NOTCH1 and adrenal cortex carcinoma: In previous studies, Notch1 mutations were associated with the invasiveness of LGACC.[11] In previous studies, overexpression of Notch1 has shown significant reductions in overall survival and relapse-free survival in cancer patients.[12,13] Shahzan Anjum et al[13] investigated the relationship between Notch receptor expression and tumor aggressiveness in lacrimal ACC, and patients with Notch1 overexpression showed a greater likelihood of neuroaggression and a lower disease-free survival rate.