Estimation of Concentration of Chosen Adhesive Factors in Suprarenal Tumours of “Incidentaloma” Type
Krzysztof Kołomecki, Henryk Stępień, Tomasz Stępień, Zbigniew Pasieka, Krzysztof Kuzdak
T. Stępień ☒ )
Department of Endocrinological and General Surgery, Institute of Endocrinology, Medical University of Łódź, 91-425 Łódź, Poland
Abstract
The role of adhesive molecules in the pathogenesis of adrenal gland tumours formation remains unclear. Here we present the concentrations of soluble vas- cular cell adhesion molecule-1 (sVCAM-1) and soluble intracellular adhesion molecule-1 (sICAM-1) in the blood of patients with adrenal “incidentaloma”. We found that the mean concentrations of sVCAM and sICAM in the serum of the patients with adrenocortical cancers were significantly higher than those of the patients with benign adenomas or control cases. These results suggest that the levels of adhesion molecules may be a marker of malignancy of adre- nal incidentalomas.
Introduction
In recent times the involvement of adhesive molecules in the development of many neoplasms and noncancer diseases such as atherosclerosis, asthma, kid- ney and hepatic diseases, and others has been widely discussed. The role of adhesive molecules has been studied most thoroughly in inflammatory reac- tions. It seems that neoplastic cell invasion is a process similar to transmigra- tion of leucocytes to an inflammatory focus, and thus comparative examina- tion of adhesive receptors present on normal and neoplastic cells is very im- portant for research, and possibly also for diagnostic and therapeutic purpos- es [1, 2].
There are three types of adhesive molecules: selectins, integrins, and the immunoglobin (Ig) superfamily: vascular cell adhesion molecule (VCAM) and intracellular adhesion molecule (ICAM) [1]. The Ig superfamily receptors are composed of a variable number of repeated immunoglobulin-like domains [3]. These molecules, expressed generally in endothelium, interact with inte- grins and selectins and control firm adherence of cells, for example leucocytes
@ Springer-Verlag Berlin Heidelberg 2003
[4]. Cellular adhesion molecules VCAM-1 and ICAM-1 have been implicated in tumour progression and metastasis in malignant melanoma, renal cell car- cinoma, glioblastoma, and others [5-7].
A significant clinical problem which still awaits solution is determining whether the character of the tumour is benign or malignant, which is particu- larly difficult in hormonally inactive adrenal tumours of “incidentaloma” type. In our earlier reports we demonstrated the role of proangiogenic factors in the development of suprarenal tumours, which makes it possible to use them as markers of malignancy of these neoplasms [8, 9]. Recent reports show that adhesive factors affect the process of angiogenesis in a significant way [10].
Aim of Study
The aim of this work was to evaluate the concentrations of the soluble forms of VCAM-1 and ICAM-1 (sVCAM-1 and sICAM-1) in the blood at the patients with tumour of suprarenal glands inactive hormonally like malignant or be- nign “incidentaloma”.
Material and Methods
The study comprised 29 patients with hormonally inactive suprarenal tu- mours of “incidentaloma” type treated in the Clinic of General and En- docrinological Surgery, Medical University of Łódź, between 1999 and 2001. In ten patients (six women and four men, mean age 57 years), cancer of adre- nal glands was diagnosed. In seven of these patients, the tumour was removed with the adrenal gland, and pathological examination using histochemical tests revealed the malignant character of the tumour. In three cases the tu- mour was inoperative (T4N1M1), as numerous distant metastases were pres- ent, together with infiltration in neighbouring tissues, including blood vessels, and neoplastic cachexia. The diagnosis was based on clinical symptoms, fine needle aspiration biopsy (BACC), and computed tomography (CT) with CT densitometry. In 19 patients (12 women and seven men, mean age 43 years) adenoma corticis glandulae suprarenalis was revealed by histopathology after removal of the tumour.
The control group comprised ten healthy persons (five women and five men, mean age 48 years).
In all patients, serum concentrations of sVCAM-1 and sICAM-1 were deter- mined by the ELISA method using kits from R&D Systems (Minneapolis, Mich., USA).
Statistical evaluation was carried out using Student’s t-test.