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The usefulness of determining the serum concentrations of vascular endothelial growth factor (VEGF) and its soluble receptor type 2 (sVEGF-2) in the differential diagnosis of adrenal incidentalomas.
[adrenal incidentaloma]
Angiogenesis
plays
an
important
role
in
tumour
growth
,
progression
and
invasiveness
.
Vascular
endothelial
growth
factor
(
VEGF
)
is
a
recognised
angiogenesis-stimulating
factor
.
Soluble
VEGF
receptors
(
sVEGFRs
)
have
antiangiogenic
properties
.
Recent
studies
have
indicated
that
serum
concentrations
of
these
factors
show
a
good
correlation
with
the
aggressiveness
of
these
tumours
in
various
organs
.
The
aim
of
this
study
was
to
assess
the
usefulness
of
determining
serum
concentrations
of
VEGF
and
sVEGFR-
2
in
patients
with
adrenal
incidentalomas
.
The
study
included
51
patients
:
38
women
aged
53
.
57
±
10
.
12
years
and
13
men
aged
54
.
66
±
12
.
73
years
without
a
history
of
cancer
but
with
non-functioning
adrenal
tumours
incidentally
detected
on
a
CT
scan
.
The
analysis
of
the
CT
images
included
such
morphological
features
of
the
tumour
as
:
tumour
size
,
tumour
homogenicity
,
tumour
density
before
and
after
administration
of
an
intravenous
contrast
medium
,
and
the
value
of
percentage
washout
of
the
contrast
medium
from
the
tumour
.
Based
on
the
above
criteria
,
we
identified
a
group
of
40
patients
with
adrenal
tumours
who
met
the
CT
criteria
for
benign
adenomas
(
Group
1
)
and
11
patients
whose
incidentally
discovered
tumours
did
not
meet
the
radiological
criteria
for
benign
adenomas
,
thereby
providing
grounds
for
referring
these
patients
for
surgery
(
Group
2
)
.
The
control
group
consisted
of
20
healthy
sex-
and
age-matched
individuals
.
The
mean
serum
concentrations
of
VEGF
in
the
study
and
control
groups
were
similar
,
although
patients
with
adrenal
tumours
had
significantly
higher
concentrations
of
sVEGFR-
2
than
healthy
individuals
.
There
were
no
significant
differences
in
the
mean
concentrations
of
VEGF
and
sVEGFR-
2
between
the
patients
undergoing
surgery
(
Group
2
)
and
the
patients
not
undergoing
surgery
(
Group
1
)
,
or
between
the
patients
undergoing
surgery
(
Group
2
)
and
the
control
group
.
Postoperative
histopathology
of
the
resected
adrenal
tumours
revealed
benign
adrenocortical
adenoma
in
eight
patients
and
the
following
in
the
remaining
patients
:
adrenocortical
carcinoma
in
one
patient
,
phaeochromocytoma
in
one
patient
and
ganglioneuroma
in
one
patient
.
The
adrenocortical
carcinoma
patient
had
the
highest
concentration
of
VEGF
,
while
this
patient
's
concentration
of
sVEGFR-
2
was
the
lowest
in
the
study
group
.
In
the
patients
diagnosed
with
ganglioneuroma
and
phaeochromocytoma
,
VEGF
and
sVEGFR-
2
concentrations
did
not
differ
significantly
from
their
mean
concentrations
in
the
study
group
.
There
were
also
no
relationships
between
the
serum
concentrations
of
VEGF
or
sVEGFR-
2
and
the
following
parameters
:
tumour
size
,
precontrast
and
postcontrast
tumour
densities
or
the
value
of
percentage
washout
.
Positive
correlations
were
,
however
,
identified
between
the
concentration
of
VEGF
and
the
concentrations
of
total
cholesterol
and
LDL-cholesterol
.
Determining
the
serum
concentrations
of
such
angiogenesis
markers
as
VEGF
and
sVEGFR-
2
seems
useful
in
the
evaluation
of
the
nature
of
incidentally
detected
adrenal
masses
(
incidentalomas
)
,
especially
in
the
preoperative
differential
diagnosis
of
adrenal
masses
that
do
not
meet
the
CT
criteria
for
benign
tumours
.
Diseases
Validation
Diseases presenting
"incidentally detected adrenal masses"
symptom
adrenal incidentaloma
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