Clinical laboratory最新文献

Background: Ovarian cancer (OC) is an invasive gynecological cancer with an overall 5-year survival rate of less than 45%. Endoplasmic reticulum (ER) stress plays a crucial role in regulating oncogenic events and immune-modulatory pathways, influencing malignant progression, antitumor immunity, and treatment response. However, the full scope of ER stress in ovarian cancer remains poorly understood and warrants further investigation.

Methods: RNA sequencing and clinical data were sourced from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus database (GEO). ER stress-related genes associated with ovarian tumor prognosis were identified, and an ER stress risk score model was developed using LASSO regression. We utilized this ER stress risk score to explore differences in immune cell infiltration. Furthermore, the biological role and expression of the risk gene KRT8 were validated through molecular biology experiments.

Results: We identified 573 genes related to ER stress that were differentially expressed genes (DEGs) between normal and tumor tissues. The ER stress-related risk signature (ERRS) constructed using the TCGA dataset was regarded as an independent and significant prognostic model for predicting cancer progression and instructing clinical decisions. Additionally, KRT8 was found to be overexpressed in ovarian cancer cells and tissues. Downregula-tion of KRT8 inhibited ovarian cancer cell proliferation and migration (in both SKOV3 and OVCAR8 cells) in vitro.

Conclusions: The ER stress-related gene model we developed can be utilized to assess the prognostic risk for OC patients. Importantly, KRT8 was identified as a key risk gene in ovarian cancer, promoting tumor progression, and holds potential as a novel therapeutic target.

Background: The aim of this study is to examine the effectiveness of oscillation-induced depolymerization in mitigating pseudothrombocytopenia (PTCP) under varying oscillatory conditions.

Methods: A total of 161 patients diagnosed with PTCP and admitted between May 2020 and November 2023 were included in the study. The patients were categorized into four groups based on oscillation parameters: 1,500 rpm for 1 minute, 1,500 rpm for 3 minutes, 3,000 rpm for 1 minute, and 3,000 rpm for 3 minutes. Platelet (PLT) depo-lymerization was assessed pre- and post-oscillation in each group, and peripheral blood smears were examined to evaluate platelet distribution. Additionally, the Mindray BC-6800 Plus hematology analyzer, in combination with a special stain, was utilized to verify depolymerization and identify the most appropriate depolymerization method for clinical application.

Results: PLT counts were significantly higher in the 3,000 rpm for 3 minutes and the 3,000 rpm for 1 minute groups compared to the 1,500 rpm for 1 minute group (p < 0.05). However, no significant differences in white blood cell and red blood cell counts were observed across the oscillation conditions (p > 0.05). Depolymerization rates in the 3,000 rpm groups were significantly higher than those in the 1,500 rpm groups (p < 0.05). The oscillation-induced depolymerization rate in the 3,000 rpm for 3 minutes group reached 93.79%, which was significantly greater than that in the special stain group (11.80%) (p < 0.05). Logistic regression analysis identified elevated lymphocyte count and potassium level as risk factors for incomplete depolymerization, while total bilirubin, direct bilirubin, and indirect bilirubin levels were found to be protective factors (p < 0.05).

Conclusions: Oscillation at 3,000 rpm for 3 minutes resulted in the highest rate of platelet depolymerization and demonstrated favorable clinical efficacy for PTCP management. Monitoring of lymphocyte count, potassium, total bilirubin, direct bilirubin, and indirect bilirubin levels is essential to facilitate timely implementation of the oscillation method, thereby reducing the incidence of PTCP and enhancing the accuracy of clinical detection.

Background: Cholestasis in primary biliary cholangitis (PBC) induces delta bilirubin and lipoprotein-X (LpX), complicating biochemical interpretation.

Methods: Comparative wet/dry chemistry analyses, total cholesterol (TC)/apolipoprotein B (Apo B) ratio calculation, and clinical-laboratory integration were utilized.

Results: Delta bilirubin (87.4 µmol/L) masked true bilirubin levels, while LpX falsely elevated LDL-cholesterol (LDL-C) (23.98 mmol/L) and induced pseudohyponatremia (Na⁺: 135 → 142 mmol/L).

Conclusions: Integrated methodologies and clinician-laboratory collaboration are essential to mitigate diagnostic pitfalls in PBC.

Background: Cefoperazone/sulbactam (CPZ/SAM) is a first-line antibacterial drug in clinical practice.

Methods: This article reports a case of extreme elevation of INR due to the use of CPZ/SAM four days. After drug withdrawal and administration of fresh frozen plasma, the coagulation function returned to normal.

Results: The INR results were extremely elevated, which is believed to be caused by taking CPZ/SAM.

Conclusions: When patients take CPZ/SAM anti-infection therapy, the patient's coagulation function should be closely monitored for the prevention of the occurrence of adverse reactions.

Background: Loop-mediated isothermal amplification (LAMP) is a molecular diagnostic method known for its rapid processing and operational simplicity due to its isothermal amplification process. While LAMP has demonstrated comparable diagnostic accuracy to PCR in certain applications, its performance may vary depending on assay design and implementation. This study aimed to evaluate the diagnostic performance of the MmaxSure™ assay (MmaxSure™; Mmonitor, Daegu, South Korea) in detecting SARS-CoV-2, comparing it with the STANDARD™ M nCoV Real-Time Detection Kit (STANDARD; SD BioSensor, Suwon, South Korea) using nasopharyngeal and oropharyngeal swab specimens.

Methods: A total of 333 specimens were included in the analysis, consisting of 113 positive and 220 negative nasopharyngeal and oropharyngeal swab samples. All specimens were tested using the MmaxSure™ assay, and the results were compared to those obtained using the STANDARD™ M nCoV Real-Time Detection Kit. The diagnostic performance of the MmaxSure™ assay was evaluated in terms of positive percent agreement (PPA), negative percent agreement (NPA), and Cohen's kappa index for inter-assay agreement. Sensitivity, specificity, and limit of detection (LOD) for SARS-CoV-2 variants were also determined.

Results: The MmaxSure™ assay demonstrated a 100% PPA and a 100% NPA with the STANDARD™ M nCoV Real-Time Detection Kit. The Cohen's kappa index was 1.0, indicating perfect agreement between the two diagnostic methods. The MmaxSure™ assay exhibited a high sensitivity, detecting SARS-CoV-2 variants at a LOD of 2 - 4 copies/µL, without cross-reactivity with other pathogens.

Conclusions: The MmaxSure™ Fast SARS-CoV-2 Detection Kit, based on LAMP technology, exhibited a high level of diagnostic accuracy in detecting SARS-CoV-2. Its rapid turnaround time and minimal equipment requirements suggest its potential suitability for point-of-care applications. However, further prospective studies with a broader range of clinical specimens and real-world validation are needed to confirm its diagnostic utility across diverse settings.

Background: The performance of the Mindray BC-7900 automated hematology analyzer was evaluated to deter-mine whether the instrument fulfills clinical requirements.

Methods: The BC-7900 hematology analyzer was evaluated based on the background count, carryover rate, precision, linear range, sample stability, comparability of results from different sample aspiration modes, comparability of results between instruments, erythrocyte sedimentation rate (ESR) for small blood volumes, and its ability to flag for abnormal leukocytes.

Results: The background count was consistently 0, and the maximum carryover rate was 0.54%. The coefficients of variation for the repeatability and the within-laboratory precision were within the allowable ranges. Verification of the linear range yielded r2 ≥ 0.994. The sample stability met the deviation requirements at both ambient and cryogenic temperatures. The results obtained from the two sample aspiration modes were comparable. The routine blood parameter values were highly correlated with those obtained using the BC-6800Plus analyzer. Specifically, the correlation coefficients for white blood cell count (WBC), neutrophil percentage (Neu%), lymphocyte percentage (Lym%), nucleated red blood cell percentage (NRBC%), RBC, hemoglobin (HGB), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and impedance (PLT-I) and hybrid platelet counts (PLT-H) were all greater than 0.99. The correlation coefficients for monocyte percentage (Mon%), eosinophil percentage (Eos%), and basophil percentage (Baso%) were all greater than 0.91, while the coefficient for the mean corpuscular hemoglobin concentration (MCHC) was greater than 0.89. Compared with the Westergren method, the results of ESR for both standard and trace blood sample volumes were well correlated, with correlation coefficients of 0.943 and 0.952, respectively. Additionally, the analyzer demonstrated excellent sensitivity and specificity for flagging for immature granulocytes (95.4% and 93.8%, respectively) and abnormal lymphocytes (86.9% and 90.7%). Finally, the hematological malignant cell (HMC) channel showed high sensitivity (98.4%) and moderate specificity for detecting blasts (including abnormal promyelocytes).

Conclusions: The BC-7900 automated hematology analyzer demonstrated strong performance, providing accurate and reliable results that meet clinical application requirements. This instrument provides excellent ESR detection methods for trace and standard blood sample volumes and an effective method for flagging blast cells.

Background: Fluctuations in vitamin D (VITD) impact the health status of individuals across the globe. The present study aimed to assess the seasonal and regional variations in VITD status among the Iraqi population and highlight the extent of these differences across age and gender groups.

Methods: A total of 5,014 participants attending a single-consultation outpatient clinic for routine blood tests from three different regions of Iraq [the North (N, 825), the Middle (N, 3277), and the South (N, 912) regions] were recruited. The participants from the Middle region were enrolled throughout the seasons of the year (January through December 2023), whereas participants from the North and South regions were enrolled only during the winter season.

Results: The study revealed a wide range level of VITD spanning from 3 - 110 ng/mL (mean 26.5 ± 15.7 ng/mL). Deficiency (levels < 20 ng/mL) was found in 39% of participants, including 11% with severe deficiency (< 10 ng/mL). Females had significantly higher VITD levels than males. Seasonal analysis revealed significantly lower VITD levels during the winter season (24.8 ± 14.3 ng/mL) as compared to the spring and summer (28.3 ± 14.6 and 28.5 ± 15.5 ng/mL, respectively), while significantly higher levels were observed in autumn (31.3 ± 16.4 ng/mL). Regionally, lower VITD levels were recorded in the North of Iraq (21.7 ± 17 ng/mL) compared to the Middle and Southern regions (24.8 ± 14.3 and 25.1 ± 14.2 ng/mL, respectively). VITD levels also varied by age, with the youngest age groups (< 15, and 16 - 30 years) consistently exhibiting the highest deficiency rates throughout the year and across all regions, with the highest rates observed in winter and the Northern region.

Conclusions: Deficient VITD status in Iraq was found in almost one-third of the population. Deficiency levels were high in the young-age groups in all the regions and seasons. Clear regional and seasonal variations in the 25(OH)D level were spotted among the Iraqi population.

Background: Elevated urinary amylase is usually associated with pancreatic disease, but non-pancreatic factors such as fecal contamination can also lead to false elevation.

Methods: The retrospective analysis of a 75-year-old patient with acute cerebral infarction identified fecal contamination as the cause of falsely elevated urinary amylase.

Results: Initial urine test showed amylase > 24,000 U/L, the level of which decreased to 164 U/L after standardized urine collection. Abdominal CT confirmed normal pancreatic morphology and uniform density.

Conclusions: Fecal contamination is the key source of falsely elevated urinary amylase. Strict pre-analytical quality control is the key to preventing laboratory errors.

Background: The prompt and accurate diagnosis of bloodstream infections are crucial. However, the routine conventional method of identification and antibiotic susceptibility testing (AST) of bacteria from the positive blood culture typically takes several days. We aimed to develop a rapid method for bacterial identification and AST in bloodstream infections, with the goal of accelerating diagnosis and enabling earlier treatment.

Methods: Our rapid method based on the biochemistry of identification and the microdilution broth method of AST for bacteria isolated from pediatric positive blood culture bottles is highly efficient and time-saving. In this study, we included 80 positive blood culture samples from pediatric patients. The samples were processed by centrifugation with the gel tube and then divided into Gram-positive and Gram-negative groups. Identification and AST were performed using an automated culture antibiogram device based on biochemical methods and microdilution broth method. For routine processing, media inoculated with positive blood culture were kept in the incubator for about 20 hours. The discrepancies in identification and AST were compared between the rapid and routine methods.

Results: The results showed that 30 bacterial strains were categorized as Gram-positive and 50 as Gram-negative. The results showed a high level of agreement in identification, with 77 out of 80 samples (96.25%) showing concordant results between the rapid method and routine method. A total of 1,194 AST assays were performed. The rapid method demonstrated an essential agreement of 96.82% and a categorical agreement of 97.82%. Minor errors ratio, major errors ratio, and very major errors ratio were 1.17%, 0.84%, and 0.17%, respectively.

Conclusions: The rapid method holds potential for efficient and reliable identification and AST of bacteria from positive pediatric blood culture bottles.

Background: Molecular diagnosis of respiratory infections has made great progress following the advent of multiplex diagnostic methods allowing simultaneous detection of several targets at the same time.

Methods: In this prospective study, a comparison of two respiratory multiplex diagnostic kits used in our laboratory was performed on samples of patients hospitalized for severe acute respiratory infection during 2023 - 2024: FilmArray® Respiratory Panel 2.1 plus and Xpert® Xpress SARS-CoV-2/Flu/RSV.

Results: The results showed excellent agreement between the two tests, with a coefficient of Cohen's kappa of 0.960. The discrepancies were only relevant for the influenza A research results, for which Cohan's Kappa was 0.879. These discrepancies involved samples with a low viral load (only one probe detected by Xpert® Xpress SARS-CoV-2/Flu/RSV (Flu A1) with a cycle threshold ˃ 35).

Conclusions: As a result, both techniques remain of interest and depend on the clinical context of patients and the period of diagnosis, which will allow clinicians to rationalize the prescription of the two techniques to better meet the expectations of patients.