iLABMED最新文献

{"title":"Selection Bias in Chronic Kidney Disease Patients and Its Implications for Interpreting the Clinical Significance of Biomarkers","authors":"Qun Ye, Haixia Li, Lu Pang","doi":"10.1002/ila2.70066","DOIUrl":"https://doi.org/10.1002/ila2.70066","url":null,"abstract":"<p>We read with interest the study by Haque et al. titled “Clinical Relevance and Diagnostic Utility of Standard Serum Biomarkers in Advanced Chronic Kidney Disease (CKD): A Single-Center Observational Study From Bangladesh” published in <i>iLABMED</i> in 2026 [<span>1</span>]. This research provides valuable data for evaluating biomarkers of CKD in Bangladesh. However, patient selection bias inherent to the study design may have influenced the findings; the significant changes reported in parathyroid hormone (PTH), creatinine, and serum calcium are characteristic of advanced CKD and may not reflect the biomarker profile of early-stage CKD.</p><p>This bias is clear in the patient cohort. Of 70 CKD patients, 81.4% had stage 4 disease, 15.7% had stage 3b, and 2.9% had stage 5. Patients with CKD stages 1–3a were excluded. This over-representation of advanced CKD impacts the observed biomarker profile; compared with healthy controls, serum creatinine and PTH levels were approximately threefold higher, and calcium was approximately 10% lower. However, it is well known that in early CKD (stages 1–3a), a mild decline in the estimated glomerular filtration rate may not be accompanied by a significant rise in serum creatinine. In addition, the increase in PTH is not usually pronounced and serum calcium levels often remain within the normal range. Therefore, the significant changes reported in this study are primarily attributable to advanced CKD, which was predominant in the cohort, rather than representing the full spectrum of CKD [<span>2</span>].</p><p>This selection bias was noted by the authors and attributed to late patient referral, reflecting limitations in early CKD screening and awareness in Bangladesh [<span>3</span>]. However, it also results in serious limitations to the external validity of the study's findings [<span>4</span>]. For example, although the authors conclude that PTH and creatinine can serve as highly effective indicators for CKD detection, they may not be useful for the diagnosis and monitoring of early CKD. In resource-limited settings, identifying suitable biomarkers for early screening is crucial [<span>5</span>]. However, the design of this study limits its applicability in these settings.</p><p>Limited external validity also precludes health economic evaluations. The CKD burden comes not only from adverse clinical outcomes but also from the high costs of late-stage management, including dialysis, transplantation, and hospitalization for complications [<span>6, 7</span>]. Although serum creatinine testing is inexpensive, PTH relies on costly immunoassay technologies [<span>8</span>]. The lack of early-stage patients in this study makes it impossible to assess whether using biomarkers such as PTH is cost-effective in early screening settings [<span>9</span>].</p><p>We agree with the authors that future research should include a broader range of CKD stages. Given the resource constraints associated with long-term follow-up (t","PeriodicalId":100656,"journal":{"name":"iLABMED","volume":"4 3","pages":"204-205"},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ila2.70066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and Management of Polycythemia Vera Complicated by Cerebral Infarction and Subdural Hematoma: A Case Report","authors":"Hui Zhao,&nbsp;Jie Feng,&nbsp;Yu Jing,&nbsp;Wei Xie,&nbsp;Yingjiao Sha,&nbsp;Yanhong Gao","doi":"10.1002/ila2.70073","DOIUrl":"https://doi.org/10.1002/ila2.70073","url":null,"abstract":"<p>Myeloproliferative neoplasms are hematologic disorders associated with increased thrombotic and hemorrhagic risk. However, they are often underrecognized in patients presenting with cerebrovascular events. We report the case of a 70-year-old man who developed an acute cerebral infarction in the left temporal lobe accompanied by limb weakness. Neuroimaging revealed multiple cerebrovascular stenoses and widespread atherosclerotic vascular disease. During follow-up, he developed a subdural hematoma. Further evaluation demonstrated persistent blood count abnormalities and splenomegaly. Bone marrow biopsy revealed a hypercellular marrow with trilineage proliferation (panmyelosis), characterized by prominent erythroid, granulocytic, and megakaryocytic lineages. Molecular testing revealed the <i>Janus kinase</i> 2 Valine 617 Phenylalanine mutation. Combined with elevated hemoglobin levels, these findings fulfilled the diagnostic criteria for polycythemia vera in the fifth edition of the World Health Organization Classification of Haematolymphoid Tumors. This case highlights that coexisting ischemic and hemorrhagic cerebrovascular events with unexplained hematologic abnormalities or splenomegaly should prompt <i>Janus kinase</i> 2 mutation screening and bone marrow examination to enable early diagnosis of myeloproliferative neoplasm and prevent further complications.</p>","PeriodicalId":100656,"journal":{"name":"iLABMED","volume":"4 3","pages":"197-203"},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ila2.70073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpretation of Key Updates in the 36th Edition of Clinical and Laboratory Standards Institute M100 Standard","authors":"Kanghong Xu,&nbsp;Qi Wang,&nbsp;Hui Wang","doi":"10.1002/ila2.70069","DOIUrl":"https://doi.org/10.1002/ila2.70069","url":null,"abstract":"<p>The Clinical and Laboratory Standards Institute M100 document serves as a cornerstone standard for clinical microbiology laboratories in China. Maintaining the scientific rigor of its predecessors, the 36th edition incorporates updated epidemiological cutoff values, pharmacokinetic/pharmacodynamic data, and clinical efficacy evidence to revise several key components. Aimed at improving the clinical predictive value of antimicrobial susceptibility testing results and guiding precise anti-infective therapy, this article provides a summary review of key updates in the 36th edition of Clinical and Laboratory Standards Institute M100. Key revisions include comprehensive species-specific susceptibility breakpoints for major clinical pathogens, removal of outdated epidemiological cutoff values, optimization of laboratory testing procedures, updated antimicrobial susceptibility profiles for anaerobes, and adjustments to routine quality control criteria. Collectively, these changes further standardize and refine guidelines for diverse bacterial species.</p>","PeriodicalId":100656,"journal":{"name":"iLABMED","volume":"4 3","pages":"133-138"},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ila2.70069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regulatory Effects of Ammonium Chloride in an In Vitro Model of Hepatic Encephalopathy: Mechanisms Involving ACTA2-Mediated Cytoskeletal Remodeling","authors":"Yue Tang,&nbsp;Jia Liu,&nbsp;Chengrong Bian,&nbsp;Wenwen Yuan,&nbsp;Wang Zhang,&nbsp;Fan Feng,&nbsp;Boan Li","doi":"10.1002/ila2.70067","DOIUrl":"https://doi.org/10.1002/ila2.70067","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Hyperammonemia is a central feature of hepatic encephalopathy (HE) and contributes to astrocytic dysfunction; however, the mechanisms underlying ammonia-induced cytoskeletal remodeling remain unclear. This study aimed to identify key molecular mediators of ammonia-induced astrocyte injury and to elucidate the role of &lt;i&gt;ACTA2&lt;/i&gt; in this process.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We established an in vitro HE model using the human astrocyte line SVG p12 treated with either ammonium chloride (NH&lt;sub&gt;4&lt;/sub&gt;Cl) (5–20 mM) or serum from patients with HE. Cellular responses were evaluated by cell counting kit-8 assay and flow cytometry. RNA sequencing was performed to identify key regulatory genes, followed by molecular and functional validation of the lead candidate, &lt;i&gt;ACTA2&lt;/i&gt;, which encodes alpha-smooth muscle actin (&lt;i&gt;α&lt;/i&gt;-SMA), using knockdown and overexpression strategies. Filamentous actin organization was assessed by phalloidin staining and fluorescence microscopy. The expressions of water channel (aquaporin-4) and junction-associated proteins (zonula occludens-1, occludin, claudin-5) were measured to characterize astrocytic junctional protein alterations.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;NH&lt;sub&gt;4&lt;/sub&gt;Cl exposure effectively recapitulated the cytotoxic effects of serum from patients with HE, revealing a distinct biphasic response: low-dose ammonia (5 mM) transiently boosted metabolic activity, whereas higher doses (10–20 mM) reduced viability, promoted apoptosis, and caused G2/M phase arrest. RNA-seq, cytoskeletal analysis, and biochemical validation identified &lt;i&gt;ACTA2&lt;/i&gt; downregulation as a sentinel event in ammonia-induced injury. Functional assays demonstrated that &lt;i&gt;ACTA2&lt;/i&gt; deficiency phenocopied NH&lt;sub&gt;4&lt;/sub&gt;Cl-induced cytotoxicity, while its restoration significantly mitigated apoptosis and cell cycle arrest. Ammonia treatment led to upregulation of aquaporin-4 alongside altered expression of junctional proteins, marked by diminished zonula occludens-1 and claudin-5 expression and elevated occludin levels. Mechanistically, NH&lt;sub&gt;4&lt;/sub&gt;Cl reduced the phosphorylation of FAK (Tyr397) and proto-oncogene tyrosine-protein kinase Src (c-Src) (Tyr416), whereas &lt;i&gt;ACTA2&lt;/i&gt; overexpression in NH&lt;sub&gt;4&lt;/sub&gt;Cl-treated cells restored their activation, implicating suppression of the &lt;i&gt;α&lt;/i&gt;-SMA-FAK/c-Src signaling axis in ammonia-induced astrocytic injury.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study demonstrates that NH&lt;sub&gt;4&lt;/sub&gt;Cl disrupts cell cytoskeleta","PeriodicalId":100656,"journal":{"name":"iLABMED","volume":"4 3","pages":"168-180"},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ila2.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Term Effects of Temperature and Relative Humidity on Hand, Foot, and Mouth Disease in Guiyang, China, From 2022 to 2024: Distributed Lag Nonlinear Model–Based Analysis","authors":"Xihong Zhang,&nbsp;Yue Wang,&nbsp;Hua Hu,&nbsp;Jun Yang,&nbsp;Jing Li,&nbsp;Xian Yu","doi":"10.1002/ila2.70074","DOIUrl":"https://doi.org/10.1002/ila2.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Meteorological factors, including temperature and relative humidity, have been associated with the incidence of hand, foot, and mouth disease (HFMD). However, these associations vary across regions. Guiyang, a city characterized by a subtropical plateau humid climate, remains understudied with respect to the short-term associations of temperature and relative humidity with HFMD incidence. This study aimed to quantify the short-term associations of these meteorological factors with HFMD risk in this understudied setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Daily HFMD surveillance and meteorological data (temperature and relative humidity) from Guiyang, China (2022–2024) were analyzed using a distributed lag nonlinear model to characterize exposure–lag–response associations over a maximum lag of 14 days. Relative risks (RRs) with 95% confidence intervals (CIs) were estimated to quantify the effects. Subgroup analyses by sex, age group, and the population category were also performed to identify susceptible populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 42,910 HFMD cases among children aged 0–14 years were included. Both temperature and relative humidity exhibited nonlinear associations with HFMD risk. For temperature, risk peaked at 27.00°C with a 3-day lag (RR = 1.10; 95% CI: 1.06–1.15). For relative humidity, the highest point estimate of risk occurred at 94% relative humidity on the exposure day (RR = 1.10; 95% CI: 0.92–1.34). The high-temperature–high-relative-humidity condition was associated with the highest cumulative risk (RR = 1.30; 95% CI: 1.04–1.64). The condition involving extremely low temperature and relative humidity was associated with persistent protective effects. Subgroup analyses revealed that children younger than 3 years and scattered children were more susceptible to the effects of the high-temperature–high-relative-humidity condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Temperature and relative humidity were associated with HFMD incidence in Guiyang, with nonlinear and lagged associations observed, and the highest cumulative risks were observed under the high-temperature–high-relative-humidity condition. These findings support the consideration of meteorological factors in HFMD early warning systems and suggest the need for targeted interventions during high-risk weather conditions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100656,"journal":{"name":"iLABMED","volume":"4 3","pages":"158-167"},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ila2.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Multidrug-Resistant Bacteria on Hospital Face Masks: A Surveillance Report","authors":"Shilpa Malakar,&nbsp;Priyambada Singh,&nbsp;Priya Sutaoney,&nbsp;Kamal Shah,&nbsp;Nagendra Singh Chauhan","doi":"10.1002/ila2.70071","DOIUrl":"https://doi.org/10.1002/ila2.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nosocomial infections have become a major concern, with the COVID-19 pandemic leading to increased utilization of face masks. Masks act as a barrier to ensure the safety against the respiratory threat; continued use enables the bacteria to fester, which raises the risk of contamination. The aim of this study was to investigate the bacteria from masks worn by hospital staff and evaluate their implications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 10 masks worn by intensive care unit staff for 20–24 h were collected. A novel mask-press technique was used to isolate bacteria on selective agar media. Morphological and biochemical characterizations and then antibiotic susceptibility testing using the Kirby-Bauer Disc-Diffusion method were performed against 11 antibiotics. The most resistant isolate underwent molecular identification via 16S rDNA sequencing and phylogenetic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 10 masks, 8 exhibited bacterial growth, and 400 bacterial colonies were obtained. Samples 1 and 6 showed very low bacterial burden, almost negligible and were excluded. Isolated genera were <i>Bacillus</i>, <i>Streptococcus</i>, <i>Staphylococcus</i>, <i>Klebsiella</i>, and <i>Enterococcus</i>. The highly resistant strain was identified as <i>Klebsiella michiganensis</i> (GenBank Accession No. PP854651.1), a rarely documented nosocomial pathogen that was found to be resistant to 10 of 11 tested antibiotics, including cefotaxime, methicillin and ciprofloxacin. On the contrary, the Viridans group <i>Streptococci</i> showed susceptibility to all antibiotics except cloxacillin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The intensive care unit face mask may harbor multidrug-resistant <i>Klebsiella michiganensis</i> over a long period, even posing a risk of transmission to immunocompromised patients. The mask–press technique proved to be effective in the full recovery of bacteria. The findings indicate that more effort is needed to enhance mask decontamination procedures, standardize disposal practices, and conduct larger surveillance studies to evaluate the clinical significance of mask-associated bacterial reservoirs in healthcare settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100656,"journal":{"name":"iLABMED","volume":"4 3","pages":"181-193"},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ila2.70071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redefining Fatty Liver Disease: How Updated Nomenclature Reshapes Clinical Laboratory Diagnostics","authors":"Ran Wei,&nbsp;Yuanyue Guan,&nbsp;Meiqing Zhai,&nbsp;Xiuying Zhao","doi":"10.1002/ila2.70070","DOIUrl":"https://doi.org/10.1002/ila2.70070","url":null,"abstract":"<p>The nomenclature of fatty liver disease has undergone substantial evolution, transitioning from nonalcoholic fatty liver disease to metabolic-associated fatty liver disease, and more recently to metabolic dysfunction-associated steatotic liver disease. This updated nomenclature has driven a fundamental transformation in laboratory diagnostic strategies. The diagnostic framework has progressively shifted from reliance on exclusionary criteria to a multidimensional, integrated approach centered on metabolic and inflammatory biomarkers. This review aims to elucidate similarities and differences among nonalcoholic fatty liver disease, metabolic-associated fatty liver disease, and metabolic dysfunction-associated steatotic liver disease with respect to diagnostic criteria, epidemiological profiles, underlying pathogenic mechanisms related to insulin resistance, noninvasive imaging assessment, and key laboratory indicators.</p>","PeriodicalId":100656,"journal":{"name":"iLABMED","volume":"4 3","pages":"139-148"},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ila2.70070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Interleukin-6 Promoter Polymorphisms and Disease Susceptibility: A Review of Current Evidence","authors":"Junyi Li,&nbsp;Yiling Xv,&nbsp;Qingfeng Ma,&nbsp;Wei Wang","doi":"10.1002/ila2.70072","DOIUrl":"https://doi.org/10.1002/ila2.70072","url":null,"abstract":"<p>Interleukin 6 (IL-6), a type of cytokine, plays a role in the onset, progression, and prognosis of various diseases. IL-6's single nucleotide polymorphisms (SNPs) markedly affect clinical conditions by influencing gene expression, including that of other cytokines. This review synthesizes existing literature to explore the relationship between IL-6 SNPs and diseases. Current evidence indicates that these SNPs are associated with the clinicopathological features of different diseases, with these associations partly influenced by population ethnicity. Although IL-6 SNPs could potentially serve as biomarkers for disease susceptibility and progression, larger-scale studies across diverse regions and populations are required to confirm their clinical significance.</p>","PeriodicalId":100656,"journal":{"name":"iLABMED","volume":"4 3","pages":"149-157"},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ila2.70072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computational Intelligence Accelerates CRISPR-Cas-Based Diagnostic Design","authors":"Hengyu Wang,&nbsp;Qiurun He,&nbsp;Xuhu Mao,&nbsp;Yong Sheng","doi":"10.1002/ila2.70065","DOIUrl":"https://doi.org/10.1002/ila2.70065","url":null,"abstract":"<p>Computational intelligence, including pangenome-guided target mining, machine-learning-based guide RNA optimization, and autonomous AI agents, is shifting CRISPR diagnostic design from empirical screening to systematic, data-driven engineering and accelerating the path from pathogen discovery to deployable diagnostics.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":100656,"journal":{"name":"iLABMED","volume":"4 3","pages":"194-196"},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ila2.70065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Biomarker-Based Fatty Liver Indices Into Multidisciplinary Treatment Pathways for Digestive Tumors","authors":"Xudong Song,&nbsp;Jingjing Dai,&nbsp;Guoquan Tao","doi":"10.1002/ila2.70056","DOIUrl":"https://doi.org/10.1002/ila2.70056","url":null,"abstract":"&lt;p&gt;We read the recent study by Ding et al. [&lt;span&gt;1&lt;/span&gt;], which was published by &lt;i&gt;iLABMED&lt;/i&gt; in 2025 with great interest in which the laboratory-based fatty liver index (FLI-L) and the physical examination–combined laboratory-based fatty liver index (FLI-PL) were developed and validated.&lt;/p&gt;&lt;p&gt;The authors provide a quantitative approach for fatty liver screening with impressive diagnostic performance (area under the curve of 0.902 for the FLI-PL) that is non-invasive, cost-effective, and easily accessible. When only clinical laboratory blood markers are available, the FLI-L is recommended for screening. If both anthropometric measurements and laboratory markers are available, the FLI-PL can be used. Both indicators have high diagnostic power; thus, if the model evaluates the liver as normal, the likelihood of fatty liver is very low. In this context, ultrasound could potentially be omitted to reduce screening costs. In addition, both models are significantly correlated with fatty liver grading, indicating their ability to reflect the degree of hepatic steatosis.&lt;/p&gt;&lt;p&gt;However, in the context of digestive surgical oncology and multidisciplinary treatment (MDT), we believe that these non-invasive, cost-effective, and easily accessible indices could be integrated into clinical diagnosis and treatment evaluation pathways, although challenges remain [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Our primary concerns relate to generalizability and compatibility. Regarding generalizability in oncologic cohorts, the model was developed primarily in a health assessment population. By contrast, patients with tumors often present with systemic inflammation, malnutrition, or hypermetabolic states, which may affect the generalizability of the index [&lt;span&gt;3&lt;/span&gt;]. Therefore, it is essential to validate its diagnostic performance in these populations. Regarding compatibility with existing workflows, it is necessary to explore how these indices can be seamlessly incorporated into busy MDT workflows. Specifically, the complementary relationship between these indices and standard imaging (ultrasound, computed tomography/magnetic resonance imaging) requires clarification—whether they should function as a gatekeeping screening tool or as a supplementary metric when imaging is inconclusive.&lt;/p&gt;&lt;p&gt;Correlation with clinical endpoints is also important. Future research should extend beyond diagnostic accuracy to verify whether FLI-L/FLI-PL scores correlate with specific oncologic outcomes, such as postoperative complication rates, chemotherapy tolerance, or tumor recurrence risk, thereby establishing their prognostic value [&lt;span&gt;4, 5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Fortunately, there are notable opportunities. First, optimization of preoperative risk stratification is a key application. For patients undergoing hepatectomy (e.g., for colorectal liver metastases or hepatocellular carcinoma), fatty liver significantly increases the risk of post-hepatectomy liver failure [&lt;span&gt;6&lt;/span&gt;]. The FLI-PL cou","PeriodicalId":100656,"journal":{"name":"iLABMED","volume":"4 2","pages":"130-131"},"PeriodicalIF":0.0,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ila2.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}