Metabolic Subtyping of Adrenal Tumors: Prospective Multi-Center Cohort Study in Korea

被引:13
作者
Ku, Eu Jeong [1 ]
Lee, Chaelin [2 ]
Shim, Jaeyoon [2 ]
Lee, Sihoon [3 ]
Kim, Kyoung-Ah [4 ]
Kim, Sang Wan [5 ]
Rhee, Yumie [6 ]
Kim, Hyo-Jeong [7 ]
Lim, Jung Soo [8 ]
Chung, Choon Hee [8 ]
Chun, Sung Wan [9 ]
Yoo, Soon-Jib [10 ]
Ryu, Ohk-Hyun [11 ]
Cho, Ho Chan [12 ]
Hong, A. Ram [13 ]
Ahn, Chang Ho [14 ]
Kim, Jung Hee [15 ]
Choi, Man Ho [2 ]
机构
[1] Chungbuk Natl Univ, Chungbuk Natl Univ Hosp, Dept Internal Med, Coll Med, Cheongju, South Korea
[2] Korea Inst Sci & Technol, Mol Recognit Res Ctr, 5 Hwarang Ro 14 Gil, Seoul 02792, South Korea
[3] Gachon Univ, Dept Internal Med, Coll Med, Incheon, South Korea
[4] Dongguk Univ, Coll Med, Dept Internal Med, Ilsan Hosp, Goyang, South Korea
[5] Seoul Natl Univ, Dept Internal Med, Seoul Metropolitan Govt, Boramae Med Ctr,Coll Med, Seoul, South Korea
[6] Yonsei Univ, Dept Internal Med, Coll Med, Seoul, South Korea
[7] Eulji Univ, Nowon Eulji Med Ctr, Dept Internal Med, Seoul, South Korea
[8] Yonsei Univ, Dept Internal Med, Wonju Coll Med, Wonju, South Korea
[9] Soonchunhyang Univ, Coll Med, Dept Internal Med, Cheonan Hosp, Cheonan, South Korea
[10] Catholic Univ Korea, Coll Med, Dept Internal Med, Div Endocrinol & Metab,Bucheon St Marys Hosp, Bucheon, South Korea
[11] Hallym Univ, Coll Med, Dept Internal Med, Chuncheon Sacred Heart Hosp, Chunchon, South Korea
[12] Keimyung Univ, Dept Internal Med, Sch Med, Daegu, South Korea
[13] Chonnam Natl Univ, Dept Internal Med, Med Sch, Gwangju, South Korea
[14] Seoul Natl Univ, Bundang Hosp, Dept Internal Med, Coll Med, Gwangju, South Korea
[15] Seoul Natl Univ, Seoul Natl Univ Hosp, Dept Internal Med, Coll Med, 101 Daehak Ro, Seoul 03080, South Korea
基金
新加坡国家研究基金会;
关键词
Steroid metabolism; Supervised machine learning; Adrenal neoplasm; Cushing syndrome; Primary hyperaldosteronism; PRIMARY ALDOSTERONISM; CUSHINGS-SYNDROME; DIAGNOSIS; 18-HYDROXYCORTISOL; 18-OXOCORTISOL; SOCIETY; MANAGEMENT; SECRETION; MS/MS;
D O I
10.3803/EnM.2021.1149
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Conventional diagnostic approaches for adrenal tumors require multi-step processes, including imaging studies and dynamic hormone tests. Therefore, this study aimed to discriminate adrenal tumors from a single blood sample based on the combination of liquid chromatography-mass spectrometry (LC-MS) and machine learning algorithms in serum profiling of adrenal steroids. Methods: The LC-MS-based steroid profiling was applied to serum samples obtained from patients with nonfunctioning adenoma (NFA. n=73). Cushing's syndrome (CS, n=30), and primary aldosteronism (PA, n=40) in a prospective multicenter study of adrenal disease. The decision tree (DT), random forest (RF), and extreme gradient boost (XGBoost) were performed to categorize the subtypes of adrenal tumors. Results: The CS group showed higher scrum levels of 11-deoxycortisol than the NFA group, and increased levels of tctrahydrocorti-sone (THE), 20 alpha-dihydrocortisol, and 60-hydroxycortisol were found in the PA group. However, the CS group showed lower levels of dehydroepiandrosterone (DHEA) and its sulfate derivative (DHEA-S) than both the NFA and PA groups. Patients with PA expressed higher serum 18-hydroxycortisol and DHEA but lower THE than NFA patients. The balanced accuracies of DT, RF, and XGBoost for classifying each type were 78%, 96%, and 97%, respectively. In receiver operating characteristics (ROC) analysis for CS, XGBoost, and RF showed a significantly greater diagnostic power than the DT However, in ROC analysis for PA, only RF exhibited better diagnostic performance than DT. Conclusion: The combination of LC-MS-based steroid profiling with machine learning algorithms could be a promising one-step diagnostic approach for the classification of adrenal tumor subtypes.
引用
收藏
页码:1131 / 1141
页数:11
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