eur J Endocrinol 171(1), 1–7 (2014). https://doi.org/10.1530/EJE-14-0061CrossRefPubMed

48.

Araujo-castro M. Treatment of primary hyperaldosteronism. Med. Clin. (Barc). S0025-7753(20)30323-7,(2020). https://doi.org/10.1016/j.medcli.2020.04.029

49.

T. Wannachalee, A.F. Turcu, Developments in primary aldosteronism subtyping using steroid profiling. Horm. Metab. Res. 52(6), 373–378 (2020). https://doi.org/10.1055/a-1141-3526CrossRefPubMed

50.

S. Ulick, J.D. Blumenfeld, S.A. Atlas, J.Z. Wang, E.D. Vaughan, The unique steroidogenesis of the aldosteronoma in the differential diagnosis of primary aldosteronism. J. Clin. Endocrinol. Metab. 76(4), 873–878 (1993). https://doi.org/10.1210/jcem.76.4.8473399CrossRefPubMed

51.

M. Wolley, M. Thuzar, M. Stowasser, Controversies and advances in adrenal venous sampling in the diagnostic workup of primary aldosteronism. Best. Pract. Res. Clin. Endocrinol. Metab. 34(3), 101400 (2020). https://doi.org/10.1016/j.beem.2020.101400CrossRefPubMed

52.

S. Ulick, M.D. Chu, Hypersecretion of a new corticosteroid, 18-hydroxycortisol in two types of adrenocortical hypertension. Clin. Exp. Hypertens. A. 4(9-10), 1771–1777 (1982). https://doi.org/10.3109/10641968209061640CrossRefPubMed

53.

R.D. Gordon, S.M. Hamlet, T.J. Tunny, C.E. Gomez‐Sanchez, L.S. Jayasinghed̊, Distinguishing aldosterone-producing adenoma from other forms of hyperaldosteronism and lateralizing the tumour pre-operatively. Clin. Exp. Pharmacol. Physiol. 13(4), 325–328 (1986). https://doi.org/10.1111/j.1440-1681.1986.tb00357.xCrossRefPubMed

54.

J.L. Benham, M. Eldoma, B. Khokhar, D.J. Roberts, D.M. Rabi, G.A. Kline, Proportion of patients with hypertension resolution following adrenalectomy for primary aldosteronism: a systematic review and meta-analysis. J. Clin. Hypertens. (Greenwich) 18(12), 1205–1212 (2016). https://doi.org/10.1111/jch.12916CrossRef

55.

M. Terzolo, A. Stigliano, I. Chiodini, P. Loli, L. Furlani, G. Arnaldi et al. AME position statement on adrenal incidentaloma. Eur. J. Endocrinol. 164(6), 851–870 (2011). https://doi.org/10.1530/EJE-10-1147CrossRefPubMed

56.

S. Minowada, K. Kinoshita, M. Hara, K. Isurugi, T. Uchikawa, T. Niijima, Measurement of urinary steroid profile in patients with adrenal tumor as a screening method for carcinoma. Endocrinol. Jpn. 32(1), 29–37 (1985). https://doi.org/10.1507/endocrj1954.32.29CrossRefPubMed

57.

S. Grondal, B. Eriksson, L. Hagenas, S. Werner, T. Curstedt, Steroid profile in urine: a useful tool in the diagnosis and follow up of adrenocortical carcinoma. Acta Endocrinol. (Copenh) 122(5), 656–663 (1990). https://doi.org/10.1530/acta.0.1220656CrossRef

58.

I. Bancos, W. Arlt, Diagnosis of a malignant adrenal mass: the role of urinary steroid metabolite profiling. Curr. Opin. Endocrinol. Diabetes Obes. 24(3), 200–207 (2017). https://doi.org/10.1097/MED.0000000000000333CrossRefPubMed

59.

S.C. Tiu, A.O.K. Chan, N.F. Taylor, C.Y. Lee, P.Y. Loung, C.H. Choi et al. Use of urinary steroid profiling for diagnosing and monitoring adrenocortical tumours. Hong Kong Med. J. 15(6), 463–470 (2009)PubMed

60.

I. Bancos, A.E. Taylor, V. Chortis, A.J. Sitch, C. Jenkinson, C.J. Davidge-Pitts et al. Urine steroid metabolomics for the differential diagnosis of adrenal incidentalomas in the EURINE-ACT study: a prospective test validation study. Lancet Diabetes Endocrinol. 8(9), 773–781 (2020). https://doi.org/10.1016/S2213-8587(20)30218-7CrossRefPubMedPubMedCentral

61.

H. Sasano, T. Suzuki, H. Nagura, T. Nishikawa, Steroidogenesis in human adrenocortical carcinoma: Biochemical activities, immunohistochemistry, and in situ hybridization of steroidogenic enzymes and histopathologic study in nine cases. Hum. Pathol. 24(4), 397–404 (1993). https://doi.org/10.1016/0046-8177(93)90088-xCrossRefPubMed

62.

V. Chortis, A.E. Taylor, P. Schneider, J.W. Tomlinson, B.A. Hughes, D.M. O’Neil et al. Mitotane therapy in adrenocortical cancer induces CYP3A4 and inhibits 5α-reductase, explaining the need for personalized glucocorticoid and androgen replacement. J. Clin. Endocrinol. Metab. 98(1), 161–171 (2013). https://doi.org/10.1210/jc.2012-2851CrossRefPubMed

Titel: Urine steroid profile as a new promising tool for the evaluation of adrenal tumors. Literature review
verfasst von: Marta Araujo-Castro
Pablo Valderrábano
Héctor F. Escobar-Morreale
Felicia A. Hanzu
Gregori Casals
Publikationsdatum: 21.11.2020
Verlag: Springer US
Erschienen in: Endocrine / Ausgabe 1/2021
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-020-02544-6

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