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Life-threatening autoimmune hemolytic anemia following mRNA COVID-19 vaccination: don’t be too prudent with the red gold mRNA - COVID-19疫苗接种后危及生命的自身免疫性溶血性贫血:不要过于谨慎地使用红金
Pub Date : 2022-03-11 DOI: 10.1515/cclm-2022-0118
S. De Bruyne, Stijn Van Landeghem, A. Schauwvlieghe, L. Noens
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引用次数: 8
Biological variation and reference change value as decision criteria in clinical use of tumor biomarkers. Are they really useful? 生物变异和参考变化值作为肿瘤生物标志物临床应用的判定标准。它们真的有用吗?
Pub Date : 2022-03-10 DOI: 10.1515/cclm-2022-0047
R. Dittadi, A. Fabricio, M. Gion
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引用次数: 2
Automated prediction of low ferritin concentrations using a machine learning algorithm 使用机器学习算法自动预测低铁蛋白浓度
Pub Date : 2022-03-08 DOI: 10.1515/cclm-2021-1194
S. Kurstjens, Thomas de Bel, A. van der Horst, R. Kusters, J. Krabbe, J. V. van Balveren
Abstract Objectives Computational algorithms for the interpretation of laboratory test results can support physicians and specialists in laboratory medicine. The aim of this study was to develop, implement and evaluate a machine learning algorithm that automatically assesses the risk of low body iron storage, reflected by low ferritin plasma levels, in anemic primary care patients using a minimal set of basic laboratory tests, namely complete blood count and C-reactive protein (CRP). Methods Laboratory measurements of anemic primary care patients were used to develop and validate a machine learning algorithm. The performance of the algorithm was compared to twelve specialists in laboratory medicine from three large teaching hospitals, who predicted if patients with anemia have low ferritin levels based on laboratory test reports (complete blood count and CRP). In a second round of assessments the algorithm outcome was provided to the specialists in laboratory medicine as a decision support tool. Results Two separate algorithms to predict low ferritin concentrations were developed based on two different chemistry analyzers, with an area under the curve of the ROC of 0.92 (Siemens) and 0.90 (Roche). The specialists in laboratory medicine were less accurate in predicting low ferritin concentrations compared to the algorithms, even when knowing the output of the algorithms as support tool. Implementation of the algorithm in the laboratory system resulted in one new iron deficiency diagnosis on average per day. Conclusions Low ferritin levels in anemic patients can be accurately predicted using a machine learning algorithm based on routine laboratory test results. Moreover, implementation of the algorithm in the laboratory system reduces the number of otherwise unrecognized iron deficiencies.
目的实验室检测结果解释的计算算法可以为检验医学的医生和专家提供支持。本研究的目的是开发、实施和评估一种机器学习算法,该算法使用最小的一组基本实验室测试,即全血细胞计数和c反应蛋白(CRP),自动评估贫血初级保健患者体内铁储量低的风险(由低铁蛋白血浆水平反映)。方法利用贫血初级保健患者的实验室测量数据来开发和验证机器学习算法。该算法的性能与来自三家大型教学医院的12名检验医学专家进行了比较,这些专家根据实验室检测报告(全血细胞计数和CRP)预测贫血患者是否有低铁蛋白水平。在第二轮评估中,算法结果作为决策支持工具提供给检验医学专家。结果基于两种不同的化学分析仪建立了两种不同的低铁蛋白浓度预测算法,ROC曲线下面积分别为0.92(西门子)和0.90(罗氏)。与算法相比,实验室医学专家在预测低铁蛋白浓度方面的准确性较低,即使知道算法作为支持工具的输出。在实验室系统中实施该算法,平均每天新增1例缺铁诊断。结论基于常规实验室检测结果的机器学习算法可准确预测贫血患者低铁蛋白水平。此外,该算法在实验室系统中的实施减少了未被识别的铁缺乏症的数量。
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引用次数: 10
Trimester-specific reference values for the anticardiolipin antibody by chemiluminescence immunoassay in healthy pregnancy 用化学发光免疫分析法测定健康妊娠期抗心磷脂抗体特异性参考值
Pub Date : 2022-03-02 DOI: 10.1515/cclm-2022-0044
Rui Gao, Xin-ai Yue, Wanrong Huang, F. Yu, Lang Qin
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引用次数: 0
Prognostic significance of soluble CD25 in patients with sepsis: a prospective observational study 可溶性CD25在脓毒症患者中的预后意义:一项前瞻性观察研究
Pub Date : 2022-02-28 DOI: 10.1515/cclm-2022-0068
Chun-Mei Huang, Xinjie Xu, Wenqi Qi, Qinmin Ge
Abstract Objectives The diagnosis of sepsis is challenging, the need for sensitive and specific diagnostic and prognostic biomarkers has not been met. Soluble CD25 (sCD25) is a readily available biomarker reported to represent the severity of the disease. This study aimed to assess the association between sCD25 and mortality in patients with sepsis. Methods In total, 329 adult patients with sepsis were screened through a prospective, observational study. We investigated the severity scores and sCD25 levels at admission to the intensive care unit (ICU), defined by sepsis (sepsis-3). The prognostic value of sCD25 was assessed using receiver operating characteristic (ROC) curves and binary logistic regression models in predicting unfavourable outcome. The correlations between variables and severity of disease were analysed by Spearman correlation tests. Results After entering the ICU, the sCD25 level and sequential organ failure assessment (SOFA) score were significantly higher in nonsurvivors than in survivors. The prognostic values estimated by the ROC curves were 0.678 for sCD25 and 0.945 for SOFA score at ICU admission. sCD25 had a modest ability to predict poor outcome. Logistic regression showed that increased levels of sCD25 were independently associated with unfavourable outcome. Spearman correlation tests showed that sCD25 levels were positively correlated with disease severity. Conclusions In sepsis patients, increased sCD25 levels were independently associated with poor clinical outcomes. Further research is needed to improve the understanding of the pathophysiology of this relationship.
摘要目的脓毒症的诊断具有挑战性,对敏感和特异性的诊断和预后生物标志物的需求尚未得到满足。可溶性CD25 (sCD25)是一种容易获得的生物标志物,据报道可代表疾病的严重程度。本研究旨在评估sCD25与脓毒症患者死亡率之间的关系。方法通过前瞻性观察性研究筛选329例成年脓毒症患者。我们调查了重症监护病房(ICU)入院时的严重程度评分和sCD25水平,以脓毒症(sepsis-3)定义。采用受试者工作特征(ROC)曲线和二元logistic回归模型评估sCD25在预测不良预后方面的预后价值。采用Spearman相关检验分析各变量与疾病严重程度的相关性。结果进入ICU后,非存活患者的sCD25水平和顺序器官衰竭评分(SOFA)明显高于存活患者。ICU入院时sCD25评分和SOFA评分的ROC曲线预测预后值分别为0.678和0.945。sCD25预测不良预后的能力一般。逻辑回归显示sCD25水平升高与不良结果独立相关。Spearman相关检验显示sCD25水平与疾病严重程度呈正相关。结论:在脓毒症患者中,sCD25水平升高与临床预后不良独立相关。需要进一步的研究来提高对这种关系的病理生理学的理解。
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引用次数: 2
Continuous monitoring of SARS-CoV-2 seroprevalence in children using residual blood samples from routine clinical chemistry 利用常规临床化学残血样本持续监测儿童SARS-CoV-2血清阳性率
Pub Date : 2022-02-25 DOI: 10.1515/cclm-2022-0037
Felix Wachter, A. Regensburger, Antonia Sophia Peter, F. Knieling, A. Wagner, David Simon, A. Hoerning, J. Woelfle, K. Überla, A. Neubert, M. Rauh
Abstract Objectives The assessment of SARS-CoV-2 infections in children is still challenging, but essential for appropriate political decisions. The aim of this study was to investigate whether residual blood samples can be used for SARS-CoV-2 seroprevalence monitoring in pediatrics. Methods In this repeated cross-sectional cohort study, anonymous residual blood samples from pediatric patients aged 0–17 years were collected in three time-periods (Oct.–Nov. 2020, April 2021, and June–July 2021) and analyzed for SARS-CoV-2 Spike protein (anti-S) and nucleocapsid (anti-N) antibodies using commercial antibody assays. 28 reactive samples were used to compare antibody levels with a pseudotyped neutralization assay. The results were further compared to the official national COVID-19 surveillance data to calculate the number of unreported cases. Results In total, n=2,626 individual blood samples were analyzed. In this unvaccinated pediatric cohort anti-S and anti-N antibody seroprevalence increased over the three time periods (anti-S: 1.38–9.16%, and 14.59%; anti-N: 1.26%, to 6.19%, and 8.56%). Compared to the national surveillance data this leads to a 3.93–5.66-fold increase in the number of unreported cases. However, a correlation between the cumulative incidence of the individual provinces and our assigned data was found (r=0.74, p=0.0151). In addition, reactive samples with anti-S and anti-N and samples with only anti-S showed neutralization capabilities (11/14 and 8/14, respectively). Anti-S levels were not significantly different between age groups and sexes (all p>0.05). Conclusions The present study suggests that residual blood samples from routine laboratory chemistry could be included in the estimation of the total SARS-CoV-2 seroprevalence in children.
目的评估儿童SARS-CoV-2感染情况仍然具有挑战性,但对适当的政治决策至关重要。本研究的目的是探讨残血样本是否可用于儿科SARS-CoV-2血清阳性率监测。方法在这项重复横断面队列研究中,收集0-17岁儿童患者的匿名残血样本,时间为3个时间段(10月- 11月)。2020年、2021年4月和2021年6月至7月),并使用商业抗体测定法分析SARS-CoV-2刺突蛋白(抗s)和核衣壳(抗n)抗体。28个反应性样品被用来比较抗体水平与假型中和试验。将结果进一步与官方国家COVID-19监测数据进行比较,以计算未报告病例数。结果共分析了n= 2626份个体血液样本。在这个未接种疫苗的儿童队列中,抗s和抗n抗体的血清阳性率在三个时间段内增加(抗s: 1.38-9.16%, 14.59%;anti-N分别为1.26%、6.19%和8.56%)。与国家监测数据相比,这导致未报告病例数量增加了3.93 - 5.66倍。然而,单个省份的累积发病率与我们分配的数据之间存在相关性(r=0.74, p=0.0151)。此外,含有抗s和抗n的活性样品和只含有抗s的活性样品表现出中和能力(分别为11/14和8/14)。抗s水平在不同年龄组和性别间无显著差异(p>0.05)。结论常规化验血残留样本可用于儿童SARS-CoV-2血清总阳性率的估计。
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引用次数: 9
CSF-interleukin 6 for early diagnosis of ventriculitis in a broad intensive care setting csf -白细胞介素6在广泛重症监护室早期诊断脑室炎中的作用
Pub Date : 2022-02-25 DOI: 10.1515/cclm-2021-1233
Sylvia Mink, W. List, P. Reimann, P. Fraunberger
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引用次数: 1
Two co-inherited hemoglobin variants revealed by capillary electrophoresis during quantification of glycated hemoglobin 在糖化血红蛋白定量期间,毛细管电泳揭示了两种共同遗传的血红蛋白变异
Pub Date : 2022-02-24 DOI: 10.1515/cclm-2021-1242
Giovanni Antonello, Carlo Lo Monaco, P. Napoli, Daniel A. Solimando, C. Curcio, G. Barberio, S. Maoggi, G. Ivaldi, M. Nigra
Abstract Objectives The observation of numerous new structural defects in hemoglobin (Hb) has often been linked to the evolution and development of device technologies used for the separation and quantification of hemoglobin components. However, the increased use of preventive tests for hemoglobinopathies and separative methods to quantify glycated hemoglobin (HbA1c) also contributed to these observations, as demonstrated by the case described here. Our aim is to emphasize that different separative method can provide more useful information in patient management. Methods A 64-year-old diabetic woman of Moroccan descent was examined in the context of HbA1c monitoring. The test was performed using high performance liquid chromatography (HPLC) and capillary electrophoresis (CE) systems. Molecular characterization was performed by direct sequencing of the β and α globin genes. Results The two methods used showed the presence of an anomalous fraction identified as HbS, already observed previously, but only through CE it was possible to observe the presence of another variant and its hybrid components. Direct sequencing of β and α globin genes confirmed heterozygous HbS [β6 (A3) Glu→Val; HBB: c.20A>T] and allowed to identify a mutation on the α2, [α114 (GH2) Pro→Leu gene; HBA2: c.344C>T] corresponding to the rare Hb Nouakchott variant. Conclusions The two Hb variants highlighted by the EC and the molecular characterization therefore allowed adequate advice, the correct assessment of HbA1c and metabolic status and therefore better clinical management of the patient. The availability of different instruments in the same laboratory, confirming situations of diagnostic uncertainty, represents a valuable opportunity that should be encouraged.
目的血红蛋白(Hb)中许多新结构缺陷的观察通常与用于分离和定量血红蛋白成分的设备技术的演变和发展有关。然而,越来越多地使用血红蛋白病预防性检测和分离方法定量糖化血红蛋白(HbA1c)也促成了这些观察结果,正如本文所述的病例所证明的那样。我们的目的是强调不同的分离方法可以为患者管理提供更多有用的信息。方法对1例64岁摩洛哥裔糖尿病女性进行糖化血红蛋白监测。采用高效液相色谱(HPLC)和毛细管电泳(CE)系统进行检测。通过β和α珠蛋白基因的直接测序进行分子表征。结果两种方法均发现了HbS的异常组分,但只有通过CE才能观察到另一种变体及其杂交组分的存在。β和α珠蛋白基因直接测序证实杂合HbS [β6 (A3) Glu→Val;HBB: c.20A>T],并允许鉴定α2突变,[α114 (GH2) Pro→Leu基因;HBA2: c.344C>T]对应罕见的Hb Nouakchott变异。因此,EC强调的两种Hb变异和分子特征可以提供充分的建议,正确评估HbA1c和代谢状态,从而更好地对患者进行临床管理。在同一实验室使用不同的仪器,确认诊断不确定的情况,是一个宝贵的机会,应予以鼓励。
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引用次数: 2
The value proposition of integrative diagnostics for (early) detection of cancer. On behalf of the EFLM interdisciplinary Task and Finish Group “CNAPS/CTC for early detection of cancer” 综合诊断对癌症(早期)检测的价值主张。代表EFLM跨学科任务和完成小组“CNAPS/CTC早期癌症检测”
Pub Date : 2022-02-24 DOI: 10.1515/cclm-2022-0129
M. Froelich, E. Capoluongo, Z. Kovacs, S. Patton, E. Lianidou, V. Haselmann
Abstract Disruptive imaging and laboratory technologies can improve clinical decision processes and outcomes in oncology. However, certain obstacles must be overcome before these technologies can be fully implemented as part of the standard for care. An integrative diagnostic approach represents a unique opportunity to unleash the full diagnostic potential and paves the way towards personalized cancer diagnostics. To meet this demand, an interdisciplinary Task Force of the EFLM was initiated as a consequence of an EFLM/ESR during the CELME 2019 meeting in order to evaluate the clinical value of CNAPS/CTC (circulating nucleic acids in plasma and serum/circulating tumor cells) in early detection of cancer. Here, an overview of current disruptive techniques, their clinical implications and potential value of an integrative diagnostic approach is provided. Furthermore, requirements such as the establishment of diagnostic tumor boards, development of adequate software solutions and a change of mindset towards a new generation of diagnosticians providing actionable health information are presented. This development has the potential to elevate the position and clinical recognition of diagnosticians.
颠覆性成像和实验室技术可以改善肿瘤学的临床决策过程和结果。然而,在这些技术作为护理标准的一部分得到充分实施之前,必须克服某些障碍。综合诊断方法代表了释放全部诊断潜力的独特机会,并为个性化癌症诊断铺平了道路。为了满足这一需求,在CELME 2019会议期间,作为EFLM/ESR的结果,EFLM的一个跨学科工作组被启动,以评估CNAPS/CTC(血浆和血清中的循环核酸/循环肿瘤细胞)在癌症早期检测中的临床价值。在这里,概述了目前的破坏性技术,他们的临床意义和潜在价值的综合诊断方法提供。此外,还提出了诸如建立肿瘤诊断委员会、开发适当的软件解决方案和改变对提供可操作健康信息的新一代诊断医生的观念等要求。这一发展有可能提升诊断医师的地位和临床认可度。
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引用次数: 4
Frontmatter
Pub Date : 2022-02-01 DOI: 10.1515/cclm-2022-frontmatter3
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引用次数: 0
期刊
Clinical Chemistry and Laboratory Medicine (CCLM)
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