Diagnostic accuracy of using multiple cytokines to predict aldosterone-producing adenoma

Abstract

Here, we aimed to study the important cytokines in plasma to identify the aldosterone-producing adenoma (APA). 19 unilateral primary aldosteronism (UPA) patients and 19 healthy people were divided into UPA group and Control group, and the serum of bilateral adrenal veins and inferior vena cava collected by adrenal blood sampling (AVS) in UPA patients and the serum from the healthy subjects were all used to detect multiple cytokines by Luminex immunoassays. Additionally, The UPA patients subjected to laparoscopic adrenalectomy were divided into different groups by pathological results for further study. According our results, IP-10, CXCL9 and RANTES were significantly higher in UPA group compared with control group, and the combination of the three cytokines have significant predictive power for predicting UPA, while the correlational analyses demonstrated that IP-10 and CXCL9 were positively correlated with BP and HR, while EGF was positively correlated with HDL. Additionally, IL-1b was suggested to be the most potential diagnostic biomarker to discriminate the APA and unilateral adrenal hyperplasia (UAH). The present findings might suggest a possibility of IP-10, CXCL9 and RANTES served as a sign to help UPA diagnosis and finally used to assist the diagnosis of APA, while IL-1b was suggested to be the most potential diagnostic biomarker to identify the APA from the UAH patients.

Figure 1

(a) ROC curves of single-indicator analysis of IP-10, CXCL9 and RANTES; (b) ROC curves of combined analysis of IP-10, CXCL9 and RANTES. (c)The correlational analyses in the 16 statistically significant cytokines with the clinical indicators in the comparison of UPA group and control group.

Figure 2

The correlation between the clinical indicators and some cytokines. (a) The correlation between the BP value and some significant cytokines. (b) The correlation between the HR, HDL, and BMI and the cytokines.

Figure 3

HE staining of the UPA patients. Scale bar, 50 μm. (a) The pathological result of part APA patients. (b) The pathological result of part UAH patients.

Figure 4

The correlation analysis between the clinical materials with the cytokines and the ROC curve of different histological type prediction. (a) The correlation analysis in the Middle group. (b) The correlation analysis in the Same group. (c) The correlation analysis in the Opposite group. (d) The ROC curve in the Middle group. (e) The ROC curve in the Same group. (f) The ROC curve in the Opposite group.

Figure 5

(a) The sections are shown at 40 × magnification. The expressions of RANTES, CXCL9, and IP-10 were visible in adrenal cells (brown cytoplasm). (b) The sections are shown at 40 × magnification. The expression of IL-1 was visible in adrenal cells (brown cytoplasm). (c) The result of Mann–Whitney test between UPA and control group. (d) The result of Mann–Whitney test between APA and UAH group.