Aiding in assessing malignancy in adrenal masses
May aid in improving diagnostic and prognostic prediction and dissect disease mechanisms for the following applications:
-Diagnostic assessment and follow up of adrenal cortical carcinoma (ACC)
-Differential diagnostic assessment of adrenal tumors
-Additional assessment related to Cushing syndrome, mild autonomous cortisol secretion, primary aldosteronism, inborn errors of steroidogenesis, polycystic ovary syndrome
This test is not useful for establishing eligibility for a specific treatment as results must be interpreted in conjunction with the clinical status of the patient.
This test offers an accurate, rapid, cost-effective, noninvasive tool to better assess malignant adrenal tumors and assist clinicians in determining whether an adrenal mass is benign or malignant.
Testing begins with a clinical risk assessment based on clinical data before integration with biochemical steroid data to assess the probability of a malignant adrenal cortical carcinoma (ACC) or other malignancy (sarcoma, lymphoma, other) as well as the probability of a benign mass (adenoma, myelolipoma, cyst, other).
Clinical data includes age at diagnosis, gender, mode of discovery and hormonal status along with tumor diameter and an unenhanced computerized tomography (CT) scan density measurement of the tumor (in Hounsfield units).
Steroids and their metabolites are extracted, analyzed, quantitated, and reported. Each reported analyte also includes a Z-score. An integrated risk assessment based on clinical data in combination with biochemical steroid data is reported to assess the probability of a malignant ACC or other malignancy as well as the probability of a benign mass.
For more information, see Adrenal Mass Panel Clinical Data Definition of Malignancy Predictors.
Liquid Chromatography-Tandem Mass Spectrometry, High-Resolution Accurate Mass (LC-MS/MS HRAM)
Adrenal Cortical Carcinoma
Adrenal Cortical Adenoma
Androsterone
Etiocholanolone
Dehydroepiandrosterone
16a-OH-Dehydroepiandrosterone
5-Pregnenetriol
5-Pregnenediol
Tetrahydro-11-Corticosterone
Tetrahydro-11-Deoxycorticosterone
Pregnanediol
17a-OH-Pregnanolone
Pregnanetriol
Pregnanetriolone
Tetrahydrodeoxycortisol
Cortisol
6B-OH-Cortisol
Tetrahydrocortisol
5a-Tetrahydrocortisol
B-Cortol
11B-OH-Androsterone
11B-OH-Etiocholanolone
Cortisone
Tetrahydrocortisone
a-Cortolone
B-Cortolone
11-Oxoetiocholanolone
ACC
ACCSP
Steroid
Steroid Panel
SP25
sarcoma
lymphoma
benign mass
adenoma
myelolipoma
cyst
AN
ANN
ETIO
DHEA
16a-DHEA
5PT
5PD
THB
THDOC
PD
17HP
PT
PTONE
THS
6B-OH-CORT
THF
5a-THF
11B-OH-AN
11B-OH-ET
THE
11B-OXO-ET
ACA
ACTH
Adrenocorticotropic hormone
HRAM
11B-hydroxyandrosterone
11B-hydroxyetiocholanolone
11-OXO-ET
16a-hydroxydehydroepiandrosterone
17a-hydroxypregnanolone
6B-hydroxycortisol
aCortolone
tetrahydrocorticosterone
tetrahydrodeoxycorticosterone
CAH
Hydroxylase Deficiency
CAH21
CA21H
Congenital Adrenal hyperplasia
Corticosteroids
CYP21
11Beta-OH-AN
11Beta-hydroxyandrosterone
11Beta-OH-ET
11Beta-hydroxyetiocholanolone
16alpha-DHEA
16alpha-hydroxydehydroepiandrosterone
17alpha-hydroxypregnanolone
5alpha-tetrahydrocortisol
6Beta-OH-cort
6Beta-hydroxycortisol
alpha-Cortolone
Beta-Cortol
Beta-Cortolone
Testing begins with a clinical risk assessment based on clinical data before integration with biochemical steroid data to assess the probability of a malignant adrenal cortical carcinoma (ACC) or other malignancy (sarcoma, lymphoma, other) as well as the probability of a benign mass (adenoma, myelolipoma, cyst, other).
Clinical data includes age at diagnosis, gender, mode of discovery and hormonal status along with tumor diameter and an unenhanced computerized tomography (CT) scan density measurement of the tumor (in Hounsfield units).
Steroids and their metabolites are extracted, analyzed, quantitated, and reported. Each reported analyte also includes a Z-score. An integrated risk assessment based on clinical data in combination with biochemical steroid data is reported to assess the probability of a malignant ACC or other malignancy as well as the probability of a benign mass.
For more information, see Adrenal Mass Panel Clinical Data Definition of Malignancy Predictors.
Urine
Ship specimens frozen.
The following information is required. Testing cannot proceed without this information (NA or Not Applicable are not acceptable responses).
-Age at diagnosis (Years, not offered for pediatric patients)
-Gender (Male, Female)
-Mode of discovery (incidental, cancer staging, other)
-Tumor diameter (mm)
-Unenhanced computerized tomography (CT) (Hounsfield units)
-Hormonal excess (Yes = Present, No=Absent)
-Collection duration and 24-hour volume
If information is not provided within 5 days of specimen receipt at MCL, testing may be delayed or canceled.
If not ordering electronically, Adrenal Mass Panel Patient Information is required.
Question ID | Description | Answers |
---|---|---|
AC1AG | Age at Diagnosis | |
AC2GD | Gender | |
AC3MD | Mode of Discovery | |
AC4TZ | Tumor Diameter (mm) | |
AC5HX | Unenhanced CT (Hounsfield units) | |
AC6HM | Hormonal Excess | |
TM66 | Collection Duration | |
VL66 | Urine Volume |
Supplies: Sarstedt 5 mL Aliquot Tube (T914)
Container/Tube: Plastic urine tube
Specimen Volume: 4 mL
Collection Instructions:
1. Collect urine for a full 24 hours (required) and record the total volume.
2. Do not add preservatives. Specimens containing preservatives will be canceled.
3. Entire 24 hour collection must be mixed well prior to aliquoting into a 5 mL plastic tube.
Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens for multiple collections.
Adrenal Mass Panel Patient Information is required if not ordering electronically.
Note: The application of temperature controls must occur within 4 hours of completion of the collection.
Ambient | No |
Refrigerate | OK |
Frozen | OK |
50% Acetic Acid | No |
Boric Acid | No |
Diazolidinyl Urea | No |
6M Hydrochloric Acid | No |
6M Nitric Acid | No |
Sodium Carbonate | No |
Thymol | No |
Toluene | No |
2 mL
Gross hemolysis | OK |
Gross icterus | OK |
Specimens with preservatives | Reject |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Urine | Frozen (preferred) | 90 days | |
Refrigerated | 14 days |
Aiding in assessing malignancy in adrenal masses
May aid in improving diagnostic and prognostic prediction and dissect disease mechanisms for the following applications:
-Diagnostic assessment and follow up of adrenal cortical carcinoma (ACC)
-Differential diagnostic assessment of adrenal tumors
-Additional assessment related to Cushing syndrome, mild autonomous cortisol secretion, primary aldosteronism, inborn errors of steroidogenesis, polycystic ovary syndrome
This test is not useful for establishing eligibility for a specific treatment as results must be interpreted in conjunction with the clinical status of the patient.
Testing begins with a clinical risk assessment based on clinical data before integration with biochemical steroid data to assess the probability of a malignant adrenal cortical carcinoma (ACC) or other malignancy (sarcoma, lymphoma, other) as well as the probability of a benign mass (adenoma, myelolipoma, cyst, other).
Clinical data includes age at diagnosis, gender, mode of discovery and hormonal status along with tumor diameter and an unenhanced computerized tomography (CT) scan density measurement of the tumor (in Hounsfield units).
Steroids and their metabolites are extracted, analyzed, quantitated, and reported. Each reported analyte also includes a Z-score. An integrated risk assessment based on clinical data in combination with biochemical steroid data is reported to assess the probability of a malignant ACC or other malignancy as well as the probability of a benign mass.
For more information, see Adrenal Mass Panel Clinical Data Definition of Malignancy Predictors.
Approximately 80 million computerized tomography (CT) scans are performed in the United States every year. Adrenal tumors are found incidentally in about 5% of patients undergoing abdominal CT. Most of these tumors will be benign, but a small fraction are adrenal cortical carcinomas (ACC), a cancer with high mortality and frequent recurrence. Even for localized disease, the 5-year survival rates do not exceed 65%, while distant spread is associated with a greater than 90% mortality rate. Early diagnosis of a malignant adrenal mass is therefore imperative to assure timely and appropriate therapy.
Unfortunately, CT imaging alone is very limited in its ability to distinguish benign from malignant adrenal tumors since only very small and hypodense lesions can be easily dismissed as benign. The sizeable group of patients with larger or denser tumors ends up with an arduous workup that frequently includes additional imaging studies, hormonal testing, and biopsy. However, even the latter has both a high diagnostic false-positive and false-negative rate, and ultimately the tumor is often resected, sometimes unnecessarily. On the other hand, the delays due to the diagnostic work might compromise optimal care for those tumors that prove malignant.
In addition, patients who are believed to probably not have adrenal cancer after their workup, and those who opt out of surgery, often still require long-term follow up with regular re-imaging and repeated hormone testing, with resultant radiation exposure and high healthcare costs.
This adrenal mass panel is a noninvasive and more accurate test to diagnose malignant adrenal tumors, via urinary steroid profiling. It differentiates ACC, a rare and lethal tumor, from benign adrenocortical adenomas (ACA), including those that overproduce corticosteroids, or mineral steroids, or sex steroids, or those that are hormonally inactive. The test utilizes both clinical and laboratory data. The clinical parameters are age at diagnosis and sex of the patient, the size of the tumor by CT scanning and its CT density in Hounsfield units, whether it was detected incidentally or not, and whether there is evidence of hormone overproduction. All of this data are readily available for almost all patients with an adrenal mass and are used by an algorithm to calculate the pretest probability of having ACC. The steroid profile testing is then performed, and the results are added into the risk calculation algorithm to generate an integrated probability. The final result will provide the referring physicians a highly accurate probability for ACC and will thereby facilitate the optimal choice of further investigation, if any, based on an informed discussion between doctor and patient. In addition, it allows, albeit with lesser accuracy, the detection of malignant adrenal tumors that are not ACCs.
Finally, standalone steroid profiles can be performed for the purpose of offering the diagnosis of complex assessment of steroidal disorders, disease monitoring of patients with ACC, and for novel investigations, such as biopharma studies.
Understanding the Adrenal Glands:
The human body has 2 adrenal glands, one above each kidney. Adrenal glands influence many processes and functions of the body, mainly through production of 3 types of steroid hormones:
-Mineralocorticoids (eg, aldosterone, which helps control blood pressure)
-Glucocorticoids (eg, cortisol, which is important for metabolism, immune response, and stress)
-Sex steroids (eg, DHEAS, a precursor of testosterone and estradiol)
These steroids are all synthesized from cholesterol via enzymes in the adrenal glands. In benign ACA, near-normal levels of precursor and bioactive steroids are produced. By contrast, ACC frequently shows abnormal patterns of steroid production. By measuring 25 different steroid metabolites, even subtle abnormalities can be detected. This is the basis for the assessment capability of profiling 25 steroids. In addition, catecholamines-the "flight or fight hormones"-are also synthesized in a different portion of the adrenal glands. This portion is not examined in the ACC panel.
Epidemiology of Adrenal Tumors:
Adrenal masses are found in 1% to 5% of the adult population. The prevalence increases with age, to around 10% in 70-year-old patients.
Although the majority of these tumors are benign, around 30% of adrenal tumors (>4cm) are malignant (half are represented by ACC), and the survival rate for these patients is very poor unless detected early.
Note: Due to the wide range of urine steroid metabolite concentrations seen in healthy individuals and their skewed distribution, the reference values are based on the back calculated +/- 3SD of log transformed data.
Males 18-49 years:
Androsterone: 182-29,212 mcg/24 hour
Etiocholanolone: 133-23,272 mcg/24 hour
Dehydroepiandrosterone: <5-81,554 mcg/24 hour
16a-OH-Dehydroepiandrosterone: 13-29,945 mcg/24 hour
5-Pregnenetriol: 23-7,328 mcg/24 hour
5-Pregnenediol: 13-2,823 mcg/24 hour
Tetrahydro-11-Corticosterone: 8-1,961 mcg/24 hour
Tetrahydro-11-Deoxycorticosterone: <5-316 mcg/24 hour
Pregnanediol: 12-3,812 mcg/24 hour
17a-OH-Pregnanolone: 15-2,466 mcg/24 hour
Pregnanetriol: 66-9,409 mcg/24 hour
Pregnanetriolone: <5-550 mcg/24 hour
Tetrahydrodeoxycortisol: 7-1520 mcg/24 hour
Cortisol: <5-903 mcg/24 hour
6B-OH-Cortisol: 13-2,303 mcg/24 hour
Tetrahydrocortisol: 152-22,723 mcg/24 hour
5a-Tetrahydrocortisol: 157-24,059 mcg/24 hour
B-Cortol: 30-5,115 mcg/24 hour
11B-OH-Androsterone: 108-11,987 mcg/24 hour
11B-OH-Etiocholanolone: 22-8,312 mcg/24 hour
Cortisone: 12-842 mcg/24 hour
Tetrahydrocortisone: 271-44,355 mcg/24 hour
a-Cortolone: 140-14,885 mcg/24 hour
B-Cortolone: 72-9,740 mcg/24 hour
11-Oxoetiocholanolone: 70-8,446 mcg/24 hour
Males > or =50 years:
Androsterone: 118-25,389 mcg/24 hour
Etiocholanolone: 127-15,640 mcg/24 hour
Dehydroepiandrosterone: 7-4,260 mcg/24 hour
16a-OH-Dehydroepiandrosterone: 11-6,183 mcg/24 hour
5-Pregnenetriol: 24-2,162 mcg/24 hour
5-Pregnenediol: 17-1,296 mcg/24 hour
Tetrahydro-11-Corticosterone: 16-1,674 mcg/24 hour
Tetrahydro-11-Deoxycorticosterone: <5-297 mcg/24 hour
Pregnanediol: 23-1,846 mcg/24 hour
17a-OH-Pregnanolone: 18-1,747 mcg/24 hour
Pregnanetriol: 115-5,432 mcg/24 hour
Pregnanetriolone: 5-221 mcg/24 hour
Tetrahydrodeoxycortisol: 12-1,277 mcg/24 hour
Cortisol: 12-597 mcg/24 hour
6B-OH-Cortisol: 22-2,406 mcg/24 hour
Tetrahydrocortisol: 331-19,009 mcg/24 hour
5a-Tetrahydrocortisol: 155-35,266 mcg/24 hour
B-Cortol: 56-3,541 mcg/24 hour
11B-OH-Androsterone: 142-13,135 mcg/24 hour
11B-OH-Etiocholanolone: 69-6,805 mcg/24 hour
Cortisone: 24-732 mcg/24 hour
Tetrahydrocortisone: 454-34,576 mcg/24 hour
a-Cortolone: 211-17,591 mcg/24 hour
B-Cortolone: 114-8,434 mcg/24 hour
11-Oxoetiocholanolone: 155-7,174 mcg/24 hour
Females 18-49 years:
Androsterone: 90-29,625 mcg/24 hour
Etiocholanolone: 127-24,568 mcg/24 hour
Dehydroepiandrosterone: <5-12,317 mcg/24 hour
16a-OH-Dehydroepiandrosterone: 5-31,248 mcg/24 hour
5-Pregnenetriol: 17-4,166 mcg/24 hour
5-Pregnenediol: 6-2,900 mcg/24 hour
Tetrahydro-11-Corticosterone: 13-1,548 mcg/24 hour
Tetrahydro-11-Deoxycorticosterone: <5-833 mcg/24 hour
Pregnanediol: 8-44,760 mcg/24 hour
17a-OH-Pregnanolone: 7-3,208 mcg/24 hour
Pregnanetriol: 50-9,768 mcg/24 hour
Pregnanetriolone: <5-139 mcg/24 hour
Tetrahydrodeoxycortisol: 7-1,047 mcg/24 hour
Cortisol: 11-642 mcg/24 hour
6B-OH-Cortisol: 22-2,061 mcg/24 hour
Tetrahydrocortisol: 185-16,515 mcg/24 hour
5a-Tetrahydrocortisol: 45-22,591 mcg/24 hour
B-Cortol: 28-4260 mcg/24 hour
11B-OH-Androsterone: 59-12,462 mcg/24 hour
11B-OH-Etiocholanolone: 32-6,354 mcg/24 hour
Cortisone: 19-749 mcg/24 hour
Tetrahydrocortisone: 262-32,461 mcg/24 hour
a-Cortolone: 207-13,931 mcg/24 hour
B-Cortolone: 63-7,489 mcg/24 hour
11-Oxoetiocholanolone: 63-7,449 mcg/24 hour
Females > or =50 years:
Androsterone: 32-10,134 mcg/24 hour
Etiocholanolone: 52-10,946 mcg/24 hour
Dehydroepiandrosterone: <5-10,046 mcg/24 hour
16a-OH-Dehydroepiandrosterone: <5-9,982 mcg/24 hour
5-Pregnenetriol: 10-1,901 mcg/24 hour
5-Pregnenediol: <5-2,732 mcg/24 hour
Tetrahydro-11-Corticosterone: 14-1,229 mcg/24 hour
Tetrahydro-11-Deoxycorticosterone: <5-123 mcg/24 hour
Pregnanediol: 8-2,138 mcg/24 hour
17a-OH-Pregnanolone: <5-571 mcg/24 hour
Pregnanetriol: 26-3,444 mcg/24 hour
Pregnanetriolone: <5-348 mcg/24 hour
Tetrahydrodeoxycortisol: 8-801 mcg/24 hour
Cortisol: 9-336 mcg/24 hour
6B-OH-Cortisol: 25-1,365 mcg/24 hour
Tetrahydrocortisol: 237-14,050 mcg/24 hour
5a-Tetrahydrocortisol: 92-12,604 mcg/24 hour
B-Cortol: 29-3289 mcg/24 hour
11B-OH-Androsterone: 86-9,280 mcg/24 hour
11B-OH-Etiocholanolone: 40-7,002 mcg/24 hour
Cortisone: 15-555 mcg/24 hour
Tetrahydrocortisone: 359-24,320 mcg/24 hour
a-Cortolone: 125-17,472 mcg/24 hour
B-Cortolone: 82-5,784 mcg/24 hour
11-Oxoetiocholanolone: 78-6,571 mcg/24 hour
Reference values have not been established for patients who are younger than 18 years of age.
Test provides clinical risk values based on clinical data alone as well as integrated risk values based on clinical data in combination with biochemical steroid data. Reported risk values correspond to the probability of a malignant adrenal cortical carcinoma (ACC) or other malignancy (eg, sarcoma, lymphoma) as well as the probability of a benign mass (eg, adenoma, myelolipoma, cyst).
Test results provide the referring physician with probabilities for a variety of outcomes, thereby aiding the interpretation of clinical status and optimal paths for further investigation, if any, based on an informed discussion between provider and patient. Test results should always be interpreted in conjunction with all other clinical findings as they cannot be interpreted as absolute evidence for the presence or absence of malignant disease.
For more information, see Adrenal Mass Panel Clinical Data Definition of Malignancy Predictors.
Test not offered for pediatric patients. Risk assessments are based off of adult populations.
Test results cannot be interpreted as absolute evidence for the presence or absence of malignant disease. This test should not form the sole basis for a diagnosis or treatment decision as results must be interpreted within the clinical context of the patient and should always be used in conjunction with clinical findings.
This test may be difficult to interpret in pregnant women and in patients with severe impairment of liver or kidney function.
Risk assignments for other malignancy may not be as accurate as risk assignment for adrenal cortical carcinoma (ACC) or adrenal cortical adenoma (ACA).
1. Arlt W, Biehl M, Taylor AE, et al: Urine steroid metabolomics as a biomarker tool for detecting malignancy in adrenal tumors. J Clin Endocrinol Metab. 2011 Dec;96(12):3775-3784. doi: 10.1210/jc.2011-1565
2. Hines JM, Bancos I, Bancos C, et al: High-resolution, accurate-mass (HRAM) mass spectrometry urine steroid profiling in the diagnosis of adrenal disorders. Clin Chem. 2017 Dec;63(12):1824-1835. doi: 10.1373/clinchem.2017.271106
3. Bancos I, Arlt W: Diagnosis of a malignant adrenal mass: the role of urinary steroid metabolite profiling. Curr Opin Endocrinol Diabetes Obes. 2017 Jun;24(3):200-207. doi: 10.1097/MED.0000000000000333
4. Fassnacht M, Arlt W, Bancos I, et al: Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol. 2016 Aug;175(2):G1-G34. doi: 10.1530/EJE-16-0467
Steroids and their metabolites are extracted and analyzed with internal standard for detection by liquid chromatography-tandem mass spectrometry, high-resolution accurate mass.(Unpublished Mayo method)
Clinical predictors and steroid data are algorithmically integrated to give a likelihood of adrenal cortical carcinoma, other malignancy, or benign mass.
Monday
This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.
0015M
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
ACC | Adrenal Mass Panel, 24 Hr, U | 95556-7 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
AC1AG | Age at Diagnosis | 63932-8 |
AC2GD | Gender | 76691-5 |
AC3MD | Mode of Discovery | 95557-5 |
AC4TZ | Tumor Diameter (mm) | 21889-1 |
AC5HX | Unenhanced CT (Hounsfield Units) | 95558-3 |
AC6HM | Hormonal Excess | 95559-1 |
TM66 | Collection Duration | 13362-9 |
VL66 | Urine Volume | 3167-4 |
607276 | ACC - Clinical Risk | 95787-8 |
607277 | Other Malignancy - Clinical Risk | 95788-6 |
607278 | Benign Mass - Clinical Risk | 95789-4 |
607279 | ACC - Integrated Risk | 95790-2 |
607280 | Other Malignancy - Integrated Risk | 95791-0 |
607281 | Benign Mass - Integrated Risk | 95792-8 |
607333 | Comment | 77202-0 |
607283 | Androsterone | 6705-8 |
607284 | Androsterone Z-score | 95560-9 |
607285 | Etiocholanolone | 2268-1 |
607286 | Etiocholanolone Z-score | 95561-7 |
607287 | Dehydroepiandrosterone | 13612-7 |
607288 | Dehydroepiandrosterone Z-score | 95562-5 |
607289 | 16a-OH-Dehydroepiandrosterone | 95563-3 |
607290 | 16a-OH-DHEA Z-score | 95564-1 |
607291 | 5-Pregnenetriol | 95565-8 |
607292 | 5-Pregnenetriol Z-score | 95566-6 |
607293 | 5-Pregnenediol | 95567-4 |
607294 | 5-Pregnenediol Z-score | 95568-2 |
607295 | Tetrahydro-11-Corticosterone | 95569-0 |
607296 | TH-11-Corticosterone Z-score | 95570-8 |
607297 | Tetrahydro-11-Deoxycorticosterone | 95571-6 |
607298 | TH-11-Deoxycorticosterone Z-score | 95572-4 |
607299 | Pregnanediol | 2834-0 |
607300 | Pregnanediol Z-score | 95573-2 |
607301 | 17a-OH-Pregnanolone | 95574-0 |
607302 | 17a-OH-Pregnanolone Z-score | 95575-7 |
607303 | Pregnanetriol | 2836-5 |
607304 | Pregnanetriol Z-score | 95576-5 |
607305 | Pregnanetriolone | 50643-6 |
607306 | Pregnanetriolone Z-score | 95577-3 |
607307 | Tetrahydrodeoxycortisol | 2996-7 |
607308 | Tetrahydrodeoxycortisol Z-score | 95578-1 |
607309 | Cortisol | 14158-0 |
607310 | Cortisol Z-score | 95579-9 |
607311 | 6B-OH-Cortisol | 13611-9 |
607312 | 6B-OH-Cortisol Z-score | 95580-7 |
607313 | Tetrahydrocortisol | 2995-9 |
607314 | Tetrahydrocortisol Z-score | 95581-5 |
607315 | 5a-Tetrahydrocortisol | 21044-3 |
607316 | 5a-Tetrahydrocortisol Z-score | 95582-3 |
607317 | B-Cortol | 53634-2 |
607318 | B-Cortol Z-score | 95583-1 |
607319 | 11B-OH-Androsterone | 6701-7 |
607320 | 11B-OH-Androsterone Z-score | 95584-9 |
607321 | 11B-OH-Etiocholanolone | 6700-9 |
607322 | 11B-OH-Etiocholanolone Z-score | 95585-6 |
607323 | Cortisone | 14044-2 |
607324 | Cortisone Z-score | 95586-4 |
607325 | Tetrahydrocortisone | 16116-6 |
607326 | Tetrahydrocortisone Z-score | 95587-2 |
607327 | a-Cortolone | 55906-2 |
607328 | a-Cortolone Z-score | 95588-0 |
607329 | B-Cortolone | 95589-8 |
607330 | B-Cortolone Z-score | 95590-6 |
607331 | 11-Oxoetiocholanolone | 6703-3 |
607332 | 11-Oxoetiocholanolone Z-score | 95591-4 |
607282 | Interpretation | 73884-9 |