<b><i>Purpose:</i></b> The aim of this study was to investigate the expression patterns of glucose metabolism-related proteins and their clinicopathologic implications in adrenal cortical neoplasms (ACN) and pheochromocytoma (PCC). <b><i>Methods:</i></b> Immunohistochemical staining was performed to evaluate glucose metabolism-related proteins (GLUT1, CAIX, hexokinase II, G6PDH, PHGDH, and SHMT1) in 132 ACN cases (115 adrenal cortical adenoma [ACA] and 17 adrenal cortical carcinoma [ACC]) and 189 PCC cases. <b><i>Results:</i></b> Expression levels of GLUT1 in tumor cells ([T]; <i>p</i> < 0.001), GLUT1 in stromal cells ([S]; <i>p</i> < 0.001), G6PDH (<i>p</i> < 0.001), and SHMT1 (<i>p</i> = 0.002) were higher in ACN than in PCC. GLUT1 (T; <i>p</i> = 0.045) and PHGDH (<i>p</i> = 0.043) levels were higher in ACC than in ACA. In a univariate analysis of ACN, GLUT1 (T; <i>p</i> = 0.017), CAIX (S; <i>p</i> = 0.003), and PHGDH (<i>p</i> = 0.009) levels were correlated with a shorter overall survival (OS). GLUT1 (T; <i>p</i> = 0.001) and PHGDH (<i>p</i> < 0.001) were related to a shorter OS in PCC. GLUT1 (T) positivity (<i>p</i> = 0.043) in ACN predicted a poor OS in a multivariate Cox analysis. In PCC, high GAPP score (<i>p</i> = 0.026), GLUT1 (T; <i>p</i> = 0.002), and PHGDH (<i>p</i> < 0.001) were independent prognostic factors for poor OS. <b><i>Conclusions:</i></b> The adrenal gland tumors ACN and PCC had different expression patterns of glucose metabolism-related proteins (GLUT1, G6PDH, and SHMT1), with higher expression levels in ACN than in PCC. GLUT1 and PHGDH were significant prognostic factors in these adrenal neoplasms.
Clinical and pathological analysis of 116 cases of adult adrenal cortical adenoma and literature review
