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Helsinki scoring system
| Parameter | Score |
|---|---|
| Mitoses > 5 per 50 higher-power fields (10 mm2) | 3 |
| Necrosis | 5 |
| Ki67 proliferation index (%)* | Numeric value of the Ki67 index from the highest proliferative area |
| Score 0 to 8.5: adrenal cortical adenoma | |
| Score > 8.5: adrenal cortical carcinoma | |
| Score > 17: adverse prognosis |
*The original study used an automated image analysis for the assessment of the Ki67 proliferation index
