Clinical laboratory最新文献

Background: Uncontrolled systemic inflammatory responses significantly contribute to the pathogenesis of severe community-acquired pneumonia (CAP) following SARS-CoV-2 infection (CASP). Elderly populations, being particularly vulnerable to respiratory infections, demonstrate both increased susceptibility to SARS-CoV-2 infection and greater disease severity. This study aimed to identify readily available routine hematological biomarkers that could serve as independent risk factors for predicting severe CASP (sCASP) in elderly patients.

Methods: A retrospective study was conducted to analyze 77 elderly people with CASP. According to the severity of the disease, the elderly people were divided into a non-sCASP group and a sCASP group, and the routine comprehensive laboratory examinations were compared.

Results: A total of 77 elderly patients with CASP were enrolled in this study, comprising 35 cases in the non-sCASP group and 42 cases in the sCASP group. Significant differences were observed in admission laboratory parameters, including routine blood counts, coagulation profiles, liver and kidney function tests, inflammatory markers, and composite laboratory-derived indices, between non-sCASP and sCASP cases infected with SARS-CoV-2 Omicron subvariants BA.5.2 and BF.7 (p < 0.05). Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses identified lactate > 1.95 mmol/L, D-dimer > 0.85 mg/L, and IL-6 > 33.5 pg/mL as the most probable independent risk factors for sCASP in elderly patients. Notably, the combined diagnostic model (lactate-D-dimer-IL-6) demonstrated superior predictive performance for disease severity (AUC = 0.981; 95% CI: 0.954 - 1) compared to any single biomarker alone.

Conclusions: Elevated admission lactate, D-dimer, and IL-6 can be used as independent risk factors for the evaluation of CASP severity in elderly people, and the joint detection might be a better choice. This is imperative for guiding the development of effective interventions to alleviate severe patients' symptoms and burden.

Background: The aim is to investigate the origin of a rare fetal double partial trisomy 6 and 9 using CMA and guide reproductive counseling.

Methods: Parental karyotyping and fetal chromosomal microarray analysis (CMA) were performed to analyze chromosomal abnormalities. A literature review was conducted for similar cases.

Results: Parental karyotyping revealed a maternal balanced translocation, 46,XX,t(6;9)(p25;q21.1), while the fetus had 47,X?,+der(9)t(6;9)(p25;q21.1)dmat, indicating duplication 6pter→p25 and 9pter→q21.1. CMA confirmed both fragments as pathogenic copy number variations (pCNVs). This represents the first reported case of concurrent partial trisomy 6 and 9.

Conclusions: The aberration likely resulted from 3:1 meiotic segregation. CMA enhances detection of chromosomal abnormalities and their origins. Prenatal invasive testing remains crucial for translocation carriers.

Background: This study documents a rare case of lymphocytic variant hypereosinophilic syndrome (L-HES) [1], progressing to fatal hemophagocytic lymphohistiocytosis (HLH).

Methods: A 70-year-old female with eosinophilia (85.6%) underwent cytokine profiling, flow cytometry, and bone marrow examination.

Results: A Th2-to-Th1 cytokine shift (IL-5↓/IFN-γ↑) preceded HLH onset. Despite therapy, the patient succumbed to refractory disease.

Conclusions: Cytokine monitoring may predict L-HES-to-HLH transformation, suggesting JAK inhibitors for high-risk cases.

Background: The challenge in the use of MALDI-TOF MS for detection of microorganisms in culture-positive blood bottles is sample preparation. This study aimed to evaluate the accuracy of an in-house blood culture pretreatment kit coupled with MALDI-TOF MS system for directly identifying pathogens.

Methods: A total of 114 blood samples were pre-enriched and identified using an in-house blood culture pretreatment kit and MALDI-TOF MS. The performance of the methods was compared to that of the conventional bacte-rial culture plus VITEK® 2 Compact.

Results: The kit showed high identification rates for both Gram-negative and Gram-positive bacteria, compared to that of conventional bacterial culture (p > 0.05). The identification rate of Gram-negative bacteria using the serum separator tube method was significantly higher than that of Gram-positive bacteria and yeasts (p < 0.05).

Conclusions: The kit can be used for the pretreatment of blood culture bottles, which can significantly shorten the identification and reporting times.

Background: During our daily routine in laboratory, we noticed that in patients with changes in white blood cell (WBC) count, which are accompanied by elevated levels of C-reactive protein (CRP), a decrease in the levels of iron is found, even though the hemoglobin concentration is within the reference range. We aimed to figure out if low levels of iron are related to infections and whether they are signs of anemia and aimed to evaluate the possible correlations between iron levels and WBC and CRP.

Methods: We performed a descriptive and retrospective study including 159 outpatients with signs of infections and with normal concentration of hemoglobin, from January 2023 through December 2024. We used Jamovi Statistical Software version 2.3.28. We used the Shapiro-Wilk test for normal distribution and F-test for variances. We tested differences with Mann-Whitney and ANOVA for non-parametric variables between two or more groups, respectively. We performed Pearson's correlations and did the linear regression analysis. A two-sided p-value equal to or less than 0.05 was considered statistically significant.

Results: The study included 70 women (44%) and 89 men (56%), with a median age of 27 years (1 - 91 years) and 32 years (1 - 91 years), respectively. Based on one-way ANOVA or Mann-Whitney test for independent samples, we found differences in iron levels between children, adults, and elderly (p < 0.001) and differences between nor-mal and elevated levels of WBC (p = 0.019). We also found correlations between iron and CRP (r = -0.255, p = 0.001), iron and WBC (r = -0.337, p < 0.001), and CRP and WBC (r = 0.189, p = 0.017). Based on regression anal-ysis, CRP and WBC can both serve as a predictor of serum iron levels, with a probability of 15.2%.

Conclusions: We conclude that there is a correlation between iron levels and CRP and WBC and that low levels of iron are related to settings of infections.

Background: Liver transplantation (LT) is often accompanied by large intraoperative transfusions of blood products and worsens the patient's prognosis. The aim of our study was to identify the predictors of intraoperative frozen plasma (FP) transfusion in LT. At the same time, the effect of intraoperative plasma transfusion on clinical outcomes was evaluated as well.

Methods: Our retrospective study included 114 adult patients undergoing LT between January 1, 2020 and November 30, 2021. Patient demographics, including age, gender, and weight, were acquired. Patients were classified into one of two cohorts, FP transfusion and no FP transfusion, according to intraoperative FP transfusion or not. We used non-parametric Mann-Whitney U test and chi-squared test to compare the differences between the two groups. Variables significantly associated with intraoperative FP transfusion were included in multivariate logistic analysis. The multivariate logistic analysis was used to analyze the independent risk factors of intraoperative FP transfusion.

Results: Preoperative Fg (OR = 2.441, CI: 1.169 - 5.096, p = 0.017) and packed red blood cell transfusion (OR = 0.595, CI: 0.447 - 0.791, p < 0.001) were found to be predictive of FP transfusion. Intraoperative FP transfusions were significantly associated with worse clinical outcomes of postoperative PLT count, Fg, inpatient days, and length of ICU stay. There were statistically significant differences between the FP transfusion group and the non-FP transfusion group.

Conclusions: Preoperative Fg and intraoperative packed red blood cell transfusion were predictive of intraoperative FP transfusion. Intraoperative FP transfusion can reduce postoperative platelet and fibrinogen, prolong the hospital stay of patients, and increase the length of ICU stay.

Background: Pancreatic neuroendocrine tumors (pNETs), rare neoplasms originating from pancreatic islet cells, have limited morphological descriptions in smears following bone marrow metastasis.

Methods: This study reports a rare case of pancreatic neuroendocrine tumor (pNET) with bone marrow metastasis, comprehensively evaluated through an integrated diagnostic approach encompassing clinical assessment, bone marrow aspiration with morphologic analysis, flow cytometry, cross-sectional imaging, and lymph node biopsy.

Results: Bone marrow smears revealed scattered blast-like cells with fine chromatin and granular cytoplasm, mimicking acute myeloid leukemia, but these cells were negative for myeloperoxidase. Flow cytometry identified CD45-/CD56+ cell population lacking hematopoietic markers. Imaging identified a pancreatic mass with wide-spread bone destruction, and lymph node biopsy confirmed metastatic pNET via positive staining for chromo-granin A and synaptophysin.

Conclusions: This case highlights the diagnostic challenges posed by pNET bone marrow involvement and emphasizes the importance of integrating morphology, immunophenotyping, and clinical data to avoid misdiagnosis and ensure timely, appropriate treatment.

Background: Thrombus formation and dissolution are important indicators for the diagnosis and prognosis of various diseases. D-dimer and fibrin degradation product (FDP) are key biomarkers reflecting this process. However, studies on the distribution and characteristics of these biomarkers by age and gender in Koreans are lacking. The aim of this study was to utilize test data from EONE Laboratories, a large contract research institute, from 2017 through 2023 to analyze the age- and gender-specific distribution of D-dimer and FDP levels, changes in testing demand during the COVID-19 pandemic, and correlation between the tests, thereby providing basic data for a diagnosis strategy for thrombosis.

Methods: Data from EONE Laboratories collected between 2017 and 2023 were analyzed. After excluding individuals aged < 20 years, 11,483 adult cases with recorded gender and age were included. Microsoft Excel 2010, jamovi, and SPSS Statistics were used to compare testing trends by year, distribution by age and gender, and positive test rates.

Results: In total, 11,483 out of 169,921 D-dimer and FDP test results were analyzed. The number of annual inspections exhibited a significant pattern, with a considerable increase of 153.7% between 2018 and 2019. Women aged 30 - 39 years had higher levels of D-dimer and FDP; a decrease was observed in those in their 40s, and an increase was observed in older individuals, forming a U-shaped curve. For men, the test results showed a steady increase with age. A significant correlation was found between D-dimer and FDP test results (χ² = 3836.57, p < 0.001).

Conclusions: D-dimer and FDP test results in South Koreans varied by age and gender. The COVID-19 pandemic significantly increased testing demand. These findings offer useful insights for diagnosing and treating thrombotic diseases.

Background: The mean platelet volume to platelet count ratio (MPV/PC) is a potential non-invasive marker of liver fibrosis in chronic liver diseases.

Methods: A total of 232 patients with chronic hepatitis B (CHB), chronic hepatitis C (CHC), non-alcoholic liver cirrhosis (NALC), and alcoholic liver cirrhosis (ALC), along with 143 healthy controls, were analyzed. MPV and PC were measured within 2 hours using an ADVIA 2120 analyzer. ANOVA and ROC analyses evaluated group differences and diagnostic performance.

Results: MPV/PC was significantly elevated in NALC and ALC compared to CHB, CHC, and controls (p < 0.001). ROC analysis for cirrhosis showed 88.3% sensitivity and 94.4% specificity (AUC = 0.946).

Conclusions: MPV/PC is significantly increased in liver cirrhosis regardless of etiology, suggesting disrupted platelet homeostasis. It may serve as a sensitive, non-invasive marker for fibrosis. Further validation incorporating fibrosis biomarkers is recommended.

Background: This study aimed to explore differences between thromboelastography (TEG) and conventional coagulation tests (CCTs) in evaluating coagulation function and analyze the diagnostic value of each indicator from these two methods in thrombosis among patients with gastric cancer.

Methods: We included 150 patients with gastric cancer and divided them into thrombus and non-thrombus groups. We obtained TEG (R, K, α-angle, and MA) and CCT (PT, APTT, Fib, D-D, and PLT) indicators and analyzed the ROC curve to determine the diagnostic value of each indicator in the occurrence of thrombosis.

Results: Compared with the control group, the gastric cancer group had decreased R and K and increased α-angle and MA. PT, FIB, D-D, and PLT in CCTs increased, while APTT slightly decreased, with statistically significant differences. The ROC results showed that R, K, α-angle, MA, PT, FIB, and D-D are closely related to the occurrence of thrombosis. The area under the curve for combined detection was 0.952 (95% CI: 0.913 - 0.990).

Conclusions: Both TEG and CCTs are of diagnostic value for venous thrombosis in patients with gastric cancer. These two methods should be used together for a better prediction of thrombosis in patients with gastric cancer.