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Diagnostic and Prognostic Value of Fas and Telomeric-Repeat Binding Factor-1 Genes in Adrenal Tumors

Endocrine Surgical Oncology Fellows (H.K., N.W.), Department of Surgery, University of California San Francisco (UCSF), UCSF/Cancer Center (D.G.G., M.Y.) and UCSF/Mount Zion Medical Center (M.G.W., O.H.C.), San Francisco, California 94143; Surgical Service, Veterans Affairs Medical Center (Q.-Y.D.), San Francisco, California 94121; Department of Surgery, The University of Tokyo (H.K.), Tokyo 113, Japan; and First Department of Surgery, Yokohama City University, School of Medicine (N.W.), Yokohama 236, Japan

Address all correspondence and requests for reprints to: Quan-Yang Duh, M.D., Surgical Service 112, Veterans Affairs Medical Center, 4150 Clement Street, San Francisco, California 94121. E-mail: quan-yang.duh{at}med.va.gov.

It is often difficult to distinguish histologically between an adrenal cortical cancer and a benign adenoma, or to predict the prognosis of patients with adrenal cortical cancers. In this investigation, we examined whether apoptosis-regulating genes, bcl-xL and fas, and a telomere-related gene, telomeric-repeat binding factor-1 (TRF-1), differ between adrenal cortical cancers and benign adrenal tumors. Tissues from 4 adrenal cortical cancers were compared with 7 normal adrenal tissues, 17 cortical adenomas, 4 cortical hyperplasias, and 20 pheochromocytomas for expressions of bcl-xL and fas by RT-PCR, and for expressions of TRF-1 by real-time quantitative RT-PCR. All benign adrenal tissues expressed both the antiapoptosis gene, bcl-xL, and proapoptosis gene, fas, but the adrenal cortical cancers expressed only bcl-xL and not fas. TRF-1 increased by more than 30-fold in the adrenal cortical cancers, compared with benign adrenal tissues, and inversely correlated with the prognosis of patients with the adrenal cortical cancers. This lack of expression of fas in adrenal cortical cancer may help to distinguish it from benign adrenal tumors. The level of TRF-1 expression may be helpful prognostically for patients with adrenal cortical cancers.

This work was supported in part by Mt. Zion/ Health Systems, The James Martin Foundation, The Heller Family Foundation, and The Friends of Endocrine Surgery. Part of this study was presented at the 93rd Annual Meeting of The American Association for Cancer Research, San Francisco, California, April 6–10, 2002; and the 84th Annual Meeting of The Endocrine Society, San Francisco, California, June 19–22, 2002.

Abbreviations: hTERT, Human telomerase reverse transcriptase; TRF-1, telomeric-repeat binding factor-1.