Laboratory medicine最新文献

Objective: In this study, the association between preoperative levels of serum liver enzymes and overall survival (OS) was evaluated in patients with resectable pancreatic cancer.

Methods: Preoperative serum levels of alanine aminotransferase (ALT), aspartate aminotransferases (AST), γ-glutamyltransferase, alkaline phosphatase, and lactate dehydrogenase of 101 patients with pancreatic ductal adenocarcinoma (PDAC) were collected. Univariate and multivariate Cox hazard models were used to identify independent variables associated with OS in this cohort.

Results: Patients with elevated AST levels had significantly worse OS than patients with lower AST levels. A nomogram was created using TNM staging and AST levels and was shown to be more accurate in prediction than the American Joint Committee on Cancer 8th edition standard method.

Conclusion: Preoperative AST levels could be a novel independent prognostic biomarker for patients with PDAC. The incorporation of AST levels into a nomogram with TNM staging can be an accurate predictive model for OS in patients with resectable PDAC.

Background: Interprofessional education is essential for students enrolled in health care professional programs.

Objectives: We assessed the attitudes towards and the beliefs about interprofessional education (IPE) among program directors of medical laboratory science (MLS) and medical laboratory technician (MLT) programs accredited by the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS). We also investigated the inclusion of IPE in the curricula of such programs.

Methods: We emailed the link to an anonymous 22-item cross-sectional survey to 468 program directors and tabulated the responses.

Results: Program directors who support the need to include IPE within the curricula of MLT and MLS programs showed a generally positive attitude towards IPE. The beliefs about IPE among our respondents were not homogeneous. Program directors who have not yet implemented IPE in the curriculum may not have had an opportunity to experience the practical benefits of IPE.

Conclusion: Although barriers to IPE implementation exist, half of the respondents reported having already implemented IPE within their curricula.

Objective: In this study, we aimed to evaluate the serum creatinine (SCr) levels with the reference change value (RCV) in patients receiving colistin treatment.

Methods: We retrospectively recorded the SCr levels of 47 patients receiving colistin treatment before treatment and on days 3 and 7 after treatment. RCV was calculated with the asymmetrical RCV formula (Z = 1.64, P < .05). Percent (%) increase in the SCr results of the patients was compared with RCV and values exceeding RCV were regarded as statistically significant.

Results: The RCV was calculated as 15.6% for SCr. Compared with pretreatment values, SCr value on day 3 was 32/47 and on day 7 it was 36/47; as these results exceeded RCV, they were considered statistically significant.

Conclusion: Use of RCV in the interpretation of results between serial measurements will provide a more rapid and sensitive method when making decisions.

Myeloproliferative neoplasms are rare in childhood. They are categorized as Philadelphia chromosome-positive and Philadelphia chromosome-negative. Chronic myeloid leukemia (CML) is the most common myeloproliferative disease in which the Philadelphia chromosome is detected as a result of BCR-ABL rearrangements. In others, the most common genetic abnormality is JAK2V617F mutation. The coexistence of these 2 abnormalities in CML is unexpected, and rare cases have recently been reported in adults. We present a child who had a very high platelet count in which we found this coexistence. The clinical presentation, laboratory findings, management, and prognosis of this coexistence is challenging in such a rare condition.

Objective: The aim of the study was to assess the diagnostic value of tumor markers in discriminating between lung cancer and benign chest diseases (BCDs).

Methods: There were 322 patients enrolled in this investigation including 180 cases of lung cancer and 142 cases of BCD. Serum neuron-specific enolase (NSE), cancer antigen 125, cancer antigen 19-9, squamous cell carcinoma-related antigen, and cytokeratin fragment 19 (CYFRA 21-1) were compared between different populations, cancer stages, and before and after treatment. Logistic regression and receiver operating characteristic curves were used to evaluate the diagnostic markers.

Results: Both NSE and CYFRA 21-1 were significantly associated with lung cancer. The CYFRA 21-1 showed the best performance, as well as its combinations, for lung cancer diagnosis. It also showed significant change 6 months after radical surgery in lung cancer patients.

Conclusion: The marker CYFRA 21-1 could be developed as an adjuvant marker for the early diagnosis of lung cancer and as a prognostic marker for lung cancer treatment.

Serum protein electrophoresis (SPE) and immunofixation (IFE) assays are commonly used to diagnose and monitor patients with multiple myeloma (MM). Identifying analytical interferences in SPE and IFE caused by therapeutic monoclonal antibodies (tmAbs) can be challenging. Here we report the case of a 72-year-old male with a long history of relapsed immunoglobulin (Ig)G kappa MM. A follow-up SPE showed the original peak plus 2 additional cathode peaks. Immunofixation was ordered as a reflex test to investigate the new peaks that showed initial patient monoclonal IgG kappa in addition to 2 restricted bands of the IgG kappa type. Therapeutic monoclonal antibody interference was suspected and the patient's chart was reviewed. The patient was not on any antimyeloma monoclonal antibody therapy. However, preexposure prophylaxis therapeutic monoclonal antibodies tixagevimab plus cilgavimab (Evusheld) for severe acute SARS-CoV-2 was administered approximately 45 minutes before sample collection, which led to the identifiable spikes and correlated bands. After 2 days, the IgG kappa bands disappeared, confirming this therapy's effect on SPE and IFE. Therefore, clinical pathologists should be aware of when providers prescribe new monoclonal antibody therapy and become familiar with the position of commonly prescribed (tmAbs) therapies at their institutions.

Objective: To compare the diagnostic performance of 10 mathematical formulae for identifying thalassemia trait in blood donors.

Methods: Compete blood counts were conducted on peripheral blood specimens using the UniCel DxH 800 hematology analyzer. Receiver operating characteristic curves were used to evaluate the diagnostic performance of each mathematical formula.

Results: In the 66 donors with thalassemia and 288 subjects with no thalassemia analyzed, donors with thalassemia trait had lower values for mean corpuscular volume and mean corpuscular hemoglobin than subjects without thalassemia donors (77 fL vs 86 fL [P < .001]; 25 pg vs 28 pg [P < .001]). The formula developed by Shine and Lal in 1977 showed the highest area under the curve value, namely, 0.9. At the cutoff value of <1812, this formula had maximum specificity of 82.35% and sensitivity of 89.58%.

Conclusions: Our data indicate that the Shine and Lal formula has remarkable diagnostic performance in identifying donors with underlying thalassemia trait.

Objective: A nontargeted metabolomics approach was established to characterize serum metabolic profile in type 3c diabetes mellitus (T3cDM) secondary to chronic pancreatitis and compare with T2DM.

Methods: Forty patients were recruited for metabolite analysis based on liquid chromatography-mass spectrometry. Cluster heatmap and KEGG metabolic pathway enrichment analysis were used to analyze the specific and differential metabolites. The receiver operating characteristics (ROCs) were generated and correlation analysis with clinical data was conducted.

Results: Metabolites including sphingosine, lipids, carnitine, bile acid, and hippuric acid were found to be different between T2DM and T3cDM, mainly enriched in bile acid biosynthesis, fatty acid biosynthesis, and sphingolipid metabolic pathways. The ROCs were generated with an area under the curve of 0.907 (95% confidence interval, 0.726-1) for the model with 15 metabolites.

Conclusion: T3cDM is characterized by increased sphingosine, carnitine, bile acid, and most lipids, providing novel biomarkers for clinical diagnosis and a future direction in research on pathophysiological mechanisms.

Objective: Metabolic-associated fatty liver disease (MAFLD) is new nomenclature for the fatty liver condition associated with metabolic dysfunction. This study aimed to investigate the association between apolipoprotein B/A1 (apo B/A1) ratio, lipoprotein(a), and MAFLD in a Korean population.

Methods: This study consisted of 14,419 subjects in the Korean population. Multivariate logistic regression was conducted to analyze the association between apo B/A1 ratio and MAFLD.

Results: The prevalence of MAFLD in the general Korean population was 34.5%. The apo B/A1 ratio (odds ratio: 3.913, P = .019) was independently associated with MAFLD. Lipoprotein(a) was significantly lower in patients with MAFLD with hepatic fibrosis (P < .0001).

Conclusion: Apolipoprotein B/A1 ratio and lipoprotein(a) have opposite associations with MAFLD. This study suggests that lipoprotein(a) should be used with caution as a biomarker for MAFLD, especially in patients with hepatic fibrosis.