促肾上腺皮质激素依赖性库欣病的非侵入性生化检测：我们还需要岩下窦采样吗？
Non-Invasive Biochemical Testing of ACTH-dependent Cushing's Disease: Do We Still Need Petrosal Sinus Sampling?
机构信息
Endocrinology Department, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Endocrinology Department, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
出版信息
Arch Med Res. 2023 Dec;54(8):102882. doi: 10.1016/j.arcmed.2023.102882. Epub 2023 Sep 23.
Differentiating between a pituitary from an ectopic source of ACTH could be a real one of the major challenges of clinical endocrinology. The Bilateral inferior petrosal sinus sampling (BIPSS) is considered the gold standard for identifying the source of ACTH; however, is not available worldwide. After the SARS-CoV-2 pandemic, algorithms that include biochemical and imaging tests have gained importance as an alternative to BIPSS. This review summarizes the drawbacks in the differential diagnosis of ACTH-dependent Cushing; the evolution of diagnostic tests, and the evidence that exists on their performance. As well as a comparison between the advantages and disadvantages of invasive and non-invasive tests.
鉴别 ACTH 来源于垂体还是异位，可能是临床内分泌学的一项重大挑战。双侧岩下窦取血（BIPSS）被认为是确定 ACTH 来源的金标准；但并非在全球范围内都可获得。在 SARS-CoV-2 大流行之后，包括生化和影像学检查在内的算法作为 BIPSS 的替代方法变得更为重要。本文综述了 ACTH 依赖性库欣综合征鉴别诊断中的缺陷、诊断检测方法的演变，以及关于其性能的证据。还比较了有创和无创检测的优缺点。
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