The next step: mechanisms driving adrenocortical carcinoma metastasis

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   Figure 1

   VAV2 overexpression induces cytoskeleton remodeling in H295R cells and is a marker of malignancy in ACC. (A) Cytoskeletal morphology revealed by phalloidin staining (red) in H295R/TR SF-1 cells transfected with vectors encoding either GFP or GFP-VAV2 (green). Scale bars, 5 μm. Reproduced, with permission, from Ruggiero C, Doghman-Bouguerra M, Sbiera S, Sbiera I, Parsons M, Ragazzon B, Morin A, Robidel R, Favier J & Bertherat J (2017) Dosage-dependent regulation of VAV2 expression by Steroidogenic actor-1 drives adrenocortical carcinoma cell invasion, Science Signaling, volume 10, eaal2464. Copyright 2017 American Association for the Advancement of Science. (B) OS in ACC patients with both high VAV2 expression (H-score ≥2) and high Ki67 LI (≥20%) group (red line) vs all other patients (green line) P < 0.001, Kaplan–Meier method. Reproduced, with permission, from Sbiera S, Sbiera I, Ruggiero C, Doghman-Bouguerra M, Korpershoek E, de Krijger RR, Haak H, Volante M, Papotti M, Reimondo G, et al. (2017) Assessment of VAV2 expression refines prognostic prediction in adrenocortical carcinoma, Journal of Clinical Endocrinology and Metabolism, volume 102, pages 3491–3498. Copyright 2017 Oxford University Press.
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   Figure 2

   The liquid biopsy consists of a blood draw containing CTCs, miRNAs, exosomes and ctDNAs deriving from the tumor mass. Head-to-head comparison between the applications of the different entities that can be isolated from the liquid biopsy is shown in the table. Y, yes; N, no.
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   Figure 3

   Microscopic evaluation of CTCs enriched by size of specific filter devices. (A and B) Hematoxylin/eosin staining identifies CTCs as large cells with a high nucleus/cytosol ratio; the arrow indicates a polymorphonuclear leukocyte for comparison; micropores of the ScreenCellTM filter devices (black holes) have a diameter of 8 µm. (C) Immunohistochemistry on CTC shows positivity for nuclear SF-1, indicating adrenal origin. Reproduced, with permission, from Pinzani P, Scatena C, Salvianti F, Corsini E, Canu L, Poli G, Paglierani M, Piccini V, Pazzagli M, Nesi G, et al. (2013) Detection of circulating tumor cells in patients with adrenocortical carcinoma: a monocentric preliminary study, Journal of Clinical Endocrinology and Metabolism, volume 98, pages 3731–3738. Copyright 2013 Oxford University Press.

• © 2018 Society for Endocrinology