Annales de biologie clinique最新文献

A 63-years-old man with a history of metastatic neuroendocrine tumor of the small bowel was admitted to hospital for laparoscopic lumpectomy. Following surgery, two drains were placed, one opposite the removal of the pancreatic lesions and the other opposite the hepatic lumpectomy site. A lipidogram on the drain fluids is requested for chylomicron, triglyceride and lipase determination.

The Estrogen receptor β (ESR-β) gene is suggested to have a growth inhibitory role in prostate tissue and was proposed as a new therapeutic target for prostate cancer (PCa). Precedent studies have investigated the association between the ESR-β rs1256049 polymorphism and PCa but findings were inconsistent. Thus, this meta-analysis was performed to assess whether the ESR-β rs1256049 polymorphism is associated with an increased susceptibility to PCa. Eligible studies published before February 5, 2022 were systematically searched in PubMed, Web of Science, ScienceDirect and Google Scholar databases. The sample set was extracted from 11 case-control studies involving 9390 cases and 10057 controls for the association between ESR-β rs1256049 polymorphism and PCa susceptibility. In our overall meta-analysis, no significant association between rs1256049 and PCa risk was found under all genetic models. In subgroup analysis according to ethnicity, Asians, had a significantly decreased cancer risk based on both the heterozygote genetic model (OR = 0.75, 95% CI = [0.63, 0.89] P = 0.01) and the dominant model (OR = 0.80, 95% CI [0.69, 0.94] P = 0.01). For the Caucasian group, there was a significantly increased risk observed in the allelic model (OR = 1.17, 95% CI = [1.04, 1.32] P = 0.01), heterozygote model (OR = 1.15, 95% CI = [1.01, 1.31] P = 0.03) and the dominant model (OR = 1.17, 95% CI = [1.03, 1.32] P = 0.01). Our results demonstrate that ESR-β r1256049 polymorphism may play a possible promising effect in PCa in Caucasians and a protective factor in Asians.

Flow cytometric immunophenotyping is nowadays an essential tool for diagnosis, classification and monitoring of chronic lymphoproliferative disorders (CLPD). Several recommendations on multicolor panels have been proposed in the literature but little is known about their application in routine laboratories. The CytHem group (Cytométrie Hématologique francophone), created in 2018, is organized in multiple thematic groups: among them one is dedicated to CLPD, "Cythem-SLP". The first objective of Cythem-SLP was to conduct an investigation on current practices about flow cytometry and CLPD among its members. The answers of 40 centers have been collected and investigated. Only a few of them directly apply panels proposals from the literature. Nevertheless, this investigation highlights some antibodies which are necessary for the CLPD diagnosis according to the experience of the centres. Finally, members of CytHem-SLP group are still on demand for harmonization panels proposals and interlaboratory controls.

The Lyon Hospitals Board (HCL) hemostasis laboratory has shifted from a frequentist to a long-term Bayesian approach to IQC results management, using the Hemohub® software of the Werfen corporation, which hosts the requisite Bayesian tools. IQC plans based on supplier specifications proved effective in managing analytic risk in line with the ISO 15189 standard. Long-term Hemohub® control and monitoring has been validated by acceptable feedback from the EQA organization used by the hemostasis community.

The monoclonal B-cell lymphocytosis (MBL) introduced as new entities in the 2008 WHO classification, are defined by circulating B-cell clone < 5.109/L without organomegaly and previous and/or simultaneous lymphoproliferative disorders. The MBL were subclassified in MBL CLL type (the most frequent), MBL atypical CLL type and MBL non-CLL type (rarely reported in literature). Here the clinic, cytologic, immunologic and genetic features of MBL non-CLL type were described from a series of 34 cases. As previously reported, present cases presented immunologic and genetic similarities to MZL and could be associated to the new proposed entity CBL-MZ (clonal B-cell lymphocytosis of marginal zone origin). In addition, few cases presented similarities to splenic diffuse red pulp lymphoma (SDRPL). In conclusion, according to the literature, MBL with non-CLL type (assimilated to CBL-MZ) may be a premalignant state of MZL and/or SDRPL.

The obstetrical follow-up of patients with a severe hypofibrinogenemia requires a multidisciplinary collaboration because of potential maternal-fetal complications (recurrent miscarriages, intrauterine fetal demise, post-partum hemorrhage, thrombosis). We report the obstetrical management of a multiparous patient with a severe congenital hypofibrinogenemia associated with a platelet disorder (abnormal phospholipid externalization). A therapeutic strategy based on a biweekly administration of fibrinogen concentrates associated with enoxaparin and aspirin allowed the maintenance of pregnancy. But this last one got complicated by a placenta percreta requiring a salvage hysterectomy with an appropriate hemorrhage prophylaxis.

Iron is an essential element to the well functionning of the organism and requires careful maintenance of its homeostasis. This is mainly due to hepcidin, a hormone secreted by the liver that controls the flow of iron within the body. It has a hyposideremic action by reducing the expression of ferroportin, the only protein known to this day, which can export iron into the extracellular environment. This has the effect of decreasing intestinal absorption and increasing intracellular retention, especially in macrophages. Hepcidin is stimulated by elevation of iron and inflammation while activation of erythropoiesis inhibits it. Understanding its regulation allows a better understanding of the pathophysiological mechanisms of overload diseases and iron deficiency. Therefore, hepcidin analysis is interesting for the exploration of iron homeostasis. In combination with other biological parameters of iron status, it is possible to find better instructions for therapeutic managements of iron metabolism diseases. Thus, an assaying method by coupling liquid chromatography and tandem mass spectrometry has been implemented at Grenoble University Hospital and the analytical performances of this assay met the laboratory requirements in terms of reliability of the analysis.

Introduction: Complete remission (CR) in patients with acute myeloid leukemia (AML) is still morphologicaly defined, thus corresponding to a wide range of tumor burden.

Objectives: we aimed to evaluate the residual disease (MRD) status in patients with AML, as well as perform a molecular analysis of the FLT3/ITD gene in patients with normal karyotype.

Material and methods: adult patients with AML, diagnosed according to the WHO 2016 criteria, were included. MRD was detected using flow cytometric techniques after induction treatment resulting in CR.

Results: thirty patients met our inclusion criteria. 83 % of them had an intermediate risk status, 67 % of which (20/30) having a normal karyotype. MRD and leukemic stem cell (LSC) positivity in this group was predominant with considerable decrease in benign progenitor count. The relapse-free survival (RFS) in the group of MRD negative patients with normal cytogenetics and non-mutated FLT3 gene was better than the RFS in all of our patients studied.

Conclusion: MRD and LSC are powerful prognostic factors for relapse. They should be routinely integrated to guide better management of AML.

Introduction: Urinary tract infection (UTI) diagnosis by urine culture is time- and labor- consuming. In the Ibn Rochd microbiology laboratory, up to 70% of urine culture samples yield no growth or insignificant growth.

Objective: To evaluate the new generation of Sysmex UF-4000i fluorescence flow cytometry analyzer with a blue semiconducting laser as a method to rule out negative urine samples for UTI, in comparison of urine culture.

Material and methods: Flow cytometry and microbiological analysis were performed on 502 urine samples included in the study. We used ROC analysis to determine cutoff points at which optimal sensitivity and specificity are achieved for clinical use.

Results: Our results showed that bacteria count at a cut-off of 100/μL, and/or the leucocytes count ≥ 45/μL are the optimal indicator for positive culture results. At these cut off, bacteria sensitivity (SE), specificity (SP), Positive predictive value (PPV) and negative predictive value (NPV) were 97,3%, 95%, 87,8% and 98,8% respectively. For leucocytes, SE, SP, PPV and NPV were 99,1%, 95,8%, 88,6% and 99,7% respectively.

Discussion and conclusion: The bacterial and leucocytes counts generated by UF-4000i analysis may be useful in our context as a rapid screening to exclude UTI by reducing about 70% of urines cultures and then workload. Nevertheless, further validation is needed for different patient groups especially with urological disease or immunocompromised patients.