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Figure 1.

CYP2W1 immunohistochemistry.

Examples of CYP2W1 immunostaining in normal tissue (i.e. liver and adrenal gland) and neoplastic tissues (i.e. lung cancer and adrenocortical carcinoma). A: Staining with a polyclonal antibody from Thermo Scientific (Ab #1); B: Staining with a polyclonal antibody provided by the Karolinska Institute [11], [14], [23] (Ab #2). Magnification 20X and 10X.

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Figure 2.

CYP2W1 expression in adrenal and non-adrenal tissues.

A: Relative mRNA expression levels (normalized to β-actin using the ΔCT method, [21]). B: CYP2W1 immunoreactivity evaluated as H-score (for details see Material and methods section). P values were evaluated by non parametric Kruskal-Wallis test and Bonferroni post-hoc test. ACA = adrenocortical adenoma, ACC = adrenocortical carcinoma.

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Figure 3.

Relationship between CYP2W1 immunoreactivity and clinico-pathological parameters.

A: Relationship with steroid (cortisol or aldosterone) secretion in adrenocortical adenomas with available hormonal data (ACA, n = 39). B: Relationship with steroid secretion in adrenocortical carcinomas with available hormonal data (ACC, n = 141). Multiple hormone secretion: androgen- and cortisol-secretion; single secretion: only androgen-, cortisol- or aldosterone-secretion. C: Relationship with the proliferation index (Ki67) in adrenocortical carcinomas (ACC, only samples deriving from primary surgery with known Ki67, n = 115). Legend: high Ki67>10% (median value), low Ki67≤10%. D: Relationship with Weiss score in adrenocortical carcinomas (ACC, only samples deriving from the primary surgery with known Weiss score, n = 171). Legend: high Weiss score>6 (median value), low Weiss score ≤6.

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Table 1.

Relationship between CYP2W1 immunoreactivity and baseline clinical or pathological characteristics of patients with adrenocortical carcinoma (only tumour samples derived from primary surgery, n = 196).

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Figure 4.

Impact of combined CYP2W1 immunohistochemistry and initial ENSAT tumor stage on clinical outcome in patients affected by adrenocortical carcinoma treated with mitotane only (n = 72, including both adjuvant and palliative intention).

A: Overall survival; B: Time to progression (TTP).

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Table 2.

Relationship between CYP2W1 immunoreactivity and clinical outcome of patients with adrenocortical carcinoma treated with mitotane only (n = 72).

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Figure 5.

Relationship between CYP2W1 immunoreactivity and response to therapy with mitotane only, according to treatment intention.

A: Response to therapy in patients treated in an adjuvant setting (n = 36). B: Objective response to therapy in patients treated in a palliative setting (n = 32).

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