INSM-1 - a new biomarker in the differential diagnosis of adrenal tumor lesions - a preliminary study

Alicja Szatko; Dorota Leszczynska; Urzula Ambroziak; Michał Łomiak; Malgorzata Bobrowicz; Lucyna Papierska; Wojciech Zgliczy<mi>ń</mi>ski; Piotr Glinicki

doi:10.1530/endoabs.110.P170

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Endocrine Abstracts (2025) 110 P170 | DOI: 10.1530/endoabs.110.P170

ECEESPE2025 Poster Presentations Adrenal and Cardiovascular Endocrinology (169 abstracts)

INSM-1 – a new biomarker in the differential diagnosis of adrenal tumor lesions – a preliminary study

Alicja Szatko ^1,2 , Dorota Leszczynska ³ , Urzula Ambroziak ⁴ , Michał Łomiak ³ , Malgorzata Bobrowicz ⁴ , Lucyna Papierska ³ , Wojciech Zgliczyński ³ & Piotr Glinicki ^1,2

Author affiliations

¹Centre of Postgraduate Medical Eduction, EndoLab Laboratory, Warsaw, Poland; ²Centre of Postgraduate Medical Eduction, Department of Endocrinology, Warsaw, Poland; ³Centre of Postgraduate Medical Education, Department of Endocrinology, Warsaw, Poland; ⁴Medical University of Warsaw, Department of Internal Medicine and Endocrinology, Warsaw, Poland

JOINT3622

Introduction: Diagnosis of adrenal tumors is based on various diagnostic tests: determination of hormone levels, biomarkers, performance of various functional tests, molecular tests, imaging studies, pathomorphological studies, etc., which are useful at various stages of the diagnostic and therapeutic process. Biochemical studies focus on the search for new biomarkers in the blood, that could be useful for differential diagnosis of neoplastic lesions in adrenal glands (benign / malignant, hormonally active / inactive lesions). INSM-1 (Insulinoma-associated protein 1) is a new neuropeptide that may have applications in oncological endocrinology. The peptide is produced in endocrine and neuroendocrine cells of the human body. The goal of this project was to initially evaluate the usefulness of INSM-1 in the differential diagnosis of adrenal tumors and PGL tumors.

Materials and methods: The study included 104 patients with various adrenal tumors and PGL (mean age 52 years, 94 females): 30 MACS, 12 CS, 3 ACC, 9 PA, 10 Myolipoma, 7 PHEO, 30 NFAA and 3 PGL. Diagnosis of individual tumors was made within current guidelines and confirmed by postoperative testing and/or drug treatment. Plasma INSM-1 levels were determined by ELISA immunoassay in all patients.

Results: In the groups studied (MACS, CS, ACC, PA, Myolipoma, PHEO and PGL), the sensitivity and specificity rates of the biomarker INSM-1 were determined. In MACS, the sensitivity and specificity rates were 77% and 57%, respectively, while in Cushing’s syndrome they were 58% and 37%. In tumors associated with aldosterone secretion (PA), the sensitivity and specificity of INSM-1 were 56% and 29%, while in adrenocortical carcinoma (ACC): 67% and 47%. In catecholamine-secreting tumors, the respective sensitivity and specificity rates were: PHEO 57% and 23%, while in PGL they were 67% and 40%. In benign myolipoma tumors, both rates were: 50% and 43%.

Conclusion: Preliminary studies have shown moderate usefulness of INSM-1 in the diagnosis of hypercortisolemia (MACS, ACC) in adrenal lesions and paraganglioma (PGL) tumors.