Annals of clinical and laboratory science最新文献

Objective: Atherosclerosis (AS) represents a life-threatening condition involving vascular inflammation and posing a high risk of death, yet effective therapeutic strategies remain limited. This research focused on elucidating the regulatory function of the long noncoding RNA H19 (lncRNA H19) in AS and its underlying molecular mechanisms.

Methods: To conduct the research, an AS mouse model induced by a high-fat diet and a vascular smooth muscle cell (VSMC) model exposed to oxidized low-density lipoprotein (ox-LDL) treatment were respectively constructed.

Results: There were significant aortic pathological changes and increased foam cell formation in the AS group versus the Control group. ox-LDL treatment effectively enhanced VSMC proliferation, VSMC migration, foam cell formation, and inflammatory cytokine secretion (TNF-α and IL-6), along with decreased microRNA-107 (miR-107) expression, while simultaneously increasing CD40 expression in VSMCs, all of which were reversed by knockdown of H19. Additionally, inhibition of miR-107 increased the migration and proliferation, inflammatory cytokine secretion, as well as foam cell formation in ox-LDL-treated VSMCs subjected to H19 knockdown. Moreover, miR-107 was confirmed to directly target CD40, and CD40 overexpression mitigated H19 knockdown-induced effects on ox-LDL-treated VSMCs.

Conclusion: H19 regulates the progression of AS by modulating the CD40/CD40L axis through regulation of miR-107. Targeting H19/miR-107 and CD40/CD40L may serve as a potential treatment strategy for AS.

Although granulomatous change is not commonly seen in breast cancer tumor bed and/or lymph node after neoadjuvant chemotherapy (NCT), they may mimic lymph node metastasis or tumor progression or recurrence. We present a case of diffuse sarcoid-like reaction (SLR) developed in both the breast tumor bed and axillary lymph nodes after NCT. A postmenopausal Hispanic woman presented with a 11.4 cm left breast mass with swollen lymph nodes in her left axilla. A core biopsy of the breast mass was performed, leading to the diagnosis of grade 3 invasive ductal carcinoma. The tumor is negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receoptor-2 overexpression. The patient received NCT with three cycles of doxorubicin and cyclophosphamide, followed by weekly paclitaxel for 12 weeks. After NCT, the tumor in her left breast significantly reduced in size, but the lymph nodes remained swollen. She subsequently underwent left modified radical mastectomy. Histological examination of the treated tumor bed revealed residual invasive tumor with frequent non-caseating granulomatous change. The granulomatous reaction was also seen in several axillary lymph nodes, of which only one had residual metastatic tumor cells. Idiopathic granulomatous mastitis, sarcoidosis, and infective etiologies were excluded based on the patient's medical history, imaging, and histological findings. We report a case of localized SLR in response to NCT in breast cancer tumor bed and axillary lymph nodes. Recognizing this feature is important to avoid misdiagnosis and overtreatment of SLR as residual cancer.

Objective: miR-142-5p's role in tumors is inconsistent. The PIAS3/pSTAT3 signaling is an important regulator of the tumor microenvironment. Our study assessed whether miR-142-5p and PIAS3/pSTAT3 affect oral squamous cell carcinoma (OSCC).

Methods: 83 OSCC patients were recruited to analyze the baseline characteristics. In TCGA database, we found 18 miRNAs in tumor tissues, including miR-142-5p. STAT3 protein expression was measured in tissues by IHC and the relationship of miR-142-5p with PIAS3/pSTAT3 was assessed along with cellular location of miR-142-5p by immunofluorescence staining.

Results: In TCGA database, 18 miRNAs were found to be expressed in OSCC samples. miR-142-5p was significantly downregulated in OSCC tissues compared to normal tissues. Meanwhile, PIAS3 has complementary sequences with hsa-miR-142-5p and luciferase activity was reduced. STAT3 was located in the nucleus of miR-142-5p-transfected cells. In OSCC, miR-142-5p activated PIAS3, leading to STAT3 activation. Patients with positive STAT3 expression had better survival outcomes than patients with negative STAT3 level.

Conclusion: miR-142-5p directly targets PIAS3 and induces up-regulation of STAT3 through miR-142-5p/PIAS3/pSTAT3 axis, thereby affecting the survival outcome of OSCC patients.

Small cell neuroendocrine carcinoma of the cervix (SCNEC) is a rare and highly aggressive tumor with a high rate of recurrence and metastasis. Due to its low prevalence, standardized treatment regimens for SCNEC remain undefined. This case report describes an adult patient with SCNEC who developed multiple metastases, including those in the neck, abdominal wall, and brain. The patient underwent a multidisciplinary treatment approach, including chemoradiotherapy, targeted therapy, and a PD-1 inhibitor combined with radiotherapy, achieving notable therapeutic efficacy with an overall survival exceeding 49 months. This case underscores the potential role of immunotherapy in treating SCNEC. Furthermore, the extensive tumor progression, exacerbated by disruptions during the COVID-19 pandemic and poor patient compliance highlights the importance of cervical cancer screening, early diagnosis, and treatment compliance.

Objective: This study aimed to evaluate the effect of a novel intrauterine infusion of autologous platelet-rich plasma (PRP) on endometrial condition and clinical outcomes in patients with thin endometrium undergoing frozen-thawed embryo transfer (FET) cycles.

Methods: A prospective randomized controlled trial was conducted with 70 patients diagnosed with thin endometrium at the Reproductive Medicine Center of Shenzhen Maternal and Child Health Hospital from January 2022 to June 2023. The patients were randomly divided into two groups: a single PRP infusion group and a PRP combined with endometrial microstimulation (EM+PRP) group. Endometrial thickness and classification were assessed before and after treatment. Clinical outcomes, including human chorionic gonadotropin (HCG) positivity rate, embryo implantation rate, clinical pregnancy rate, and early miscarriage rate, were analyzed.

Results: Baseline characteristics, including pre-treatment endometrial thickness, were comparable between groups. Both groups showed a significant increase in endometrial thickness after treatment (P<0.05). The EM+PRP group exhibited a greater improvement in post-treatment endometrial thickness compared to the single PRP group (P<0.05). Endometrial morphology showed improvement in both groups, but the difference was not statistically significant (P>0.05). No significant differences were found between the two groups in terms of HCG positivity rate, embryo implantation rate, clinical pregnancy rate, or early miscarriage rate.

Conclusion: Both EM+PRP and single PRP intrauterine infusion effectively increased endometrial thickness and improved clinical outcomes in patients with thin endometrium. The combined EM+PRP therapy showed potential for greater efficacy in improving endometrial condition, warranting further research in larger, multicenter studies.

Objective: This report aims to explore the significant impact of heterophilic antibodies on CK-MB immunoassays, leading to persistent false-positive results.

Case report: A 59-year-old male with a history of coronary artery disease exhibited persistently elevated CK-MB levels for over two years, despite normal troponin I levels. Further investigations, including serial dilution, blocking experiments, and testing across different platforms, confirmed the presence of heterophilic antibody interference, which was responsible for the falsely elevated CK-MB levels.

Conclusion: This case underscores the critical importance of recognizing heterophilic antibody interference in immunoassays. The use of appropriate diagnostic approaches, such as blocking antibodies, cross-platform testing, and the integration of additional diagnostic markers, is essential to prevent misdiagnosis and ensure accurate clinical decision-making.

Objective: To develop machine learning models, facilitate a more accurate diagnosis of ovarian cancer (OC), and explore potential markers.

Methods: Overall, 311 patients diagnosed with OC, 56 with borderline ovarian tumors (OTs), and 368 patients with benign OTs were defined as derivation cohort and randomly divided into training (70%) and internal validation (30%) sets. An independent external validation cohort was also established. A total of 34 variables including patients' demographic characteristics and laboratory test results were collected. Models were developed using artificial neural network, support vector machine, random forest, and extreme gradient boosting (XGBoost).

Results: All four models achieved high accuracy, with XGBoost achieving the highest area under the curve (AUC). When using the XGBoost model to differentiate OC from borderline and benign OTs, the AUC and 95% confidence interval, sensitivity, specificity, positive predictive value, and negative predictive value of the training set were 0.973 (0.962-0.985), 84.2%, 96.6%, 93.9%, and 90.6%, respectively. For the internal validation set, the values were 0.932 (0.897-0.966), 74.7%, 92.0%, 85.5%, and 85.2%. The eight most important variables were human epididymis protein 4, carbohydrate antigen 125, lactate dehydrogenase, D-dimer, age, testosterone, follicle-stimulating hormone, and hemoglobin. Subgroup analyses also revealed that this model exhibited outstanding performance in identifying early-stage OC and epithelial OC.

Conclusion: Machine learning models demonstrate excellent accuracy in distinguishing OC from borderline and benign OTs, with several potential markers being validated.

This case report describes a rare instance of hypertriglyceridemic acute pancreatitis (HTG-AP) in which both the serum amylase level and pancreatic imaging showed no significant abnormalities, presenting a significant diagnostic challenge. The case emphasizes the importance of identifying chylous serum during amylase testing as a key diagnostic clue. Upon reviewing the patient's electronic medical records and correlating the clinical presentation of persistent abdominal pain, the laboratory team raised suspicion of HTG-AP. A series of confirmatory steps, including serum dilution and close communication with the clinical team, ultimately led to a timely and accurate diagnosis. After receiving symptomatic and etiological treatment, the patient made a full recovery and had a favorable prognosis.

Objective: Diagnosing adrenal insufficiency in people living with HIV (PLWH) is challenging, especially in resource limited settings. Salivary cortisol assessment, however, is simple, minimally invasive, efficient, and cost-effective, making it a viable alternative. We evaluated whether early morning salivary cortisol measurement among PLWH could replace Synacthen test in Africans.

Methods: This cross-sectional study included 201 PLWH recruited from the HIV clinic of a tertiary health facility and a comparison group of 200 HIV-negative individuals. We used a locally established cut off and a low-dose Synacthen test to determine adrenal function. Serum and salivary cortisol samples were obtained simultaneously at baseline and during the test (at 30 and 60 minutes).

Results: The prevalence of adrenal insufficiency among PLWH was 54.7% when using a salivary cortisol-based locally established cut off, compared to 10.5% using a serum derived diagnostic cut-off (p<0.001). Adrenal insufficiency was associated with HIV diagnosis and dolutegravir (DTG) use. Compared to HIV-negative participants, PLWH on DTG had 18 times the odds of developing adrenal insufficiency (adjusted odds ratio [aOR]=18.3, 95% confidence interval [CI]: 9.58-36.5), while PLWH not on DTG had 13 times the odds (aOR=13.7, 95% CI: 6.60-30.3).

Conclusion: HIV status is associated with development of adrenal insufficiency. Salivary cortisol measurement could serve as a useful non-invasive tool for diagnosing adrenal insufficiency among PLWH in similar settings.