Minichromosome Maintenance Proteins MCM-3, MCM-5, MCM-7, and Ki-67 as Proliferative Markers in Adrenocortical Tumors

Anticancer Res. 2019 Mar;39(3):1151-1159. doi: 10.21873/anticanres.13224.

Abstract

Background/aim: Morphological features, combined with Ki-67 proliferative index, remain the standard for discriminating benign and malignant adrenocortical tumors. The aim of this study was to evaluate the role of minichromosome maintenance proteins MCM-3, MCM-5, MCM-7, and Ki-67 as proliferative markers in adrenocortical tumors.

Materials and methods: Specimens of 81 adrenocortical adenomas and 3 adrenocortical carcinomas were stained with antibodies against MCM-3, 5, 7 and Ki-67.

Results: Malignant tumors were characterized by a greater size (p=0.017), volume (p=0.017), and higher levels of Ki-67 (p=0.005), MCM-3 (p=0.005), MCM-7 (p=0.008), but not MCM-5 (p=0.069). The markers' levels were independent from the tumors' size and volume, the patient's age and hormonal status. ROC curves showed Ki-67 (AUC 0.984), MCM-3 (AUC 0.984), and MCM-7 (AUC 0.950), but not MCM-5 (AUC 0.820) to be reliable markers.

Conclusion: Ki-67, MCM-3, and MCM-7, but not MCM-5 are reliable proliferative and diagnostic markers in discerning benign and malignant adrenocortical tumors.

Keywords: Adrenocortical adenoma; Ki-67; MCM-3; MCM-5; MCM-7; adrenocortical carcinoma.

MeSH terms

  • Adenoma / diagnosis
  • Adenoma / metabolism*
  • Adrenal Cortex Neoplasms / diagnosis
  • Adrenal Cortex Neoplasms / metabolism*
  • Adrenocortical Carcinoma / diagnosis
  • Adrenocortical Carcinoma / metabolism*
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / metabolism*
  • Cell Cycle Proteins / metabolism
  • Cell Proliferation
  • Female
  • Humans
  • Ki-67 Antigen / metabolism*
  • Male
  • Middle Aged
  • Minichromosome Maintenance Complex Component 3 / metabolism*
  • Minichromosome Maintenance Complex Component 7 / metabolism*

Substances

  • Biomarkers, Tumor
  • Cell Cycle Proteins
  • Ki-67 Antigen
  • MCM3 protein, human
  • MCM5 protein, human
  • MCM7 protein, human
  • Minichromosome Maintenance Complex Component 3
  • Minichromosome Maintenance Complex Component 7