Biomarkers in medicine最新文献

Aims: This study aimed to evaluate serum levels of killer cell lectin-like receptor B1 (KLRB1, CD161) as a biomarker for distinguishing between viral and bacterial causes in patients with community-acquired pneumonia (CAP).

Materials & methods: A total of 120 individuals were enrolled between November 2024 and January 2025: 46 with viral pneumonia, 44 with bacterial pneumonia, and 30 healthy controls. Serum KLRB1 levels were measured using ELISA. Microbiological cultures, PCR testing, and serology were used to classify pneumonia etiology. Additional laboratory and radiological data were collected.

Results: Streptococcus pneumoniae and Influenza A H1N1 were the most common agents for bacterial and viral pneumonia, respectively. KLRB1, CRP, and leukocyte levels were significantly higher in bacterial cases than viral ones (p < 0.001). KLRB1 levels were also significantly higher in healthy controls compared to both pneumonia groups. ROC analysis showed a KLRB1 cutoff of 5.11 ng/mL yielded 97% sensitivity and 85% specificity in distinguishing bacterial from viral pneumonia.

Conclusions: Serum KLRB1 may serve as a valuable biomarker to differentiate between viral and bacterial CAP, supporting early diagnosis and optimized treatment decisions.

Introduction: Galectin-3 (Gal-3) is a biomarker associated with myocardial fibrosis, a key factor in the dysfunction of the functionally single ventricle (FSV) in patients after the Fontan procedure. This study aimed to evaluate the relationship between serum Gal-3 levels and echocardiographic and cardiopulmonary exercise parameters in this population.

Methods: Thirty-seven patients (23 males, 14 females) with Fontan circulation were included. All underwent speckle-tracking echocardiography (STE), cardiopulmonary exercise testing (CPET), and serum Gal-3 measurement using ELISA. Correlations between Gal-3 and clinical, echocardiographic, and CPET parameters were analyzed.

Results: Gal-3 levels correlated positively with patient age and time since Fontan completion (p < 0.05). No significant associations were found between Gal-3 and ejection fraction, global longitudinal strain (GLS), or free wall strain. However, Gal-3 showed a significant correlation with the transmural strain gradient (p < 0.05). No association was observed between Gal-3 and CPET parameters, including peak VO₂.

Conclusions: Galectin-3 may reflect fibrotic remodeling of the FSV, as suggested by its correlation with the transmural strain gradient. The absence of a relationship with exercise capacity highlights the complexity of Fontan-related dysfunction. Gal-3 shows promise as a noninvasive biomarker of myocardial fibrosis in this unique patient group.

Aims: This study aims to validate the potential of miR-93-3p, which is aberrantly expressed in acute ischemic stroke (AIS) patients, as a key biomarker for diagnosing AIS and predicting subsequent cognitive impairment.

Materials & methods: The level of miR-93-3p was measured using quantitative real-time polymerase chain reaction (qRT-PCR). Receiver operating characteristic (ROC) curves were employed to assess the diagnostic value of miR-93-3p in AIS patients and its predictive value for post-stroke cognitive impairment (PSCI) risk after AIS. Additionally, SH-SY5Y cells subjected to oxygen-glucose deprivation (OGD) were used to explore how miR-93-3p regulates cell viability, inflammation, and oxidative stress. The target genes of miR-93-3p were predicted by integrating the TarBase, TargetScan, and miRDB databases, followed by GO and KEGG pathway enrichment analysis of the candidate genes.

Results: miR-93-3p levels were higher in AIS patients, with a more pronounced increase in those with PSCI (p < 0.001). ROC curve analysis confirmed that miR-93-3p has strong diagnostic value for differentiating AIS patients from healthy controls. Moreover, miR-93-3p levels can independently predict PSCI occurrence. The levels of C-reactive protein and homocysteine were positively correlated with the level of miR-93-3p. In miR-93-3p-silenced SH-SY5Y cells, OGD-induced cell damage were reversed. The secretion of inflammatory factors and malondialdehyde (MDA) was reduced, while the intracellular levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX) were increased. The predicted targets of miR-93-3p were significantly enriched in key pathways implicated in stroke pathophysiology, including ubiquitin-mediated proteolysis, cellular response to decreased oxygen levels, and the Notch signaling pathway.

Conclusions: In conclusion, miR-93-3p may serve as a biomarker for AIS diagnosis and PSCI prediction.

Aims: This meta-analysis evaluates the diagnostic and prognostic performance of severe pneumonia through a comprehensive meta-analysis.

Patients and methods: A systematic literature search was conducted across PubMed, Embase, Cochrane Library, Web of Science, and Scopus. Studies were included if they focused on severe pneumonia patients, assessed relevant inflammatory markers, and provided sufficient data for meta-analysis.

Results: The diagnostic meta-analysis found a sensitivity of 0.72 (95% CI: 0.64-0.79) and a specificity of 0.75 (95% CI: 0.70-0.80). Area under the summary receiver operating characteristic curve was 0.80 (95% CI: 0.76-0.83). However, these pooled estimates showed high heterogeneity (I² > 80%), indicating substantial variation across studies and requiring cautious interpretation. Subgroup analyses revealed that procalcitonin (PCT) had the highest specificity. For predicting short-term mortality, a preliminary analysis of five studies (n = 463) showed a pooled sensitivity of 0.72 (95% CI: 0.64-0.79) and a specificity of 0.65 (95% CI: 0.59-0.70), suggesting a potential prognostic signal that needs validation in larger, prospective cohorts.

Conclusions: Inflammatory markers are valuable auxiliary tools to support clinical judgment in assessing severity and predicting outcomes in patients with severe pneumonia. They offer moderate accuracy in distinguishing severe from non-severe cases and in predicting short-term mortality.

Background: Cardiovascular disease (CVD) remains the leading cause of premature mortality worldwide. Among its manifestations, ischemia with non-obstructive coronary arteries (INOCA) and myocardial infarction with non-obstructive coronary arteries (MINOCA) are increasingly recognized and associated with major adverse cardiovascular events. While biomarkers are established tools for diagnosing and predicting outcomes in CVD, their role in INOCA and MINOCA remains unclear. This review summarizes current evidence on cardiovascular biomarkers and their clinical relevance in the context of INOCA and MINOCA.

Methods: A systematic review of original studies was conducted using Ovid-MedLine and Embase databases. Eligible studies included adult patients diagnosed with INOCA or MINOCA, with measurements of specific serum biomarkers.

Results: Of 1,493 records identified, 53 were included in the quantitative analysis, encompassing 10 biomarkers. Among inflammatory markers, only C-reactive protein was significantly higher in INOCA patients compared to healthy controls. Metabolic, coagulation and endothelial biomarkers showed no differences. Limited data in the MINOCA population precluded comprehensive biomarker analysis.

Conclusion: Elevated biomarkers of inflammation in INOCA suggest underlying mechanisms such as oxidative stress, cytokine activation, and immune-mediated microvascular dysfunction. Their diagnostic and prognostic potential in INOCA remains promising but requires further validation in clinical studies.

Aims: The hemoglobin-to-red cell distribution width ratio (Hb/RDW) is a prognostic biomarker in various malignancies. However, its prognostic value in endometrial cancer (EC) remains unclear. This study investigated the association between preoperative Hb/RDW ratio and 5-year overall survival (OS) in patients with EC.

Materials & methods: This retrospective cohort study included 548 patients with histologically confirmed EC who underwent surgery at a single tertiary center in Taiwan between 2010 and 2021. Patients were stratified on the basis of an Hb/RDW threshold of 1.0, which was derived from receiver operating characteristic curve analysis. Propensity score matching (1:1) and multivariate Cox regression were performed to identify the aforementioned association.

Results: Patients with an Hb/RDW ratio of < 1 had significantly poorer 5-year OS than did those with an Hb/RDW ratio of ≥ 1 (adjusted HR: 2.15; 95% CI: 1.19-3.89; p = 0.012). The association between preoperative Hb/RDW ratio and 5-year OS persisted even after propensity score matching (adjusted HR: 2.33; 95% CI: 1.20-4.55; p = 0.013).

Conclusions: The present study highlights the preoperative Hb/RDW ratio as a readily available, cost-effective biomarker with independent prognostic value in EC. This ratio may be incorporated into preoperative risk models to optimize clinical decision-making.

Background: The ossification of the posterior longitudinal ligament (OPLL) represents a disabling spinal condition. The specific function of miR-153-3p in the context of OPLL has not been elucidated.

Aim: To explore the function of miR-153-3p in OPLL and its regulatory mechanism related to KLF5.

Methods: RT-qPCR was used to detect the transcriptional levels of miR-153-3p, osteogenic markers, and inflammatory cytokines in OPLL and normal populations. The interaction between miR-153-3p and KLF5 was validated through dual-luciferase reporter assays and RNA immunoprecipitation. Cell transfection experiments were performed to analyze the effects of miR-153-3p and KLF5 on osteogenic markers and inflammatory cytokines.

Results: There was a significant decrease in miR-153-3p expression in OPLL samples. Osteogenic markers and inflammatory cytokines were significantly upregulated. The negative correlation between miR-153-3p and KLF5 was validated. MiR-153-3p was found to inhibit KLF5 expression. In ligament fibroblasts (LFC), miR-153-3p mimics uppressed the expression of osteogenic markers and inflammatory cytokines. Conversely, KLF5 overexpression reversed these inhibitory effects.

Conclusion: MiR-153-3p is downregulated in OPLL and acts as a negative regulator of OPLL progression by directly targeting KLF5, thereby inhibiting LFC osteogenic differentiation.

Introduction: Although the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) scoring system has been used in metastatic renal cell carcinoma (mRCC) for years, debate continues over its ability to predict survival.

Materials and methods: Our study was a single-center retrospective review of medical records of 181 patients diagnosed with mRCC between June 2013 and March 2023.

Results: Low serum albumin level (p < 0.001) and high serum uric acid level (p < 0.001) were significantly associated with worse OS. Furthermore, the number of metastatic sites (p = 0.003) had a significantly adverse impact on OS. Although the HGB level of <12 g/dL adversely affected OS (p = 0.042), none of the remaining parameters used for the IMDC scoring had a significant impact on OS.

Discussion: Even though the IMDC system scores them equally, we concluded that each parameter might express dissimilarities on survival; some might even lack any significant effect. Furthermore, factors such as serum albumin and uric acid levels, the presence of specific organ metastases, or the number of metastatic sites might affect survival more than the IMDC parameters. Further studies are needed to predict prognosis and develop a treatment plan using an individualized risk score that includes molecular biomarkers, imaging findings, and patient clinical characteristics.

Aim: Persons who inject drugs (PWID) are prone to bloodstream infections, but diagnosis is often delayed. This study evaluated the utility of admission serum procalcitonin for early detection of bacteremia.

Methods: A total of 131 adult male PWID admitted with suspected sepsis were prospectively enrolled.

Results: Bacteremia was confirmed in 52 (39.7%) cases, primarily due to Staphylococcus aureus and S. haemolyticus. Infective endocarditis was the leading diagnosis among bacteremic patients. Procalcitonin levels ≥0.51 ng/mL demonstrated high sensitivity (88.5%) and negative predictive value (82.9%), but low specificity (36.7%), resulting in limited diagnostic utility (area under the curve [AUC] 0.613). C-reactive protein (AUC 0.680) and serum albumin (AUC 0.723) outperformed procalcitonin. In-hospital mortality was 35.1%.

Conclusion: Admission procalcitonin has limited diagnostic value for detecting bacteremia in PWID.

Objective: This study aimed to extract radiomics (Rad) and deep learning (DL) features from preoperative CT of patients with Non-Muscle Invasive Bladder Cancer (NMIBC) and develop models incorporating clinical characteristics to assess Human-Epidermal-Growth-Factor-Receptor-2 (HER2) expression status and prognosis in these patients.

Methods: From January 2019 to December 2024, 181 patients with NMIBC were retrospectively enrolled in this study. A deep learning radio-clinical signature model (DLCS) was created by integrating DL score, Rad score, and clinicopathologic features to predict HER2 expression in NMIBC and compared with a deep learning model, a radiomic model, and a Clinical model. An additional model was built to predict Recurrence-Free Survival (RFS) in NMIBC patients.

Results: 181 patients with NMIBC were divided into a training cohort (n = 126) and a test cohort (n = 55). The DLCS model achieved the highest area under the curve (AUC) for HER2 prediction in the test cohort (AUC = 0.894 (95% CI: 0.814-0.974)). The univariate and multivariate Cox regression analyses identified both the DL score and Rad score as independent risk factors for RFS (p < 0.05).

Conclusion: The DLCS model demonstrates good diagnostic performance in predicting HER2 expression, and the prognosis model can stratify the risk of tumor recurrence in patients with NMIBC.