{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T09:26:18Z","timestamp":1766049978305,"version":"3.40.5"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T00:00:00Z","timestamp":1652832000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Science"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Adrenocortical carcinoma (ACC) is a rare malignant tumor. Genetic abnormalities that may represent therapeutic targets and prognostic factors in ACC remain unclear. Besides being one of the main cellular defense mechanisms that regulates antioxidant pathways for detoxifying reactive oxygen species (ROS), the transcription factor nuclear factor erythroid 2\u2013related factor 2 (Nrf2) promotes tumor proliferation by increasing metabolic activity. In surgical specimens from 12 cases of nonmetastatic ACCs and nine cases of benign adrenocortical adenoma (ACA), we investigated gene mutation and protein expressions for Nrf2 and the preoperative maximum standard glucose uptake (SUVmax) on [<jats:sup>18<\/jats:sup>F]fluorodeoxy\u2010glucose positron emission tomography. Three of five ACCs with a Weiss score of 7 to 9 were Nrf2\u00a0mutants; these ACCs had higher expression of Nrf2 and higher preoperative SUVmax. The other seven ACCs had a Weiss score of 3 to 6; these seven ACCs and all the ACAs were non\u2010Nrf2\u00a0gene mutants. Patients with a Weiss score of 7 to 9 and Nrf2\u00a0mutant ACC had shorter overall survival. Based on Helsinki scoring, three ACCs with a Helsinki score greater than 17\u00a0had Nrf2\u00a0mutants, higher expression of Nrf2, higher preoperative SUVmax, and shorter overall survival. Our findings indicate that Nrf2 activation and the associated increase in metabolism play roles in ACC, in particular in ACC with a Weiss score of 7 to 9 and a Helsinki score of greater than 17.<\/jats:p>","DOI":"10.1111\/cas.15379","type":"journal-article","created":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T11:04:48Z","timestamp":1650884688000},"page":"2368-2377","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association of Nrf2 expression and mutation with Weiss and Helsinki scores in adrenocortical carcinoma"],"prefix":"10.1111","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7086-6964","authenticated-orcid":false,"given":"Takao","family":"Kamai","sequence":"first","affiliation":[{"name":"Department of Urology Dokkyo Medical University  Mibu, Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Murakami","sequence":"additional","affiliation":[{"name":"Department of Urology Dokkyo Medical University  Mibu, Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyoko","family":"Arai","sequence":"additional","affiliation":[{"name":"Department of Urology Dokkyo Medical University  Mibu, Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuyuki","family":"Ishida","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology Dokkyo Medical University  Mibu, Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiki","family":"Kijima","sequence":"additional","affiliation":[{"name":"Department of Urology Dokkyo Medical University  Mibu, Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,5,18]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12022-017-9484-5"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-3020"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2010.235"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-019-0221-7"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2007.050625"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/er.2013-1029"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-18-0608"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-198403000-00001"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200212000-00009"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2014.11.015"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2015.10.017"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng.2953"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccell.2016.04.002"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2011.02.013"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2008.08.021"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccr.2012.05.016"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrc3278"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature10189"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1101\/gad.225680.113"},{"key":"e_1_2_13_21_1","article-title":"NFE2L2 is a potential prognostic biomarker and is correlated with immune infiltration in brain lower grade glioma: a pan\u2010cancer analysis","volume":"3580719","author":"Ju Q","year":"2020","journal-title":"Oxid Med Cell Longev"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13174383"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-2281"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/cas.14977"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-46124-9"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.7171\/jbt.12-2301-003"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbrc.2004.06.112"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1096\/fj.06-7759com"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1128\/MCB.00065-13"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-019-6347-0"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0806268105"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1349-7006.2006.00358.x"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cotox.2016.10.005"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cellsig.2021.110105"}],"container-title":["Cancer Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cas.15379","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cas.15379","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cas.15379","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T02:56:51Z","timestamp":1692759411000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cas.15379"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,18]]},"references-count":33,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1111\/cas.15379"],"URL":"https:\/\/doi.org\/10.1111\/cas.15379","archive":["Portico"],"relation":{},"ISSN":["1347-9032","1349-7006"],"issn-type":[{"type":"print","value":"1347-9032"},{"type":"electronic","value":"1349-7006"}],"subject":[],"published":{"date-parts":[[2022,5,18]]},"assertion":[{"value":"2022-01-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}