Thesis title: Multiparametric characterization of adreno-cortical tumors (radiomic, proteomic profiles and liquid biopsy) and association with extra-adrenal neoplasms
This study explores the hypothesis that a multiparametric, functional characterization of
adrenal tumors could provide new important advancements for the clinical management of
patients.
The research project has 4 main areas of study:
1. Radiomic characterization of adrenal masses: application of artificial intelligence techniques
enables to read adrenal-specific radiological textures and to correlate them with functional
properties and clinical outcomes of adrenal tumors.
2. Proteomic characterization: analysis of total protein expression and of proteome post-
transduction modifications not identified by gene microarray is useful to identify a defined
protein expression pattern characteristic of normal and cancer tissues, which, once
standardized, may be a helpful tool for diagnostic in this setting.
3. Immunologic characterization: while the immune cells composition of the adrenocortical
tumors has been already described, little is known about the adrenal immunogenicity and
antigen-presentation capacity. In this study a panel of specific cytokines will be tested on serum
and a gene panel will be used for gene-expression in tumor tissues.
4. Evaluation of extra-adrenal tumors in patients with ACS: a hypothetical correspondence
between cortisol levels and the appearance of a second neoplasm will be evaluated.
Furthermore, it will be explored the possible association of the appearance of an extra-adrenal
tumor with particular immune and proteomic profiles in the different series of enrolled patients.
5. Circulating cell-free DNA (cfDNA), circulating tumour DNA (ctDNA), coding and non-coding RNAs such as messenger RNA transcripts (cfRNA: cell free RNA, mRNA), and noncoding RNAs (ncRNAs) like rRNAs (ribosomal RNA), tRNAs (transferRNA), long non-coding RNAs (lncRNAs)
and microRNAs (miRNA) can be analysed with a liquid biopsy (LB). These analyses would appear to have a potential role in the prognosis, identification of specific genomic alterations, selection of targeted therapies and to provide information regarding treatment efficacy over time. In our study we wont to assess the potential applicability of the result of liquid biopsy as markers of adrenocortical malignancy