{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T16:05:58Z","timestamp":1784131558999,"version":"3.55.0"},"reference-count":8,"publisher":"Bioscientifica","issue":"7","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This Perspective comments on a recent national cohort study of ectopic ACTH syndrome that identified late-night salivary cortisol (LNSC) \u2265 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\u2013tandem 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\u2019 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.<\/jats:p>","DOI":"10.1530\/ec-26-0399","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T14:43:40Z","timestamp":1782744220000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-10","source":"Crossref","is-referenced-by-count":0,"title":["Interpreting salivary cortisol thresholds in ectopic ACTH syndrome"],"prefix":"10.1530","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1860-7965","authenticated-orcid":true,"given":"Omer Denizhan","family":"Tatar","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, Necmettin Erbakan University Faculty of Medicine 1 , ,","place":["Konya, 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