Journal of Clinical Laboratory Analysis最新文献_第9页

Prognostic Value of a Novel Model for Hepatocellular Carcinoma Patients Undergoing Transarterial Chemoembolization 一种新的肝细胞癌经动脉化疗栓塞模型的预后价值。

IF 2.9 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis

Pub Date : 2025-09-05 DOI: 10.1002/jcla.70095

Cailing Ye, Yaqiong Chen, Jiahao Chen, Zhongcheng Chen, Wensi Chen, Suqing Zhao, Bo Hu, Zhaoxia Li

Background

Hepatocellular carcinoma (HCC) patients who underwent transarterial chemoembolization (TACE) have heterogeneous clinical outcomes. Accurate prognosis prediction and risk stratification are crucial for individualized treatment. We sought to develop a novel prognostic model for overall survival (OS) that incorporated contemporary clinical and laboratory factors for estimating individual prognosis.

Methods

A total of 180 HCC patients treated with TACE were used to identify the risk factors and generate prognostic models by Cox regression analyses. Model performance was evaluated by comparing it with the Tumor-Node-Metastasis (TNM) and Barcelona-Clinic Liver-Cancer (BCLC) staging systems.

Results

A prognosis model (PI score), which consisted of neutrophil-lymphocyte ratio (NLR), γ-glutamyl transpeptidase (GGT), alpha-fetoprotein (AFP), and TNM stage, was constructed. The PI scores of each patient were calculated, and the patients were divided into subgroups based on their PI scores. The OS rate of patients in the low-risk group (PI < 0.87) was better than that of the patients in the high-risk group (PI ≥ 0.87), p < 0.001. Patients were then further divided into four stages: early stage (PI ≤ 0.49), middle stage (0.49 < PI ≤ 0.87), advanced stage (0.87 < PI ≤ 1.48), and end stage (PI > 1.48). There were statistically significant differences between the OS rates of the four groups (p < 0.001). The area under the ROC curve (AUROC) for PI score (0.746, 0.643–0.783) was higher than those of TNM (0.699, 0.620–0.763) and BCLC (0.692, 0.617–0.760).

Conclusions

The PI score had excellent predictive value for HCC patients undergoing TACE and was superior to TNM and BCLC.

背景：肝细胞癌（HCC）患者接受经动脉化疗栓塞（TACE）具有不同的临床结果。准确的预后预测和风险分层对个体化治疗至关重要。我们试图建立一种新的总生存（OS）预后模型，该模型结合了当代临床和实验室因素来估计个体预后。方法：对180例经TACE治疗的HCC患者进行Cox回归分析，确定其危险因素并建立预后模型。通过与肿瘤-淋巴结-转移（TNM）和巴塞罗那临床肝癌（BCLC）分期系统进行比较来评估模型的性能。结果：建立了由中性粒细胞-淋巴细胞比值（NLR）、γ-谷氨酰转肽酶（GGT）、甲胎蛋白（AFP）、TNM分期组成的预后模型（PI评分）。计算每位患者的PI评分，并根据PI评分将患者分为亚组。低危组患者的OS率（PI 1.48）。结论：PI评分对接受TACE的HCC患者具有极好的预测价值，优于TNM和BCLC。

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引用次数: 0

Automated Morphologic Differentiation Between Iron Deficiency Anemia and Thalassemia 缺铁性贫血与地中海贫血的自动形态学鉴别。

IF 2.9 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis

Pub Date : 2025-09-03 DOI: 10.1002/jcla.70097

Julien Guy, Marie-C Béné, Ramon Simon Lopez, Marc Maynadié, Céline Row

Background

Iron deficiency anemia (IDA) and hemoglobinopathies (HbP) are two frequent conditions characterized by microcytemia. Published criteria/scores discriminating these conditions with hematology analyzer parameters are not fully satisfactory. Although patients with HbP have been reported to have more red blood cells (RBC) with a target cell (TC) morphology than patients with IDA, obtaining TC percentages remains a time-consuming task since at least 1000 RBC must be examined.

Methods

Using the Mindray CAL 8000 2.0 0111 and MC-80 module, 152 microcytic samples from 51 patients with IDA and 101 with HbP were analyzed. Data from RBC parameters used in published scores were collected, as well as the percentages of target cells automatically provided by the MC-80.

Results

Patients with IDA had significantly lower median hemoglobin level, red blood cell numbers, and mean corpuscular hemoglobin concentration than those with HbP, yet had more microcytes. Using TC percentages provided by the MC-80 module, receiving operator characteristic curves identified this parameter as the most discriminant to segregate patients with IDA or HbP. With a 0.4% threshold, this yielded a 74.2% sensitivity and 86.3% specificity, confirming that patients with HbP have significantly higher TC percentages.

Conclusion

The automated identification and enumeration of abnormal RBC performed by Mindray MC-80 rapidly provides TC percentages, allowing for a fast discrimination between IDA and HbP in samples with microcytosis, orienting early towards confirmatory tests for these disorders. Moreover, this study confirms TC, which can obviously be obtained through other methods, as a robust parameter in this context.

背景：缺铁性贫血（IDA）和血红蛋白病（HbP）是两种常见的以小细胞血症为特征的疾病。用血液学分析仪参数区分这些条件的公布标准/分数并不完全令人满意。尽管有报道称HbP患者比IDA患者有更多靶细胞形态的红细胞（RBC），但获得TC百分比仍然是一项耗时的任务，因为必须检查至少1000个RBC。方法：采用迈瑞CAL 8000 2.0 0111和MC-80模块对51例IDA患者和101例HbP患者的152份小细胞样本进行分析。收集已发表评分中使用的RBC参数数据，以及MC-80自动提供的靶细胞百分比。结果：IDA患者中位血红蛋白水平、红细胞数量和红细胞平均血红蛋白浓度均明显低于HbP患者，但微细胞更多。使用MC-80模块提供的TC百分比，接收操作员特征曲线确定该参数是区分IDA或HbP患者的最具判别性的参数。阈值为0.4%，敏感性为74.2%，特异性为86.3%，证实HbP患者的TC百分比明显较高。结论：由迈瑞MC-80进行的异常红细胞自动鉴定和计数快速提供TC百分比，允许快速区分IDA和HbP与小细胞增多症的样品，面向这些疾病的早期确证试验。此外，本研究还证实了TC在这种情况下是一个鲁棒参数，而TC显然可以通过其他方法获得。

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引用次数: 0

Routine Laboratory Tests Predict 72-h Fatality in Patients With D-Dimer Levels ≥ 2 μg/mL: A Retrospective Cohort Study Comparing Statistical and Machine Learning Models 常规实验室检测预测d -二聚体水平≥2 μg/mL患者72小时病死率：一项比较统计模型和机器学习模型的回顾性队列研究

IF 2.9 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis

Pub Date : 2025-09-03 DOI: 10.1002/jcla.70091

Shuma Hayashi, Ryoko Hayashi, Kayoko Nakamura, Kai Saito, Hidenori Sanayama, Takahiko Fukuchi, Tamami Watanabe, Kiyoka Omoto, Hitoshi Sugawara

Background

Despite the high prognostic value of D-dimer in various clinical conditions, limited research has addressed short-term fatality prediction across disease categories. This study aimed to develop and compare models predicting 72-h fatality in patients with D-dimer levels ≥ 2 μg/mL, using laboratory variables. This timeframe was chosen based on its clinical relevance for early triage and intervention across multiple acute conditions.

Methods

We retrospectively analyzed data from 5158 patients (241 deaths within 72 h). The primary outcome was 72-h fatality; predictors included age, sex, and 40 routine hematologic, biochemical, and coagulation tests. Traditional multivariate logistic regression analysis (MLRA) was compared with four machine learning (ML) models: Prediction One, LightGBM, XGBoost, and CatBoost. External validation was performed using a separate dataset of 5550 patients (309 deaths). D-dimer levels were recorded in any clinical setting despite limited patient medical information.

Results

The 72-h fatality rate increased with increasing D-dimer levels (overall 4.67%). Major causes of death were intracranial disease (24.9%), malignancy (17.0%), and sepsis (8.3%). MLRA identified five key predictors: advanced age, low total protein and cholesterol levels, and elevated aspartate aminotransferase and D-dimer levels. Its performance (AUC 0.829, 95% CI 0.768–0.888; sensitivity 0.762; specificity 0.809) was exceeded by LightGBM (AUC 0.987; sensitivity 0.987; specificity 0.911), which outperformed Prediction One (0.814), XGBoost (0.981), and CatBoost (0.937).

Conclusion

ML models, particularly LightGBM, effectively identify high-risk patients using routine laboratory tests. The model enables timely decision-making and early risk stratification in patients with high D-dimer values, even when clinical information is limited.

背景：尽管d -二聚体在各种临床条件下具有很高的预后价值，但有限的研究涉及跨疾病类别的短期病死率预测。本研究旨在建立并比较使用实验室变量预测d -二聚体水平≥2 μg/mL患者72小时死亡率的模型。这个时间框架的选择是基于其临床相关性的早期分诊和干预多种急性条件。方法：回顾性分析5158例患者的资料（其中241例在72 h内死亡）。主要结局为72小时病死率；预测因素包括年龄、性别和40项常规血液学、生化和凝血试验。将传统的多元逻辑回归分析（MLRA）与四种机器学习（ML）模型：Prediction One、LightGBM、XGBoost和CatBoost进行比较。使用包含5550例患者（309例死亡）的单独数据集进行外部验证。d -二聚体水平记录在任何临床设置，尽管有限的患者医疗信息。结果：72 h病死率随d -二聚体水平升高而升高，总病死率为4.67%。主要死亡原因为颅内疾病（24.9%）、恶性肿瘤（17.0%）和败血症（8.3%）。MLRA确定了五个关键预测因素：高龄、总蛋白和胆固醇水平低、天冬氨酸转氨酶和d -二聚体水平升高。其性能（AUC 0.829, 95% CI 0.768-0.888，灵敏度0.762，特异性0.809）优于LightGBM (AUC 0.987，灵敏度0.987，特异性0.911)，优于Prediction One（0.814）、XGBoost（0.981）和CatBoost（0.937）。结论：ML模型，尤其是LightGBM，可通过常规实验室检查有效识别高危患者。即使在临床信息有限的情况下，该模型也能对高d -二聚体值的患者进行及时决策和早期风险分层。

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引用次数: 0

RETRACTION: Role of Matrix Metalloproteinase-9 Gene Polymorphisms in Glaucoma: A Hospital-Based Study in Chinese Patients 撤回：基质金属蛋白酶-9基因多态性在青光眼中的作用：一项基于医院的中国患者研究。

IF 2.9 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis

Pub Date : 2025-08-28 DOI: 10.1002/jcla.70094

RETRACTION: Zhao, F. Fan, Z. Huang, X. Role of Matrix Metalloproteinase-9 Gene Polymorphisms in Glaucoma: A Hospital-Based Study in Chinese Patients Journal of Clinical Laboratory Analysis 34 no. 3 (2020): e23105, https://doi.org/10.1002/jcla.23105

The above article, published online on 12 November 2019 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Rong Fu; and Wiley Periodicals LLC. The retraction has been agreed due to scientific inconsistencies and major flaws in the statistical evaluation.

The journal received a request to retract this manuscript initially. During investigation, the authors stated that original data is no longer available and did not provide documentation for the ethical approval process of this study. Nanchong Central Hospital could not be reached for comment. Subsequently, the authors stopped responding.

The conclusions of this manuscript are considered unreliable.

撤回：赵峰。范志。黄霞。基质金属蛋白酶-9基因多态性在青光眼患者中的作用：基于医院的研究。临床检验杂志34(5)。3 (2020): e23105, https://doi.org/10.1002/jcla.23105上述文章于2019年11月12日在Wiley在线图书馆（wileyonlinelibrary.com）在线发表，经期刊主编荣福同意撤回；和Wiley期刊有限责任公司。由于科学不一致和统计评估中的重大缺陷，已同意撤回。该杂志最初收到了撤回这篇稿件的请求。在调查过程中，作者表示原始数据不再可用，并且没有为本研究的伦理审批过程提供文件。记者无法联系到南充市中心医院请其置评。随后，作者们停止了回应。这份手稿的结论被认为是不可靠的。

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引用次数: 0

ACT001 Inhibits Tumor Progression and Modulates Immune Responses in Non-Small Cell Lung Cancer ACT001抑制非小细胞肺癌的肿瘤进展和调节免疫反应。

IF 2.9 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis

Pub Date : 2025-08-20 DOI: 10.1002/jcla.70066

Zhijing Shi, Yiman Li, Huijie Hou, Zhitao Wang, Hui Guo, Yang Yu, Yan Song, Zhe Chen

Background

Advancements in non-small cell lung cancer (NSCLC) therapies have improved outcomes, but challenges like low immune response, drug resistance, and side effects persist. ACT001, a novel small-molecule inhibitor, shows promise in addressing these issues.

Methods

We evaluated ACT001's anti-tumor and immunomodulatory effects in NSCLC. In vitro, its impact on proliferation, migration, invasion, and cell cycle arrest was assessed. In vivo, its effect on tumor growth in C57BL/6 mice was studied. Pull-down assays and mass spectrometry identified ACT001's interaction with STAT1/STAT3 and its regulation of PD-L1 expression.

Results

ACT001 inhibited NSCLC cell proliferation, migration, and invasion, induced cell cycle arrest, and suppressed tumor growth in vivo. It enhanced granzyme B release in CD3⁺ T cells, promoting NSCLC cell apoptosis. Mechanistically, ACT001 bound to STAT1/STAT3, suppressing their phosphorylation and reducing PD-L1 expression.

Conclusion

ACT001 exhibits antitumoral and immunomodulatory potential by targeting STAT1/STAT3 and regulating PD-L1, offering a promising therapeutic approach for NSCLC.

背景：非小细胞肺癌（NSCLC）治疗的进展改善了预后，但免疫反应低、耐药和副作用等挑战仍然存在。ACT001是一种新型的小分子抑制剂，有望解决这些问题。方法：评价ACT001在非小细胞肺癌中的抗肿瘤和免疫调节作用。体外，评估其对增殖、迁移、侵袭和细胞周期阻滞的影响。在体内研究其对C57BL/6小鼠肿瘤生长的影响。下拉试验和质谱分析鉴定了ACT001与STAT1/STAT3的相互作用及其对PD-L1表达的调节。结果：ACT001在体内抑制NSCLC细胞增殖、迁移和侵袭，诱导细胞周期阻滞，抑制肿瘤生长。增强CD3+ T细胞颗粒酶B释放，促进非小细胞肺癌细胞凋亡。机制上，ACT001结合STAT1/STAT3，抑制其磷酸化并降低PD-L1的表达。结论：ACT001通过靶向STAT1/STAT3和调节PD-L1，具有抗肿瘤和免疫调节的潜力，为非小细胞肺癌的治疗提供了一种有前景的方法。

{"title":"ACT001 Inhibits Tumor Progression and Modulates Immune Responses in Non-Small Cell Lung Cancer","authors":"Zhijing Shi, Yiman Li, Huijie Hou, Zhitao Wang, Hui Guo, Yang Yu, Yan Song, Zhe Chen","doi":"10.1002/jcla.70066","DOIUrl":"10.1002/jcla.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Advancements in non-small cell lung cancer (NSCLC) therapies have improved outcomes, but challenges like low immune response, drug resistance, and side effects persist. ACT001, a novel small-molecule inhibitor, shows promise in addressing these issues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We evaluated ACT001's anti-tumor and immunomodulatory effects in NSCLC. In vitro, its impact on proliferation, migration, invasion, and cell cycle arrest was assessed. In vivo, its effect on tumor growth in C57BL/6 mice was studied. Pull-down assays and mass spectrometry identified ACT001's interaction with STAT1/STAT3 and its regulation of PD-L1 expression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ACT001 inhibited NSCLC cell proliferation, migration, and invasion, induced cell cycle arrest, and suppressed tumor growth in vivo. It enhanced granzyme B release in CD3<sup>+</sup> T cells, promoting NSCLC cell apoptosis. Mechanistically, ACT001 bound to STAT1/STAT3, suppressing their phosphorylation and reducing PD-L1 expression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ACT001 exhibits antitumoral and immunomodulatory potential by targeting STAT1/STAT3 and regulating PD-L1, offering a promising therapeutic approach for NSCLC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 17","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Retraction: Overexpressed miR-335-5p Reduces Atherosclerotic Vulnerable Plaque Formation in Acute Coronary Syndrome 缩回：过表达的miR-335-5p减少急性冠状动脉综合征中动脉粥样硬化易损斑块的形成

IF 2.9 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis

Pub Date : 2025-08-13 DOI: 10.1002/jcla.70093

RETRACTION: Sun, D. Ma, T. Zhang, Y. Zhang, F. Cui, B. Overexpressed miR-335-5p Reduces Atherosclerotic Vulnerable Plaque Formation in Acute Coronary Syndrome Journal of Clinical Laboratory Analysis 35, no. 2 (2021): e23608 https://doi.org/10.1002/jcla.23608

The above article, published online on 5 December 2020 in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the authors; the journal Editor-in-Chief, Rong Fu; and Wiley Periodicals, LLC. The authors notified the journal of potential data irregularities. An investigation by the publisher confirmed that elements in Figure 7 were duplicated, and that elements of Figure 9 were duplicated from a previously published article by a different author group (Zhang et al. 2020 [https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2020.00804/full]). The retraction has been agreed due to the evidence of image duplication and manipulation which fundamentally compromises the conclusions presented in the article. The authors agree with this decision.

引用本文：孙东，马涛，张勇，张峰，崔波。过表达miR-335-5p降低急性冠状动脉综合征动脉粥样硬化易损斑块的形成2 (2021): e23608 https://doi.org/10.1002/jcla.23608上述文章于2020年12月5日在线发表在Wiley online Library （http://onlinelibrary.wiley.com/）上，经作者同意撤回；杂志主编荣福；和Wiley期刊有限责任公司。作者通知了该杂志潜在的数据违规行为。出版商的调查证实，图7中的元素是重复的，图9中的元素是从另一个作者组先前发表的文章中复制的（Zhang et al. 2020 [https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2020.00804/full]]）。由于图像复制和操纵的证据，从根本上损害了文章中提出的结论，因此已同意撤回。作者同意这一决定。

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引用次数: 0

Assessment of Mortality Risk in Patients With Community-Acquired Pneumonia: Role of Novel Inflammatory Biomarkers 社区获得性肺炎患者死亡风险评估：新型炎症生物标志物的作用

IF 2.9 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis

Pub Date : 2025-08-13 DOI: 10.1002/jcla.70081

Burcu Baran, Nur Aleyna Yetkin, Bilal Rabahoğlu, Nuri Tutar, İnci Gülmez

Background

Pneumonia is a lung parenchyma infection with clinical presentations ranging from mild to life-threatening. Its severity depends on factors such as the causative pathogen, the host's immune response, and existing comorbidities. This study aimed to investigate the prognostic value of novel inflammatory biomarkers for predicting in-hospital mortality in patients with community-acquired pneumonia (CAP).

Methods

This retrospective cross-sectional study included 207 hospitalized patients diagnosed with clinically and radiologically confirmed pneumonia. Laboratory data collected upon admission included complete blood count parameters, C-reactive protein (CRP), creatinine, and albumin levels. Systemic inflammatory biomarkers such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), CRP-to-albumin ratio (CAR), CRP-to-lymphocyte ratio (CLR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), prognostic nutritional index (PNI), and C-reactive protein-albumin-lymphocyte (CALLY) index were calculated.

Results

The cohort was predominantly male (69%, n = 142) with a mean age of 62.1 ± 16.3 years. The median hospital stay was 8 days, with an 11% mortality rate. Malignancy was more frequent in the nonsurvivor group (p = 0.001). Nonsurvivors had significantly lower hemoglobin (p < 0.001) and albumin (p = 0.004) levels, while CRP (p = 0.024) and creatinine (p = 0.002) were elevated. NLR (p = 0.009), CAR (p = 0.011), CLR (p = 0.006), SII (p = 0.013), and SIRI (p = 0.024) were higher in nonsurvivors, while PNI (p = 0.010) and CALLY (p = 0.003) were lower.

Conclusion

Novel inflammatory biomarkers, particularly the CALLY index, are valuable for mortality prediction in CAP, aiding in risk stratification and early management.

背景：肺炎是一种肺实质感染，临床表现从轻微到危及生命不等。其严重程度取决于致病病原体、宿主免疫反应和现有合并症等因素。本研究旨在探讨新型炎症生物标志物在预测社区获得性肺炎（CAP）患者住院死亡率方面的预后价值。方法：本回顾性横断面研究纳入207例临床及影像学确诊的肺炎住院患者。入院时收集的实验室数据包括全血细胞计数参数、c反应蛋白（CRP）、肌酐和白蛋白水平。计算全身炎症生物标志物，如中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、crp与白蛋白比值（CAR）、crp与淋巴细胞比值（CLR）、全身免疫炎症指数（SII）、全身炎症反应指数（SIRI）、预后营养指数（PNI）和c反应蛋白-白蛋白淋巴细胞（CALLY）指数。结果：该队列以男性为主（69%,n = 142），平均年龄为62.1±16.3岁。平均住院时间为8天，死亡率为11%。恶性肿瘤在非幸存者组中更为常见（p = 0.001）。结论：新的炎症生物标志物，特别是CALLY指数，对CAP的死亡率预测有价值，有助于风险分层和早期管理。

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引用次数: 0

Clinical Significance of Plasma and Peripheral Blood Mononuclear Cell EBV-DNA in Lymphoma 血浆和外周血单个核细胞EBV-DNA在淋巴瘤中的临床意义。

IF 2.9 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis

Pub Date : 2025-08-13 DOI: 10.1002/jcla.70092

Lu wang, Guobing Xu, Jianjun Xu, Qingyun Zhang

Background

Epstein Barr virus (EBV) is a ubiquitous virus that establishes latent infection in the host and plays a critical role in the development and prognosis of lymphomas. The presence of EBV-DNA in peripheral blood is a widely used tumor marker. However, there is no consensus on the preferred blood compartment for EBV-DNA testing.

Methods

We retrospectively analyzed data from 256 lymphoma patients, including 21 with Hodgkin lymphoma, 96 with B-cell lymphoma, and 139 with T-cell or NK/T-cell lymphoma. Complete matched PBMC and plasma EBV-DNA datasets were available, allowing correlation analysis and assessment of their respective clinical significance.

Results

Detectable pretreatment EBV-DNA in either plasma or PBMCs was significantly associated with worse survival outcomes (p < 0.001), with the worst prognosis observed in patients positive in both compartments. Longitudinal monitoring demonstrated that patients with negative EBV-DNA or declining viral loads in PBMCs or plasma had significantly improved progression-free survival compared to those with persistent positivity or increasing copy numbers (p < 0.001). Notably, changes in plasma EBV-DNA levels showed higher accuracy than PBMC EBV-DNA in reflecting treatment response. Multivariate analysis identified PBMC EBV-DNA positivity as an independent prognostic factor for inferior OS (p = 0.031) and PFS (p = 0.003).

Conclusion

Both plasma and PBMC EBV-DNA are valuable for prognostic evaluation in lymphoma patients. Plasma EBV-DNA demonstrates superior utility for monitoring treatment response, whereas PBMC EBV-DNA provides stronger prognostic information. Selection of the appropriate sample type should be tailored to the clinical context.

背景：eb病毒（Epstein Barr virus， EBV）是一种普遍存在的病毒，可在宿主中建立潜伏感染，在淋巴瘤的发展和预后中起关键作用。EBV-DNA在外周血中的存在是一种广泛使用的肿瘤标志物。然而，对于EBV-DNA检测的首选血室尚未达成共识。方法：我们回顾性分析了256例淋巴瘤患者的资料，其中21例为霍奇金淋巴瘤，96例为b细胞淋巴瘤，139例为t细胞或NK/ t细胞淋巴瘤。完整匹配的PBMC和血浆EBV-DNA数据集可用，允许相关性分析和评估各自的临床意义。结果：血浆或PBMC中可检测到的EBV-DNA预处理与较差的生存结果显著相关(p)。结论：血浆和PBMC中EBV-DNA对淋巴瘤患者的预后评估都有价值。血浆EBV-DNA在监测治疗反应方面显示出优越的效用，而PBMC EBV-DNA提供了更强的预后信息。应根据临床情况选择合适的样本类型。

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引用次数: 0

Multimarker Approach: An Effective Tool in the Risk Stratification of Patients Admitted to the Emergency Department 多标记方法：急诊科入院患者风险分层的有效工具。

IF 2.9 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis

Pub Date : 2025-08-05 DOI: 10.1002/jcla.70084

Marilena Minieri, Carla Prezioso, Dolores Limongi, Vito N. Di Lecce, Maria Stella Lia, Alessandro Terrinoni, Alfredo Giovannelli, Gianluigi Ferrazza, Cartesio D'Agostini, Sergio Bernardini, Jacopo M. Legramante

Background

The use of biomarkers in emergency room decision-making has significantly increased, particularly during the COVID-19 pandemic, due to urgent clinical needs. SARS-CoV-2 infection presents a spectrum of symptoms, from asymptomatic cases to severe pneumonia with respiratory failure. During the pandemic, various prognostic tools and biomarkers have been used to quickly guide patients to appropriate care upon admission. This study evaluated the effectiveness of a multimarker approach for early risk stratification of patients with confirmed SARS-CoV-2 infection in the Emergency Department. It aimed to determine if a combined biomarker panel could better predict COVID-19 severity than single biomarkers, aiding in clinical decision-making and resource management.

Methods

This retrospective observational study analyzed data from 265 patients with suspected COVID-19 admitted to the Emergency Department at the University Hospital Tor Vergata in Rome from April to December 2020. SARS-CoV-2 infection was confirmed by RT-PCR swabs. Clinical features and biomarker levels were analyzed, and mortality prediction was assessed using ROC curve analysis to determine the AUC.

Results

Results demonstrated that the predictive power for mortality increased when multiple biomarkers were considered together. The most comprehensive panel, combining MR-proADM, CRP, D-dimer, LDH, and CT score, achieved the highest accuracy (AUC: 0.866), outperforming any individual marker.

Conclusion

Combining multiple biomarkers improved the prediction of disease severity over individual biomarkers. These findings suggest that using a comprehensive biomarker panel can more accurately predict SARS-CoV-2 severity, supporting its potential utility for early risk stratification in various emergency settings and aiding in the efficient allocation of healthcare resources.

背景：由于迫切的临床需求，生物标志物在急诊室决策中的使用显著增加，特别是在COVID-19大流行期间。SARS-CoV-2感染呈现一系列症状，从无症状病例到伴有呼吸衰竭的严重肺炎。在大流行期间，已使用各种预后工具和生物标志物来快速指导患者在入院时获得适当的护理。本研究评估了多标志物方法在急诊科确诊的SARS-CoV-2感染患者早期风险分层中的有效性。该研究旨在确定联合生物标志物小组是否能比单一生物标志物更好地预测COVID-19的严重程度，从而帮助临床决策和资源管理。方法：本回顾性观察性研究分析了2020年4月至12月在罗马托尔维加塔大学医院急诊科收治的265例疑似COVID-19患者的数据。RT-PCR拭子证实SARS-CoV-2感染。分析临床特征和生物标志物水平，并采用ROC曲线分析评估死亡率预测，确定AUC。结果：结果表明，当多种生物标志物一起考虑时，死亡率的预测能力增加。结合MR-proADM、CRP、d -二聚体、LDH和CT评分的最全面的评估小组达到了最高的准确性（AUC: 0.866），优于任何单个指标。结论：与单个生物标志物相比，联合使用多种生物标志物可改善疾病严重程度的预测。这些发现表明，使用综合生物标志物面板可以更准确地预测SARS-CoV-2的严重程度，支持其在各种紧急情况下早期风险分层的潜在效用，并有助于有效分配医疗资源。

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引用次数: 0

Comparison of Univariate and Multivariate Reference Interval Methods. 单变量和多变量参考区间方法的比较。

IF 2.9 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis

Pub Date : 2025-08-01 Epub Date: 2025-06-18 DOI: 10.1002/jcla.70070

Esra Kutsal Mergen, Sevilay Karahan

Background: In clinical practice, reference intervals play a pivotal role in interpreting laboratory test results. Yet, when several tests are taken into consideration simultaneously, the traditional univariate intervals might not suffice due to the elevated risk of Type 1 errors.

Methods: This study introduces and evaluates two multivariate reference interval techniques: one based on Mahalanobis distance and the other an adaptation of the multivariate confidence interval (MCI). Using Monte Carlo simulations, we focused our assessments on the interplay between "serum ferritin and transferrin saturation" values.

Results: Upon evaluation, it became evident that the multivariate methods significantly reduced false positives. They presented enhanced accuracy over traditional univariate intervals. Notably, the method involving Mahalanobis distance stood out in terms of efficacy.

Contributions: Beyond presenting novel techniques, our research underscores the importance and potential of using multivariate approaches in clinical lab settings. The findings can guide better medical decision making, ensuring optimized allocation of healthcare resources.

背景：在临床实践中，参考区间在解释实验室检测结果中起着关键作用。然而，当同时考虑多个测试时，由于类型1错误的风险增加，传统的单变量间隔可能不够。方法：介绍并评价了两种多变量参考区间技术：一种是基于马氏距离的参考区间技术，另一种是基于多变量置信区间（MCI）的适应化参考区间技术。使用蒙特卡罗模拟，我们集中评估了“血清铁蛋白和转铁蛋白饱和度”值之间的相互作用。结果：经过评估，多元方法明显减少了假阳性。它们比传统的单变量区间具有更高的准确性。值得注意的是，涉及马氏距离的方法在功效方面表现突出。贡献：除了提出新技术，我们的研究强调了在临床实验室环境中使用多变量方法的重要性和潜力。研究结果可以指导更好的医疗决策，确保医疗资源的优化配置。

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引用次数: 0