Background: Adrenal masses are a common finding in the
adrenal gland. Steroidogenic factor 1 (SF1) is a nuclear
transcription factor that regulates genes involved in gonadal
and adrenal steroidogenesis. Ghrelin is a ligand of growth
hormone secretagogue receptor type 1 (GHS-R1). The
principal role of ghrelin is to regulate energy homeostasis and
secretion of growth hormone. Aim: to differentiate
adrenocortical adenoma, carcinoma and pheochromocytoma
immunohistochemically using steroidogenic factor-1 (SF-1)
and gherlin expression and evaluate their diagnostic and
prognostic significance in relation to various clinicopathologic
parameters.Material and methods: This is retrospective study
carried upon 45 of different cases of adrenal gland lesions
designated as: 20 cases of adrenocortical adenomas(ACA) and
10 cases of adrenocortical carcinomas(ACC) and 15 cases of
pheochromocytoma . Immunohistochemical staining
techniques were used to detect the role of SF-1 and gherlin in
the forementioned adrenal gland lesions and evaluate their
relations to different clinicopathological data and patient’s
survival. Results: SF-1 and gherlin were sensitive (100%) and
specific (95%, 100% respectively) immunohistochemical
markers in diagnosis adrenocortical carcinoma, but gherlin was
more sensitive (100%) and SF-1 was more specific (60%) in diagnosing adrenocortical adenoma. On the other side, SF-1
was more sensitive(100%) in diagnosing pheochromocytoma.
SF-1 expression in adrenocortical carcinoma revealed that strong positive SF-1expression
was associated with reduced overall survival . Conclusion:. SF1 and ghrelin
immunoreactivity may be considered sensitive and specific markers for differentiating ACC
from ACA and pheochromocytoma. However, further research is required to determine the
causes of differential ghrelin expression in adrenal tumors.