As one of the vital regulators in cell cycle, CDK1 was dramatically overexpressed, suggested a poor OS, and positively correlated with the expression of ESM1. Thus, we hypothesized that EMS1/DLL4-Notch signaling axis might regulate cell cycle by interacting with CDK1 and p21 in human ACC. This evidence concerns the gene CDK1 and adrenal cortex carcinoma.