液相色谱-串联质谱在肾上腺偶发瘤临床诊疗中的应用

Application of liquid chromatography-tandem mass spectrometry in the clinical diagnosis and treatment of adrenal incidentaloma

随着检验技术的不断发展,肾上腺偶发瘤(AI)的诊出率不断提升。在临床诊疗中,基于液相色谱-串联质谱技术进行相关激素检测可评估该类患者的肿瘤有无内分泌功能。液相色谱-串联质谱技术具备高灵敏度、高特异性、多组分的优势,已成为检测小分子激素的金标准方法。质谱技术在糖皮质激素、盐皮质激素、性激素及儿茶酚胺代谢产物中的检测具有优势。LC-MS/MS在临床实践中尚存在部分不足,具体表现为自动化程度低、标准化缺乏等。在完善LC-MS/MS临床应用和参考范围建立的工作后,临床对AI内分泌功能的判断必将更加规范。

With the development of diagnostic techniques,the diagnosis rate of adrenal incidental tumors is increasing.Disease related hormones can be detected to evaluate the endocrine function of tumors for diagnosis and treatment,especially by liquid chromatography-tandem mass spectrometry(LC-MS/MS).LC-MS/MS has the advantages of high sensitivity,specificity and multi-component,and has become the gold standard method for the detection of small molecule hormones.Mass spectrometry has advantages in the detection of glucocorticoids,halo corticoids,sex hormones and catecholamine metabolites.LC-MS/MS still has some limitations in clinical practice,which are manifested as low degree of automation and lack of standardization.After the improvement of the clinical application of LC-MS/MS and the establishment of reference scope,the clinical judgment on the endocrine function of AI will be more standardized.