Departments of Medicine (Endocrinology and Molecular Medicine), Surgery, and Physiology, Medical College of Wisconsin, 53226, Milwaukee, WI, USA.
Endocrine Research Laboratory, Aurora St. Luke's Medical Center, Advocate Aurora Research Institute, 53215, Milwaukee, WI, USA.
Pituitary. 2022 Oct;25(5):698-700. doi: 10.1007/s11102-022-01214-2. Epub 2022 Mar 25.
Late night salivary cortisol (LNSC) is a mainstay in the diagnosis of neoplastic hypercortisolism (Cushing's syndrome) with a sensitivity and specificity of > 90% in patients with syndromic signs and symptoms. Intermittent hormonogenesis (day to day variation) is common in milder Cushing's disease whereas true cyclic Cushing's syndrome (weeks to months of tumor quiescence) is unusual. In both cases, LNSC is useful as a sensitive evaluative diagnostic tool, although its lower specificity may lead to false positive results in patients without Cushing's disease. Furthermore, intermittent hormonogenesis may lead to false negative LNSC results in patients with mild Cushing's disease. Finally, LNSC is useful as an approach to follow patients after pituitary surgery to detect a recurrence even many years after a full remission.
深夜唾液皮质醇（LNSC）是诊断肿瘤性高皮质醇症（库欣综合征）的主要手段，对于有综合征体征和症状的患者，其敏感性和特异性均>90%。在较轻的库欣病中，间歇性激素生成（每天的变化）很常见，而真正的周期性库欣综合征（数周至数月的肿瘤静止期）则不常见。在这两种情况下，LNSC 作为一种敏感的评估诊断工具都很有用，尽管其特异性较低可能导致无库欣病患者出现假阳性结果。此外，间歇性激素生成可能导致轻度库欣病患者的 LNSC 结果出现假阴性。最后，LNSC 可用于在垂体手术后随访患者，以检测多年后完全缓解后的复发，即使在完全缓解后多年也很有用。
