Immune checkpoint-related genes, including CD274(PD-L1), CTLA4, HAVCR2, LAG3, PDCD-1(PD-1), PDCD1LG2(PD-L2), TIGIT, and SIGLEC15(CD33L3) were investigated to show that no significant difference was found between ACC with ESM1high and ESM1low (Figure 8C). This evidence concerns the gene CD274 and adrenal cortex carcinoma.