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Angiogenesis in human normal and pathologic adrenal cortex.

G P Bernini1, A Moretti, A G Bonadio

  • 1Department of Internal Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy. g.bernini@med.unipi.it

The Journal of Clinical Endocrinology and Metabolism
|November 5, 2002
PubMed
Summary
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Adrenal cortical carcinomas show high vascular endothelial growth factor (VEGF) but low vascular density, indicating a disconnect between angiogenic potential and actual blood vessel formation. This suggests angiogenesis influences hormone secretion in adrenal tumors.

Area of Science:

  • Endocrinology
  • Oncology
  • Pathology

Background:

  • The angiogenic phenotype is crucial for tumor growth and progression.
  • Understanding angiogenesis in adrenal tumors can provide insights into their behavior and hormonal activity.

Purpose of the Study:

  • To investigate the angiogenic phenotype in normal adrenal glands and various adrenal tumors, including adrenal cortical carcinomas (CA).
  • To explore the relationship between vascular density, vascular endothelial growth factor (VEGF) expression, and tumor type/function.

Main Methods:

  • Quantified intratumoral vascular density using CD34 staining.
  • Measured vascular endothelial growth factor (VEGF) expression in tumoral cells.
  • Compared these markers across normal adrenal glands, aldosterone-producing adenomas (APA), cortisol-producing adenomas (CPA), nonfunctioning adrenal cortical adenomas (NFA), and adrenal cortical carcinomas (CA).

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Main Results:

  • Adrenal cortical carcinomas (CA) exhibited significantly lower vascular density (110.3 vessels/mm²) compared to normal glands and adenomas (288.5–336.6 vessels/mm²).
  • CA showed significantly higher VEGF expression (85.3%) than all other groups (0.76–56.5%).
  • A dissociation between high VEGF and low vascular density was observed in CA. NFA showed minimal VEGF expression, while APA demonstrated associations between CD34, plasma renin activity, and aldosterone levels.

Conclusions:

  • Adrenal cortical carcinomas (CA) possess a unique angiogenic phenotype characterized by high VEGF expression but poor vascularization, suggesting a dissociation between angiogenic potential and capability.
  • The lack of VEGF in nonfunctioning adenomas (NFA) and the link between angiogenesis and function in aldosterone-producing adenomas (APA) indicate that the angiogenic phenotype may influence hormonal secretion in adrenal tumors.