ArticleEndocrine connections2026
Interpreting salivary cortisol thresholds in ectopic ACTH syndrome.
Article in Endocrine connections, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
This Perspective comments on a recent national cohort study of ectopic ACTH syndrome that identified late-night salivary cortisol (LNSC) ≥ 130 nmol/L as an independent predictor of mortality. The finding is clinically important because it supports the prognostic relevance of biochemical severity. However, its numerical interpretation should remain method-specific. LNSC is sensitive to sampling conditions and analytical platform, and absolute values are not necessarily interchangeable across immunoassays or between immunoassays and liquid chromatography-tandem mass spectrometry. In addition, dichotomizing a continuous biomarker can reduce information and overstate apparent separation at a data-derived cut point. Building on the original authors' own assay caveat, the threshold is best viewed as a Roche ECLIA-context signal of severe hypercortisolism, pending prospective multicenter validation using continuous biomarker modeling, assay harmonization, and subgroup analyses by tumor context and treatment era.
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