Since PD-1, PD-L1, CTLA-4, LAG-3, TIM3, and TIGIT had been approved as biomarkers for ICIs (24, 25), we analyzed the different expression level of them between the high-mRNAsi group and low-mRNAsi group, in which the expression of TIGHT, PD-L1, and CTLA4 decreased in the high-mRNAsi group (Figure 7D), indicating that ACC patients with low miRNAsi may benefit from the therapy of immune checkpoint inhibitors. This evidence concerns the gene CD274 and adrenal cortex carcinoma.