Analysis of Cancer Stem Cell Markers in Various Histological Subtypes of Adrenocortical Cancer

Adrenocortical cancer (ACC) is a rare malignant neoplasm originating from the adrenal cortex, presenting limited therapeutic options. An avenue for improving therapeutic efficacy may involve a deeper understanding of the role of adrenocortical stem/progenitor cells in the pathogenesis of this disease. Although existing data suggest stem/progenitor characteristics in certain cell populations within ACC, the challenge remains to identify adrenocortical stem cell markers directly involved in its carcinogenesis. In our study, we aimed to identify multipotency markers such as LGR5 and CD90 in various ACC types to confirm their presence and localization. The study included tumor tissue samples from 13 patients with ACC treated at the Endocrinology Research Centre (Moscow, Russia) between 2005 and 2023. We conducted immunohistochemical analyses to identify the aforementioned markers and examined the association between their expression and clinico-morphological parameters. Our pilot study results demonstrate the presence of LGR5- and CD90-positive tumor cells in all samples. Despite the small sample size, we observed statistically significant differences in disease-free survival based on the number of CD90-positive cells. These findings suggest a potential diagnostic, prognostic, and predictive value of cancer stem cell markers, underscoring the need for their further analysis in a larger cohort of patients with ACC.