[1]杜琴 赵蓓蓓 高玉婷 李冰玲 蔡国杰 蔡珂 李延兵 廖志红.串联质谱法检测尿皮质醇和唾液皮质醇在库欣综合征诊断中的研究进展[J].国际内分泌代谢杂志,2020,40(01):39-44.[doi:10.3760/cma.j.issn.1673-4157.2020.01.009]
　Du Qin,Zhao Peipei,Gao Yuting,et al.Research progress in the detection of urinary cortisol and salivary cortisol by tandem mass spectrometry in the diagnosis of Cushing's syndrome[J].International Journal of Endocrinology and Metabolism,2020,40(01):39-44.[doi:10.3760/cma.j.issn.1673-4157.2020.01.009]
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串联质谱法检测尿皮质醇和唾液皮质醇在库欣综合征诊断中的研究进展()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
40
期数:
2020年01期
页码:
39-44
栏目:
综述
出版日期:
2020-01-20

文章信息/Info

Title:
Research progress in the detection of urinary cortisol and salivary cortisol by tandem mass spectrometry in the diagnosis of Cushing's syndrome
作者:
杜琴1 赵蓓蓓2 高玉婷1 李冰玲2 蔡国杰2 蔡珂1 李延兵1 廖志红1
1中山大学附属第一医院内分泌科,广州 510000; 2广州金域医学检验中心有限公司 510000
Author(s):
Du Qin1;  Zhao Peipei2;  Gao Yuting1;  Li Bingling2;  Cai Guojie2;  Cai Ke1;  Li Yanbing1;  Liao Zhihong1
1Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510000, China; 2Guangzhou Kingmed Diagnostics Group Co.Ltd, Guangzhou 510000, China
关键词:
库欣综合征;  液相色谱-串联质谱法;  尿皮质醇;  唾液皮质醇;  诊断切点
Keywords:
Cushing's syndrome;  Liquid chromatography-tandem mass spectrometry;  Urinary cortisol;  Salivary cortisol;  Diagnostic cut-off values
DOI:
10.3760/cma.j.issn.1673-4157.2020.01.009
摘要:
尿游离皮质醇(UFC)和午夜唾液皮质醇(MSC)检测是诊断库欣综合征(CS)及其疗效监测的重要指标。串联质谱法检测类固醇激素的敏感性和特异性好,在国内外的应用越来越多。了解液相串联质谱法(LC-MS/MS)的优势和存在的问题,对CS的诊断具有重要意义。查阅相关文献,几个著名实验室用LC-MS/MS检测了UFC和MSC在健康人中的测定范围。近年来一些国内外文献也报道了LC-MS/MS检测UFC和MSC诊断CS的切点值,认为LC-MS/MS检测UFC诊断CS的切点为170 nmol/24 h。未来串联质谱法对糖皮质激素代谢组学的检测,有望对代谢综合征或CS的个性化诊断和治疗评估提供更全面、更有预测价值的信息。
Abstract:
Urinary free cortisol(UFC)and mid-night salivary cortisol(MSC)are important indicators for the diagnosis of Cushing's syndrome(CS)and its efficacy monitoring. The measurement of steroid hormones by tandem mass spectrometry becomes more and more common nowadays worldwide because of its good sensitivity and specificity. Understanding the advantages and disadvantages of liquid chromatography-tandem mass spectrometry(LC-MS/MS)is of great significance for the diagnosis of CS. According to relevant literatures, LC-MS/MS was used by several famous laboratories to detect the range of UFC and MSC in healthy people. In recent years, some literatures have also reported the cut-off value of UFC and MSC detected by LC-MS/MS for the diagnosis of CS. It is generally believed that the cut-off value of UFC detected by LC-MS/MS is 170 nmol/24 h. In future, the determination of glucocorticoid metabolomics by tandem mass spectrometry is expected to provide more comprehensive and predictive information for the individualized diagnosis and treatment evaluation of metabolic syndrome or CS.

参考文献/References:

[1] 张炜,汤正义,王卫庆,等.肾上腺意外瘤中的亚临床库欣综合征[J].中华内分泌代谢杂志,2005,21(5):420-422.DOI:10.3760/j.issn.1000-6699.2005.05.008.
[2] 李乐乐,窦京涛.如何从肾上腺意外瘤中甄选出亚临床库欣综合征[J]. 中国实用内科杂志,2017,37(10):867-870.DOI:10.19538/j.nk2017100102.
[3] Nieman LK,Biller BM,Findling JW,et al.Treatment of Cushing's syndrome:an Endocrine Society clinical practice guideline[J].J Clin Endocrinol Metab,2015,100(8):2807-2831.DOI:10.1210/jc.2015-1818.
[4] Ben-Shlomo A,Cooper O.Silent corticotroph adenomas[J].Pituitary,2018,21(2):183-193.DOI:10.1007/s11102-018-0864-8.
[5] Inder WJ.Towards a universally accepted definition of subclinical Cushing's syndrome-subclinical autonomous hypercortisolism[J].Clin Endocrinol(Oxf),2017,86(1):7-9.DOI:10.1111/cen.13244.
[6] Turpeinen U,Hämäläinen E. Determination of cortisol in serum, saliva and urine[J].Best Pract Res Clin Endocrinol Metab,2013,27(6):795-801.DOI:10.1016/j.beem.2013.10.008.
[7] El-Farhan N,Rees DA,Evans C.Measuring cortisol in serum, urine and saliva-are our assays good enough [J].Ann Clin Biochem,2017,54(3):308-322. DOI:10.1177/0004563216687335.
[8] Terzolo M,Stigliano A,Chiodini I,et al.AME position statement on adrenal incidentaloma[J].Eur J Endocrinol,2011,164(6):851-870.DOI:10.1530/EJE-10-1147.
[9] Zeiger MA,Thompson GB,Duh QY,et al.The American Association of Clinical Endocrinologists and American Association of Endocrine surgeons medical guidelines for the management of adrenal incidentalomas[J].Endocr Pract,2009(Suppl 1):1-20.DOI:10.4158/EP.15.S1.1.
[10] Tabarin A,Bardet S,Bertherat J,et al.Exploration and management of adrenal incidentalomas. French Society of Endocrinology Consensus[J].Ann Endocrinol(Paris),2008,69(6):487-500.DOI:10.1016/j.ando.2008.09.003.
[11] Fassnacht M,Arlt W,Bancos I,et al.Management of adrenal incidentalomas:European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors[J].Eur J Endocrinol,2016,175(2):G1-G34.DOI:10.1530/EJE-16-0467.
[12] Carrasco CA,Coste J,Guignat L,et al.Midnight salivary cortisol determination for assessing the outcome of transsphenoidal surgery in Cushing's disease[J].J Clin Endocrinol Metab,2008,93(12):4728-4734.DOI:10.1210/jc.2008-1171.
[13] 徐克前,主编.临床生物化学检验(精)[M].北京:人民卫生出版社, 2014:47-86.
[14] Sheriff N,McCormack AI.How useful is urinary-free cortisol in the clinic?[J].Biomark Med,2017,11(11):1009-1016.DOI:10.2217/bmm-2016-0311.
[15] Ceccato F,Boscaro M.Cushing's syndrome:screening and diagnosis[J].High Blood Press Cardiovasc Prev,2016,23(3):209-215.DOI:10.1007/s40292-016-0153-4.
[16] Aranda G,Careaga M,Hanzu FA,et al. Accuracy of immunoassay and mass spectrometry urinary free cortisol in the diagnosis of Cushing's syndrome[J].Pituitary,2016,19(5):496-502.DOI:10.1007/s11102-016-0730-5.
[17] Raff H. Update on late-night salivary cortisol for the diagnosis of Cushing's syndrome:methodological considerations[J].Endocrine,2013,44(2):346-349.DOI:10.1007/s12020-013-0013-0.
[18] Baid SK,Sinaii N,Wade M,et al. Radioimmunoassay and tandem mass spectrometry measurement of bedtime salivary cortisollevels: a comparison of assays to establish hypercortisolism[J].J Clin Endocrinol Metab,2007,92(8):3102-3107.
[19] Nieman LK,Biller BM,Findling JW,et al. The diagnosis of Cushing's syndrome:an Endocrine Society clinical practice guideline[J].J Clin Endocrinol Metab,2008,93(5):1526-1540.DOI:10.1210/jc.2008-0125.
[20] Oβwald A,Wang R,Beuschlein F,et al.Performance of LC-MS/MS and immunoassay based 24-h urine free cortisol in the diagnosis of Cushing's syndrome[J].J Steroid Biochem Mol Biol,2019,190:193-197.DOI:10.1016/j.jsbmb.2019.04.004.
[21] Ceccato F,Marcelli G,Martino M,et al.The diagnostic accuracy of increased late night salivary cortisol for Cushing's syndrome: a real-life prospective study[J].J Endocrinol Invest,2019,42(3):327-335.DOI:10.1007/s40618-018-0921-1.
[22] Yilmaz N,Tazegul G,Bozoglan H,et al.Diagnostic value of the late-night salivary cortisol in the diagnosis of clinical and subclinical Cushing's syndrome: results of a single-center 7-year experience[J].J Investig Med,2019,67(1):28-33. DOI:10.1136/jim-2018-000752.
[23] Mészáros K,Karvaly G,Márta Z,et al.Diagnostic performance of a newly developed salivary cortisol and cortisone measurement using an LC-MS/MS method with simple and rapid sample preparation[J].J Endocrinol Invest,2018,41(3):315-323.DOI:10.1007/s40618-017-0743-6.
[24] Ceccato F,Antonelli G,Frigo AC,et al.First-line screening tests for Cushing's syndrome in patients with adrenal incidentaloma: the role of urinary free cortisol measured by LC-MS/MS[J].J Endocrinol Invest,2017,40(7):753-760.DOI:10.1007/s40618-017-0644-8.
[25] 李乐乐,赵玲,窦京涛,等.尿游离皮质醇对肾上腺意外瘤中亚临床库欣综合征的诊断价值[J].中华医学杂志,2017,97(46):3632-3635.DOI:10.3760/cma.j.issn.0376-2491.2017.46.007.
[26] Lages A, Frade J, Paiva I, et al. Late-night salivary cortisol:cut-off definition and diagnostic value in Cushing's syndrome[C]. 19th European Congress of Endocrinology, Lisbon,2017.Lisbon,2017,49.
[27] Sturmer LR,Dodd D,Chao CS,et al.Clinical utility of an ultrasensitive late night salivary cortisol assay by tandem massspectrometry[J].Steroids,2018,129:35-40.DOI:10.1016/j.steroids.2017.11.014.
[28] Antonelli G,Ceccato F,Artusi C,et al.Salivary cortisol and cortisone by LC-MS/MS: validation, reference intervals and diagnostic accuracy in Cushing's syndrome[J].Clin Chim Acta,2015,451(Pt B):247-251. DOI:10.1016/j.cca.2015.10.004.
[29] Ceccato F,Barbot M,Zilio M,et al.Screening tests for Cushing's syndrome: urinary free cortisol role measured by LC-MS/MS[J].J Clin Endocrinol Metab,2015,100(10):3856-3861.DOI:10.1210/jc.2015-2507.
[30] Bukan AP,Dere HB,Jadhav SS,et al.The performance and reproducibility of late-night salivary cortisol estimation by enzymeimmunoassay for screening Cushing's disease[J].Endocr Pract,2015,21(2):158-164.DOI:10.4158/EP14186.OR.
[31] Ceccato F,Antonelli G,Barbot M,et al. The diagnostic performance of urinary free cortisol is better than the cortisol:cortisone ratio in detecting de novo Cushing's syndrome:the use of a LC-MS/MS method in routine clinicalpractice[J].Eur J Endocrinol,2014,171(1):1-7.DOI:10.1530/EJE-14-0061.
[32] Elias PC,Martinez EZ,Barone BF,et al. Late-night salivary cortisol has a better performance than urinary free cortisol in the diagnosis of Cushing's syndrome[J].J Clin Endocrinol Metab,2014,99(6):2045-2051.DOI:10.1210/jc.2013-4262.
[33] Loriaux DL.Diagnosis and differential diagnosis of Cushing's syndrome[J].N Engl J Med,2017,376(15):1451-1459.DOI:10.1056/NEJMra1505550.
[34] 中华医学会内分泌学分会.库欣综合征专家共识(2011年)[J].中华内分泌代谢杂志, 2012,28(2):96.DOI:10.3760/cma.j.issn.1000-6699.2012.02.002.

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备注/Memo

备注/Memo:
通信作者:廖志红,Email:liaozhh@mail.sysu.edu.cn
基金项目:广州市科技计划项目(201604020090)
Corresponding author: Liao Zhihong, Email:liaozhh@mail.sysu.edu.cn
Fund program:Guangzhou Science and Technology Program(201604020090)
更新日期/Last Update: 2020-01-20