Beuschlein Felix
Medizinische Klinik, Innenstadt, Ludwig Maximilian University, Munich, Germany.
Horm Res. 2007;68 Suppl 5:191-4. doi: 10.1159/000110623. Epub 2007 Dec 10.
Through the widespread use of imaging techniques with great sensitivity, adrenal tumours are often diagnosed as an incidental finding. The majority of these adrenal lesions are benign and without evidence of endocrine activity or malignancy. However, in addition to the classic forms of overt adrenal hypersecretion, it has become evident in recent years that even modest adrenal hormonal autonomy, as exhibited in clinically silent phaeochromocytoma, normokalaemic primary aldosteronism and subclinical Cushing syndrome, is associated with significant morbidity. Thus, hormone hypersecretion and growth kinetics must be ruled out for each patient using specific tests to avoid associated morbidity.
Detection and differential diagnosis of subtle changes in adrenal hormone secretion can pose a diagnostic challenge to the clinician, and accurate diagnosis is dependent on use of tests with reliable sensitivity and specificity.
随着高灵敏度成像技术的广泛应用，肾上腺肿瘤常作为偶然发现被诊断出来。这些肾上腺病变大多是良性的，没有内分泌活性或恶性肿瘤的证据。然而，除了明显的肾上腺功能亢进的经典形式外，近年来已明显看出，即使是临床上无症状的嗜铬细胞瘤、正常血钾性原发性醛固酮增多症和亚临床库欣综合征所表现出的适度肾上腺激素自主性，也与显著的发病率相关。因此，必须对每位患者使用特定检测排除激素分泌过多和生长动力学情况，以避免相关发病率。
肾上腺激素分泌细微变化的检测和鉴别诊断可能给临床医生带来诊断挑战，准确诊断依赖于使用具有可靠灵敏度和特异性的检测方法。
