Quick, inexpensive urine test may better identify adrenal cancers

Adrenal cancers may be better identified with a new liquid chromatography-tandem mass spectrometry urine test than with current imagining techniques, according to recent study findings presented at the Society for Endocrinology Annual Conference.

“Around 2% to 3% of the general population has an adrenal incidentaloma. Once detected, it is of paramount importance that the tumor is correctly classified as either a benign adenoma or a cancerous adrenocortical carcinoma,” Angela E. Taylor, PhD, of the Institute of Metabolism and Systems Research at the University of Birmingham, United Kingdom, told Endocrine Today. “While adrenocortical carcinoma is rare, it is an aggressive tumor with poor patient prognosis and should be removed immediately. Current imaging techniques used to determine adrenocortical carcinoma from adrenocortical adenoma have unfavorable sensitivities and specificities.”

Angela E. Taylor

Taylor and colleagues collected 24-hour urine samples from 130 healthy controls, 294 patients with adrenocortical adenoma and 96 with adrenocortical carcinoma. The researchers analyzed the samples for steroid excretion using a gas chromatography-mass spectrometry (GC-MS) method — which the research group developed earlier and showed to have greater sensitivity and specificity than current imaging modalities — and the novel liquid chromatography-tandem mass spectrometry (LC-MS/MS) test.

Compared with the GC-MS test, the LC-MS/MS method was as effective for identifying 16 distinct steroid metabolites, 13 of which were significantly increased in the adrenocortical carcinoma group, according to researchers. Three steroids were shown by both methods to be most effective in detecting adrenocortical carcinoma when data were evaluated by the Matrix Relevance Learning Vector Quantization.

“Our new technique has identical diagnostic capabilities to our GC-MS assay; however, it is significantly faster and cheaper to run,” Taylor said.

The technique still must be fully validated with larger studies before a simple urine test will be available for distinguishing adrenocortical carcinoma from adrenocortical adenoma, Taylor said. “For the patient, this would mean a noninvasive investigation, coupled with less CT scans, so less exposure to radiation (and less stress associated with multiple hospital visits),” she said. – by Amber Cox

Reference:

Taylor A, et al. Abstract #0274. Presented at: Society for Endocrinology Annual Conference; Nov. 2-4, 2015; Edinburgh, Scotland.

Disclosure: Taylor reports no relevant financial disclosures. The study was funded in part by EU funding and the Wellcome Trust.