Annales de biologie clinique最新文献

Blood glucose measurement remains a cornerstone in clinical biochemistry, playing a critical role in the diagnosis and monitoring of diabetes mellitus, including gestational diabetes. In France, the diagnosis of diabetes continues to rely exclusively on laboratory-based plasma or serum glucose measurement, as HbA1c is not currently accepted as a diagnostic marker. Nonetheless, several pre-analytical factors may compromise glucose measurement, particularly in vitro glycolysis, which can significantly reduce measured concentrations if not adequately controlled. In 2025, the French Society of Clinical Biology (SFBC) and the National College of Hospital Biochemistry (CNBH) established a working group with the following objectives: (i) to assess current laboratory practices for glucose measurement, and (ii) to review and update the available scientific literature to develop evidence-based recommendations. To achieve these goals, three thematic subgroups were created to conduct: 1) a literature review: focusing on pre-analytical variables, the analytical performance of blood collection tubes, the clinical indications for laboratory glucose testing, and the definition of context-specific reference values; 2) a field survey: designed to capture current practices among clinical biochemists in France and other French-speaking countries; 3) research studies involving on-site experimental trials to directly compare different methodological approaches and pre-analytical strategies. This initiative aims to provide a comprehensive overview of current practices, identify gaps in knowledge, and ultimately support the development of harmonized national recommendations for glucose measurement particularly in the diagnostic and clinical management of diabetes.

Current guidelines recommend using at least two different assays for lupus anticoagulant (LA) detection. One such assay is the dilute Russell's viper venom time (dRVVT). This study aimed to evaluate the analytical performance of the Lupus Screen and Lupus Confirm dRVVT reagents (Roche Diagnostics) on the cobas t 711 analyzer and to compare their diagnostic performance against an established reagent pair (LA1/LA2, Siemens) using the Sysmex CN-6000 analyzer (Sysmex Corporation) for LA detection. Repeatability was assessed by testing lyophilized quality control plasmas 20 times in a single run. Reproducibility was evaluated over at least five days with duplicate testing. A total of 101 anonymized patient samples were analyzed with both Roche and Siemens reagents on their respective platforms. Statistical analysis was performed using GraphPad Prism software version 9.5.0 (GraphPad Software, San Diego, CA, USA). Diagnostic performance was assessed via positive percentage agreement (PPA), negative percentage agreement (NPA), and overall rate of agreement (ORA). The within-run and between-run CVs were < 2%. Results obtained with the Roche and Siemens reagents were strongly correlated (r = 0.950, 0.923, and 0.877 for screen, confirm, and normalized screen/confirm ratios, respectively; all p < 0.001) and bias were acceptable. Assuming Siemens reagents as reference, PPA, NPA, and ORA were 92.42%, 100%, and 95.05%, respectively. The Lupus Screen and Lupus Confirm reagents demonstrated excellent analytical and diagnostic performance and are well-suited for LA detection in non-anticoagulated patient samples.

The arrival of AI in medical biology is inevitable, and in many ways these tools are already in use in our laboratories. Given this observation, it was determined that it was imperative for the French Society of Clinical Biology to offer a set of resources to enable medical biologists to master these new tools by understanding their complexity and the risks inherent in using such powerful but obscure tools. The "Clinical Biology and Artificial Intelligence" workgroup was created to meet this need. Beginning with a user survey to identify needs, we will eventually offer a set of educational content, guidelines, checklists, and practical guides to facilitate the successful integration of AI tools and their long-term monitoring in medical biology laboratories.

Dynamic endocrine tests have substantially evolved for the last ten years, corresponding to the first publication about dynamic tests on the website of National College of Biochemistry Hospital (CNBH). These modifications are linked with medical practice and imagery improvement, leading to consider several tests as useless. A group of CNBH biologists has reviewed these tests from current clinical guidelines and uptodated bibliography. Each test is presented in the form of concise summary sheet and is included in few thematic axis: corticotropic, somatotropic, gonadotropic, lactotropic and post-pituitary tests. This first paper focuses on the corticotropic axis.

Capnocytophaga canimorsus meningitis are rare invasive infection with unpredictable outcomes. Therefore, rapid diagnosis and treatment are crucial. Here, we describe a case with an initially falsely reassuring clinical presentation. Lumbar puncture reveals purulent and inflammatory cerebrospinal fluid, but the syndromic multiplex PCR remains negative. The challenging microbiological diagnosis resulted from a meticulous examination of the CSF and the performance of a 16S rRNA PCR followed by sequencing. A thorough medical history, including close contact with dogs and identification of immunosuppression factors, is critical for diagnosis, emphasizing the importance of clinical-biological collaboration.

Bone marrow metastasis of solid tumours is a sign of advanced disease, with their frequency depending on the primary cancer site. Bone marrow metastasis of bladder cancer is an unusual presentation of the disease. We present a case of a patient with non-muscle-invasive bladder cancer, presenting with recurrent macroscopic haematuria after urinary catheterisation leading to discovery of bi-cytopenia on complete blood count. Myelogram realized after sternal bone marrow aspiration showed presence of metastatic cells immunostained for urothelial nature. The clinical course was rapidly unfavorable leading to patient's death shortly after diagnosis. metastasis of bladder cancer to the bone marrow is a highly unusual situation associated with a poor prognosis.

CDT (Carbohydrate-Deficient Transferrin) has been the reference blood biological marker for screening and monitoring alcohol consumption for many years due to its high specificity. However, its generalization has been slowed by the lack of standardization of the methods used for its measurement. Thus, the limit of reference values could vary from one to three times depending on the procedure. A working group of the IFCC (International Federation of Clinical Chemistry) described a reference method validated by the IFCC and the JCTLM (Joint Committee for Traceability in Clinical Medicine). This made it possible to produce standards used by manufacturers to align their methods with the IFCC reference method. This study compared the results obtained with the «classic» procedure of a commercial capillary electrophoresis method with those obtained using the standardized IFCC procedure of the same method. The data were obtained from an external quality control from 2019 to 2024. The results show 1) a 40% decrease in the inter-laboratory dispersion of results, 2) an excellent correlation between the "Standard" procedure and the IFCC procedure and an alignment with the reference HPLC method measured in parallel. These results demonstrate the benefit of using a standardized IFCC procedure for the homogenization of CDT assay results.