Clinical laboratory最新文献

Background: This study aimed to establish reference intervals for two biomarkers actively utilized in routine annual medical check-ups in China: squamous cell carcinoma antigen (SCCA) and cytokeratin 19 fragment (CYRFA 21-1), and to understand the influence of age, gender, and benign nodule(s) on their levels.

Methods: This prospective multicenter cross-sectional study continuously enrolled apparently healthy adults attending annual medical check-ups at three sites in 2019. Serum SCCA and CYFRA 21-1 levels were measured using electrochemiluminescence immunoassays. Age- and gender-specific reference intervals for the two biomarkers were established by using the 0 - 95th percentiles with 90% confidence intervals (CIs). The 97.5th percentiles were also provided.

Results: A total of 1,017 subjects were enrolled in this study. Both biomarkers were significantly lower in females, and age was negatively associated with SCCA while positively associated with CYFRA 21-1 (all p < 0.0001). No statistically significant differences were determined between subgroups without/with benign nodule(s) despite nodule(s) status (all p > 0.05). The overall reference interval for SCCA is 0 - 2.64 ng/mL and 0 - 4.39 ng/mL for CYFRA 21-1. The age-specific reference intervals for SCCA are 0 - 2.76 ng/mL (18 - 49 years) and 0 - 2.22 ng/mL (≥ 50 years), and for CYFRA 21-1, they are 0 - 3.86 ng/mL (18 - 49 years) and 0 - 4.89 ng/mL (≥ 50 years). The gender-specific reference intervals for SCCA are 0 - 2.83 ng/mL (male) and 0 - 2.49 ng/mL (female), and for CYFRA 21-1, they are 0 - 4.34 ng/mL (male) and 0 - 4.45 ng/mL (female).

Conclusions: The reference intervals for SCCA and CYFRA 21-1 established in this study could be utilized in annual medical check-ups and contribute to the screening of lung cancer in China.

Background: CK-MB is a subtype of creatine kinase isoenzyme, mainly present in myocardial tissue. When myocardial tissue damage is severe, CK-MB is released into the blood, and the serum level significantly increases, which is an important indicator for diagnosing acute myocardial infarction.

Methods: We reported a case of pseudo-elevation of CK-MB without acute myocardial infarction.

Results: The immunosuppressive assay showed that the activity of CK-MB isoenzyme was 903.0 U/L, which was significantly increased. The patient underwent examinations such as cardiac ultrasound and coronary artery imaging, and no obvious abnormalities were found. Suspected interference, CK-MB was measured using mass immunoassay, and the result was 1.96 ng/mL, which is within the normal range.

Conclusions: When the CK-MB level (immunosuppressive assay) abnormally increases but clinical examination does not support the diagnosis of acute myocardial infarction, laboratory personnel should be aware of the short-comings of this method and use mass immunoassay to detect CK-MB to eliminate interference, and avoid unnecessary examinations and treatments for patients due to inaccurate results.

Background: Vitamin D is a fat-soluble vitamin found in two forms, sourced either from plants (D2) or animals (D3). Numerous epidemiological studies worldwide have highlighted its deficiency across diverse populations in various countries. When coupled with obesity, this deficiency becomes a significant global health concern. Our study aimed to evaluate the vitamin D levels among obese individuals in Southern Morocco.

Methods: This is a retrospective, cross-sectional descriptive study on the vitamin D status in obese subjects. This study was conducted at the "Health Universe" Diet Center in Agadir, Morocco. The measurement method involved using a Tanita® wall-mounted metal stadiometer to determine height and a Tanita® BC 418 MA segmental body composition analyzer to determine weight. The serum level of 25-hydroxyvitamin D was determined by elec-trochemiluminescence (ECLIA) using the Elecsys® and Cobas e411®.

Results: The sample of our study, consisting of 1,210 individuals, is composed of 73.5% (n = 889) females and 26.5% (n = 321) males. The mean age of the entire sample is 42.3 ± 13.1 years (ranging from 18 to 86 years). The mean BMI is 37 ± 5.69 kg/m², with a higher value in females (37.4 ± 5.85 kg/m²) compared to males (35.7 ± 5.03 kg/m²), including 42.8% moderate obesity, 34.2% severe obesity, and 23% morbid obesity. The mean serum vitamin D level in our sample is 15.7 ± 7.67 ng/mL. This level is 14.5 ± 7.42 ng/mL for females and 19.2 ± 7.31 ng/mL for males. However, only 5.3% of the subjects have an adequate serum vitamin D level, while 18% have an insufficiency, 52.5% have a moderate deficiency, and 24.2% have a severe deficiency. An inverse trend was noted for BMI, which shows a very significant inverse correlation with serum vitamin D concentration (r = -0.18 and p < 0.01).

Conclusions: Our results support the hypothesis that obesity is inversely associated with low vitamin D levels. Lifestyle improvement should be considered as the primary treatment option, aiming to enhance the dysmetabolic state associated with obesity and vitamin D deficiency.

Background: This study aimed to investigate the roles of cytokines and other laboratory parameters in determining the need for intensive care in COVID-19 patients.

Methods: This is a retrospective observational study. Demographic, clinical, and laboratory parameters of the patients were evaluated. Thirteen cytokines were measured along with baseline laboratory tests at admission and at 48-hour intervals: IL-1β, IFN-α, IFN-β, TNF-α, MCP-1, IL-6, IL -8, IL-10, IL-2p70, IL-17A, IL-18, IL-23, and IL-33.

Results: COVID-19 was confirmed by PCR in 116 hospitalized patients. The mean age was 55.3 ± 16.4 years. Seventy-four (63.8%) of the patients were male and 42 (36.2%) were female. Twenty-two (18.9%) patients (16 male, 6 female) were transferred to the intensive care unit. A significant increase in white blood cell (WBC), neutrophil (Neu) and lymphocyte (Lym) counts, Neu/Lym ratio (NLR), lactate dehydrogenase (LDH), INR (international normalized ratio), activated prothrombin time (aPTT), D-dimer (D-D), troponin (Trop), Pro-BNP (BNP), procalcitonin (PCT), ferritin (Fer), and alanine aminotransferase (ALT) values were observed in those requiring intensive care. A significant decrease was found in albumin (Alb) levels and Lym counts. Alb levels appeared to be protective against admission to intensive care. Except for IFN- α, IL-23, and IL-33, the baseline values of other cytokines were above the threshold values. MCP-1 and IL-6 were higher in patients requiring intensive care.

Conclusions: High NLR and LDH and low Alb levels, especially with an increase in MCP-1 and IL-6, were found to be the best predictors of a serious COVID-19 infection.

Background: Antibiotic exposure has been reported as a risk factor for the development of ulcerative colitis; however, the clinical results were controversial. Therefore, we performed a meta-analysis to evaluate the association of antibiotic exposure with the new onset of UC.

Methods: A comprehensive literature search for relevant studies published up to February 2024, exploring the association between antibiotic exposure and new-onset UC, was performed by using Medline and Embase, and the statistical analysis was conducted by using the Stata software.

Results: A total of 16 articles were included in the study, including 12 case-control studies and 4 cohort studies. The pooled analysis revealed that antibiotic exposure was associated with an increased risk of new-onset UC (summary OR = 1.28, 95% CI = 1.26 - 1.31). Subgroup analyses showed that both case-control studies and cohort studies have yielded consistent conclusions.

Conclusions: This meta-analysis suggests that antibiotic exposure is a risk factor for the development of UC. It is, therefore, necessary to avoid unnecessary and excessive use of antibiotics.

Background: Candida auris is an opportunistic pathogen that has become widespread in recent years and shows resistance to multiple drugs. The aim of our study was to determine the antifungal susceptibilities of C. auris isolates, to perform a dendrogram from the mass spectra of strains obtained from matrix-assisted laser desorption ionization-time of flight mass spectrometry in order to evaluate the proteomic similarities of the strains and determine the geographical clade of C. auris strains in this study by the help of Multiplex RT-PCR.

Methods: The samples yielded 58 C. auris isolates. MALDI TOF MS (BioMerieux, France) was used for identification of the isolates and Sensititre Yeast One (Thermoscientific) system was used for antifungal susceptibility testing. Dendrograms of strain's spectra were generated by using the RUO/Saramis (BioMerieux, France) database and evaluated through hierarchical clustering analysis. The selected nine strains were examined at the clade level by using Multiplex RT-PCR. Results The susceptibility profile of the strains revealed resistance to Fluconazole in 84% (MICs ≥ 32) and resistance to Amphotericin B in 60% (MIC ≥ 2). All strains were found to be sensitive to Anidulafungin and Micafungin. The dendrogram of the main spectra of C. auris isolates showed a similarity range of 35 - 100%. The nine strains studied were identified as clade 1 (South Asian).

Conclusions: It was determined that C. auris strains were members of geographical clade 1, and the Amphotericin B resistance was found to be higher than expected. This situation poses a threat to critically ill patients.

Background: Tuberculous pleurisy (TP) is one of the most common types of extrapulmonary tuberculosis, often secondary to tuberculosis (TB). Clinical and imaging manifestations of non-tuberculous mycobacterial pulmonary diseases (NTM-PD) are usually similar to those of tuberculosis. Because of their similarity and the high incidence of tuberculosis, non-tuberculous mycobacterial infections are often overlooked for a long time. Especially in people without immunodeficiency.

Methods: Mycobacterium tuberculosis (MTB) in pleural effusion was found by metagenomic next-generation sequencing (mNGS). During anti-tuberculosis treatment, mNGS of lung tissue by ultrasound-guided percutaneous lung puncture revealed that this patient had combined NTM-PD.

Results: Mycobacterium chelonae (M. chelonae) was detected by mNGS, and after anti-NTM treatment, the patient's chest CT showed that the inflammation was absorbed more than before, and the patient's symptoms improved.

Conclusions: When TB is poorly treated with standardized anti-tuberculosis therapy, comorbid non-tuberculous mycobacterial infections may be considered, and mNGS may complement traditional pathogenetic testing.

Background: Different detection platforms can lead to significant differences in the results of CA19-9. Here, a case of a 38-year-old male colon cancer patient who underwent CA19-9 testing on two platforms after surgery.

Methods: We first inspect the instrument to confirm its normal operation and good indoor quality control. Then, we conduct dilution experiments to eliminate interference from heterophilic antibodies, compare and analyze inherent differences with other platforms, and regularly follow up to dynamically monitor the patient's condition.

Results: During follow-up, the patient's CA19-9 levels rose consistently on both platforms, leading to tumor recurrence two years later, missing optimal treatment.

Conclusions: Dynamic monitoring of tumor markers should be based on a stable platform and combined with imaging examinations. For abnormal elevated results, humanistic care is needed to address the patient's fear and doubts about the test results.

Background: Lung cancer is the most lethal cancer in men and women. Recently, it has been reported that circu-lating tumor cells (CTCs) are sensitive and reliable biomarkers for tracing relapse and metastasis of cancer patients. Many studies also showed that immune cellular dysfunctions in lung cancer patients are major reasons for cancer development. In this study, we explored the clinical significance of CTCs and T lymphocyte subtypes in lung cancer patients.

Methods: A total of 92 patients with diagnosed lung cancer, including 23 squamous-cell carcinoma and 69 adenocarcinoma, were enrolled in this study. Another 10 patients with non-carcinoma nodules in their lungs were also recruited as a control group. Peripheral blood samples were drawn from the patients with lung cancer and from the control cases before the treatment. The identification of CTCs was carried out by a PatrolCTC detection method. The T lymphocyte subtypes were characterized by flow cytometry (FACS). Cytokines interleukin-2 (IL-2), interleukin-4 (IL-4), interleukin-17A (IL-17A), interleukin-10 (IL-10), and interferon  (IFN-) were detected by meso scale discovery (MSD) assay.

Results: Out of the enrolled patients, 69 (75%) patients with non-small cell lung cancer (NSCLC) were male and 23 (25 %) were female. Smoking and non-smoking history was 50% (46 cases) each. The case numbers for I - IV tumor-node-metastasis (TNM) stages were 23 (25.0%), 28 (30.4%), 16 (17.4%), and 25 (27.2%), respectively. The positive rates of the CTCs before treatment were 8.7% (2/23), 17.6% (5/28), 81.3% (13/16), and 100% (25/25) in stage I, II, III, and IV patients, respectively. Total CTCs, mixed CTCs, and mesenchymal CTCs (MCTCs) were strongly related to the progression-free survival (PFS) of the patients. In addition, total CTCs (≥ 6) and positive MCTCs also significantly correlated with recurrence and metastasis. The patients with high CTCs also had low levels of CD4, CD4/CD8 ratio, IL-2, and IFN. In contrast, IL-10 in high CTCs patients was significant elevated. These results indicate that the CTC numbers in lung cancer patients are an independent indicator for a worse PFS.

Conclusions: Higher total CTCs, mixed CTCs, and MCTCs in peripheral blood were significant biomarkers for predicting the prognosis of lung cancer patients. High CTCs also had a strong correlation with weak cellular immunity functions.

Background: The aim of the study was to improve the clinical cognition of nonaccelerating myelodysplastic/myeloproliferative neoplasms-unclassifiable (MDS/MPN-U) with 5q- karyotype and to avoid misdiagnosis or delayed diagnosis.

Methods: The clinical manifestations and laboratory results of a patient with nonaccelerating MDS/MPN-U with 5q- karyotype were analyzed, and related literature was reviewed.

Results: The patient was admitted to hospital mainly due to chest tightness and shortness of breath, aggravated for 4 days. After admission, combined with clinical manifestations, bone marrow cell morphology, immunology, multiparameter flow cytometry, cytogenetics and molecular biology, etc., the final diagnosis was MDS-MPN-U.

Conclusions: Research on the correlation between MPN-U and MDS with 5q deletion is still needed. Clinically, MPN-U combined with MDS is prone to misdiagnosis. In diagnosing MPN-U patients, it is essential to not only complete routine and immunological tests but also consider clinical manifestations and laboratory results. It is crucial to be vigilant about the possibility of concurrent diseases, especially cancer, and to choose targeted examinations in a timely manner to avoid missed or incorrect diagnoses.