Annals of clinical and laboratory science最新文献

Objective: Malignant pleural effusion (MPE) is a common complication of lung cancer with poor prognosis. Benign pleural effusion (BPE), such as tuberculous and pneumonic pleural effusion, usually has a good prognosis. Differential diagnosis between MPE and BPE remains a clinical challenge.

Methods: 52 MPE, 93 BPE, and their corresponding serum samples were analyzed by hydrogen nuclear magnetic resonance (¹HNMR) based metabolomics.

Results: The ¹HNMR study showed that some amino acids and betaine in MPE are significantly altered in pleural effusion and serum compared to BPE patients. Levels of serum glucose and glutamine have strong positive correlation with those in pleural effusion (r>0.6) for MPE patients. The area under the receiver operating characteristic curve (AUROC) values of metabolites in pleural effusion or serum were less than 0.805 in differentiating MPE from BPE. Improved an AUROC value of 0.901 was observed using pleural effusion-serum ratios of glutamic acid in differentiating MPE from BPE, which was further validated by 15 double-blind samples.

Conclusions: Compared with BPE patients, amino acids and betaine in MPE are significantly altered in pleural effusion and serum. Pleural effusion-serum ratio of glutamic acid may contribute to the rapid diagnosis of MPE from BPE by ¹HNMR analysis.

Objective: Meningioma is the most common primary adult intracranial neoplasm, and proliferation indices (PI) rise with increasing grade from WHO CNS grade 1 to 3. Ki-67 immunohistochemistry (IHC) poses a variety of technical and interpretative challenges. Here, we specifically investigated the staining intensity and its effect on interpretation and final diagnosis.

Methods: 124 high and low-grade meningiomas of various grades were blindly evaluated using different counting strategies (CS) based on the staining intensity of the nuclei as darkest (CS1), darkest+intermediate (CS2), and any staining (CS3) in hot-spots (HS) and in the context of overall proliferative activity (OPA).

Result: CSs in HS, OPA, and their average results were significantly different between low-grade and high-grade groups. PI obtained using CS3 yielded results that matched best with values expected for the corresponding WHO grade. CS had a profound impact on whether a LG meningioma would be diagnosed as one with a "high proliferation index."

Conclusion: A large body of work exists on the counting methods, clinically significant cut-off values, and inter- and intra-observer variability for Ki-67 PI interpretation. We show that Ki-67 IHC staining intensity, which to our knowledge has not been previously systematically investigated, can have a significant effect on PI interpretation in settings that influence diagnostic and clinical management decisions.

Objective: Human papillomavirus (HPV) is a double-stranded DNA virus that belongs to the papillomavirus family. High-risk (HR) genotypes of HPV are associated with cervical cancer. The combination of molecular HPV testing and cytology results in an increased detection of high-grade cervical lesions. This study compares the performance of a newly developed MolecuTech Real HPV 16/18/HR assay to that of the cobas HPV assay and Onclarity HPV Assay in Korea.

Methods: A SurePath liquid-based cytology device (BD diagnostics, NC, USA) was used to prospectively collect cervical swab specimens. Onclarity HPV Assay (Onclarity; BD diagnostics), Cobas 4800 HPV Test (Cobas; Roche, Rotkreuz, Switzerland), and MolecuTech Real HPV 16/18/HR (MolecuTech; YD, Yongin, Korea) were performed to detect HPV genotypes.

Results: Of the 438 cervical specimens, 13.7% showed the HR-HPV genotype. The concordance rates between Onclarity and MolecuTech, cobas and MolecuTech, and Onclarity and Cobas were 94.9% (kappa=0.754), 95.7% (kappa=0.768), and 95.5% (kappa=0.791), respectively. Moreover, no statistically significant differences in HPV genotyping results were observed in the cytology-positive specimens.

Conclusions: The MolecuTech Real HPV 16/18/HR assay showed good agreement in the detection of HR HPV genotypes, and similar analytical performance for the detection of HR HPV genotypes in samples with abnormal cytological findings.

Objective: Deep learning has been shown to be useful in detecting breast cancer metastases by analyzing whole slide images (WSI) of sentinel lymph nodes; however, it requires extensive analysis of all the lymph node slides. Our deep learning study attempts to provide a rapid screen for metastasis by analyzing only a small set of image patches to detect changes in tumor environment.

Methods: We designed a convolutional neural network to build a diagnostic model for metastasis detection. We obtained WSIs of Hematoxylin and Eosin-stained slides from 34 cases with equal distribution in positive/negative categories. Two WSIs were selected from each case for a total of 69 WSIs. From each WSI, 40 image patches (100x100 pixels) were obtained to yield 2720 image patches, from which 2160 (79%) were used for training, 240 (9%) for validation, and 320 (12%) for testing. Interobserver variation was also examined among 3 users.

Results: The test results showed excellent diagnostic results: accuracy (91.15%), sensitivity (77.92%), and specificity (92.09%). No significant variation in results was observed among the 3 observers.

Conclusion: This preliminary study provided a proof of concept for conducting a rapid screen for metastasis rather than an exhaustive search for tumors in all fields of all sentinel lymph nodes.

Objective: This study aimed to investigate the role and mechanism of microRNA (miR)-193a in promoting apoptosis of retinal neuronal cells in early diabetic (DM) rats.

Methods: Seventy-two male SD-grade rats were selected to establish a DM model by intraperitoneal injection of streptozotocin (STZ), and randomly divided into a control group (blank control group), a DM group (diabetic model group), a DM+miR-NC inhibitor group (miR-193a inhibition negative control group), a DM+miR-193a inhibitor group (miR-193a inhibitor group), DM+miR-NC mimic group (miR-193a overexpression negative control group), DM+miR-193a mimic group (miR-193a overexpression group), with12 rats in each group.

Results: The miR-193a expression, apoptosis rate, and Bax, Caspase3, and Caspase9 protein expression levels were elevated, and Bcl-2 protein expression was decreased in the retinal tissues of DM rats and high glucose-induced rat retinal neuronal cells, while miR-193a inhibitors reversed these processes. These dual luciferase reporter assay showed that WT1CDS, and WT1Mut were lower in the miR-193a group than in the miR-NC group (P<0.05); WT1 protein expression was reduced in the retinal tissues of DM rat and high glucose-induced rat retinal neuronal cells, and miR-193a inhibitors increased WT1 protein expression. Compared with cells co-transfected with miR-193a and WT1vector, miR-193a and WT1 cotransfection inhibited high glucose-induced apoptosis in retinal neuronal cells and regulated apoptotic protein expression. miR-193a was highly expressed and WT1 was lowly expressed in retinal tissues of DM rats and high glucose-induced rat retinal neuronal cells.

Conclusion: miR-193a could inhibit early retinal neuronal cell apoptosis in DM rats by targeting and negatively regulating WT1 expression.

Objective: The world has been faced with the repeat rise of SARS-CoV-2 variants since late 2020, including Alpha, Beta, Gamma, Delta, and the latest simultaneous emergence of far-flung spawn of Omicron sub-lineages in different parts of the globe. This has brought us the challenge of determining what factor(s) have been the selective force behind these immune evasive and therapy resistant mutations. It is very possible that such variants evolved in limited host individuals with prolonged infections, or from a localized community of patients.

Methods: This study surveys the GISAID time capsule of mutations found in viral genomes from patients with prolonged same lineage viral infections. We analyzed 288 SARS-CoV-2 genomes representing 113 patients who had same lineage viral genomes in two or more samples stored in GISAID.

Results: Of these, thirty-five (30.9%) of the 113 patients developed mutations during their infections. Samples from patients whose viral genomes showed nucleotide changes(s) (n=35) versus those that showed no change (n=78) had a statistically significant difference (p=2.121x10^-4) in duration of infection by a median of 13 days (range 0-109 days) versus 6 days (range 0-72 days), respectively. Five highly recognizable variant-defining mutations with immune evasion properties were identified in 5 cases infected by the B.1 lineages in late 2020 and early 2021.

Conclusion: This suggests the duration of infection is a contributing factor that gives rise to mutations, but not the sole factor, and individual host conditions may play a critical role in driving viral evolution.

Objective: As an immune/inflammatory indicator, the application of monocyte-lymphocyte ratio (MLR) in the treatment of severe burns is lacking. The aim of this study was to investigate the dynamic changes of the MLR value in the early stage of severe burns and its clinical value.

Methods: This is a 5-year retrospective cohort study involving 100 patients with severe burns (II-III degree and total body surface area (TBSA) >50%), in which the lymphocyte count, monocyte count, MLR value, C-reactive protein (CRP), creatinine (Scr), and capillary leakage index (CLI) were evaluated soon after injury, and 30-day mortality rates were investigated.

Results: The MLR values in non-survivors with severe burns were higher than those in survivors in the first two days after injury, while the values on the 3^rd, 5^th, 6^th and 7^th day after injury were lower than those in survivors. The differences between the 6^th and 7^th days after injury were statistically significant. According to the results of logistic and Cox regression analysis, the MLR values on the 6^th day after injury were independent predictors of mortality, and the area under the ROC curve of the 6^th day MLR for severe burn-delayed death prediction was 0.658 (95% confidence interval, 0.541-0.774), and the optimal cut-off value was 0.991. The 30-day mortality rates differed significantly between the MLR6 ≥0.991 group and the MLR6≤0.991 group (P<0.05). Within one week after injury, the MLR values were negatively correlated with Scr, CRP and CLI levels for severe burns.

Conclusions: Our results revealed the dynamic characteristics of the MLR value in the early stage of severe burns, reflecting important changes in the immune/inflammatory related stress response soon after injury, low MLR level was associated with the worsening of disease condition.

Objective: To examine the expression and function of necroptosis-associated miRNAs in esophageal squamous cell carcinoma.

Methods: A total of three microarray datasets, i.e., GSE122497, GSE114110, and GSE43732, were selected from the GEO database for differential analysis of necroptosis-related miRNA expression. The differentially expressed miRNAs were screened for target miRNAs using Kaplan-Meier survival analysis in the OncomiR database. The expression of the target miRNAs in the HEEC, KYSE-450, TE-1, and KYSE-410 cell lines was measured via qPCR. The expression of the target miRNAs in esophageal cancer cells was regulated by transfection with Lipofectamine 2000, and cell proliferation, cell migration, cell apoptosis and the cell cycle were detected by CCK-8, Transwell, and flow cytometry.

Results: The tumor tissue and peripheral blood of esophageal squamous cell cancer patients showed differential expression of 7 miRNAs related to necroptosis. Survival analysis revealed that miR-425-5p and miR-16-5p were negatively correlated with patient survival. The esophageal squamous cell carcinoma cell lines exhibited increased expression of miR-425-5p and miR-16-5p, with KYSE-410 exhibiting the most significant increase. Inhibition of miR-425-5p and miR-16-5p expression in the KYSE-410 cell line resulted in increased apoptosis, decreased proliferation, and decreased migration of esophageal cancer cells as well as a significant increase in the S phase and a decrease in the G2/M phase according to the cell cycle assay.

Conclusion: The pro-carcinogenic role of miR-425-5p and miR-16-5p has been observed in esophageal squamous cell carcinoma.

Objective: Several ways for presenting the results of osmotic fragility test have been described in the literature. Our aim was to compare the utility of a novel parameter for assessment of erythrocyte osmotic properties, i.e., 'Slope of the steepest part of hemolysis curve' with the most frequently used parameter 'Median corpuscular fragility' in order to assess the stability of erythrocytes in a blood sample during prolonged storage.

Methods: Ten whole blood samples were obtained from healthy donors. The osmotic fragility test was initially conducted on the day of venipuncture, and subsequent analyses were carried out on days 1, 2, 4, 7, 9, 11, and 14 after the venipuncture. Mean hemolysis percentage values were used to construct hemolysis curves. The steepest parts of hemolysis curves were estimated to be linear, and lines that overlapped those parts of the curves were created. The slope of these lines was calculated, and the resulting mean values are presented.

Results: A significant increase in Median corpuscular fragility values was observed, starting from day of venipuncture. We compared the average values for each day of analysis. The first significant difference in Median corpuscular fragility values was observed on day 4 compared to the day of venipuncture (p=0.006), with values 0.53±0.030 % and 0.41±0.014% respectively. Meanwhile, differences in the values of the slopes of the steepest parts of hemolysis curves were observed as early as day 2 when compared to the day of venipuncture (p=0.046), with values of -966.23±233.07 and -588.01±222.85, respectively.

Conclusion: Prolonged storage of whole blood samples leads to an increase in osmotic fragility and alters the shape of the hemolysis curve. These changes suggest that postponing the osmotic fragility test could lead to diagnostic inaccuracies. These findings suggest that slope value is a more accurate parameter for evaluating erythrocyte stability during storage, compared to commonly used Median corpuscular fragility value. Hence, it has potential importance and can be complementary to the laboratory result of the OFT. Therefore, it can be useful to provide these results jointly with the results of the OFT test.