Lancet Diabetes Endocrinol: Simple urine tests for more accurate detection of adrenal cancer are expected to be included in the guidelines.

A new study published recently in The Lancet Diabetes and Endocrinology found that simple urine testing of patients with adrenal lumps combined with routine imaging tests can help speed up diagnosis of adrenal cancer, improve patient prognosis, and reduce the need for invasive diagnostic techniques.
with the increasing use of imaging techniques such as CT and MRI scanning, they often lead to unexpected discoveries: nods in the adrenal glands.
These so-called adrenal epidms are mostly harmless, but once adrenal lumps are found, it's important to check to see if there's a risk of adrenal cancer or an excess of adrenal hormones.
adrenal cortical cancer (ACC) is a malignant tumor that is originally caused by the adrenal cortical cortical, and ACC patients have poor prognosis and can only be cured through early detection and surgery.
, accidental adrenal lumps often lead to more imaging tests to determine if the lump is cancerous.
, however, recent studies have shown that imaging is limited in its ability to determine whether a lump is malignant or benign.
, it can lead to higher costs, radiation exposure, and anxiety between patients.
The study, led by experts at the University of Birmingham in the UK, found that using urine steroid metabolomics (USM), a simple urine test to measure whether adrenal steroid hormones are excessive (a key indicator of adrenal tumors), can speed up diagnosis, allow patients who unfortunately suffer from ACC to receive treatment as quickly as possible, and help patients with harmless adrenal glands avoid unnecessary surgery.
over a six-year period, researchers studied more than 2,000 newly diagnosed adrenal tumor patients from 14 centers of the European Network for Adrenal Oncology Research (ENSAT).
after diagnosis, the patient collected a urine sample, and the researchers analyzed the types and amounts of adrenal steroids in the urine, which were automatically analyzed by computer algorithms based on machine learning.
results show fewer urine test errors than imaging tests, which often misdiagnose ACC as harmless adrenal nods.
Dr Alice Sitch and Professor Jon Deeks, diagnostic test specialists at the University of Birmingham, who were involved in the study, said: "This study shows that combining tumor size, imaging characteristics and urine testing, particularly when the adrenal glands are large and suspicious image results are available, provides considerable accuracy.
"The findings of this study will be followed by international guidelines for the treatment of adrenal tumors, and the implementation of the new tests will hopefully improve the overall prospects for patients with adrenal tumors," said Irina Bancos, co-lead author of the paper and an associate professor of endocrinology at the Mayo Clinic in the United States.
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