In addition, the mRNA expression of immune checkpoint-related genes, including CD274(PD-L1), CTLA4, HAVCR2, LAG3, PDCD-1(PD-1), PDCD1LG2(PD-L2), TIGIT, and SIGLEC15(CD33L3), were not different in ACC samples of the ESM1high group and ESM1low group. Here, CTLA4 is linked to adrenal cortex carcinoma.