Clinical biochemistry最新文献

{"title":"Rising illicit drug Adulterants: Xylazine and levamisole","authors":"Pedro E.M. Amaral ,&nbsp;Samuel O. Beane ,&nbsp;Angie Albarouki ,&nbsp;Michael J. Tan ,&nbsp;Megan J. Schoenberger ,&nbsp;Yuan Yao ,&nbsp;Li Liu ,&nbsp;Sacha N. Uljon ,&nbsp;Yusheng Zhu ,&nbsp;Donald C Hall Jr ,&nbsp;Yinghua Qiu","doi":"10.1016/j.clinbiochem.2025.110912","DOIUrl":"10.1016/j.clinbiochem.2025.110912","url":null,"abstract":"<div><div>The increasing prevalence of xylazine and levamisole as adulterants in illicit drugs presents significant challenges for medical professionals. This review aims to provide an overview of the mechanisms of action, prevalence of adulteration, and detection methods for xylazine and levamisole. Clinical implications associated with xylazine and levamisole-contaminated drugs are also discussed. It provides a comprehensive examination of methodologies for analyzing these emerging contaminants, shedding light on the challenges faced by toxicology laboratories in accurately identifying and quantifying these substances. Various analytical techniques, including but not limited to GC–MS, HPLC-MS, and HPLC-MS/MS, are explored in detail, with a focus on their strengths and limitations. This serves as a valuable resource for clinicians seeking to navigate the complexities of analyzing xylazine and levamisole in illicit drug samples. It also contributes to the existing knowledge on illicit drug adulteration by xylazine and levamisole, providing insights that can inform public health interventions, law enforcement efforts, and treatment strategies aimed at mitigating the risks associated with contaminated substances.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"137 ","pages":"Article 110912"},"PeriodicalIF":2.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phosphatidylethanol clearance after packed red blood cell transfusion","authors":"Olivia C Iverson ,&nbsp;Karlie A Smith ,&nbsp;Pragya Sharma ,&nbsp;Matthew R Buras ,&nbsp;Jaxon K Quillen ,&nbsp;Dominic L Showkeir ,&nbsp;Kathy N Alegria ,&nbsp;Loralie J Langman ,&nbsp;Paul J Jannetto ,&nbsp;Theresa N Kinard ,&nbsp;Christine LH Snozek","doi":"10.1016/j.clinbiochem.2025.110909","DOIUrl":"10.1016/j.clinbiochem.2025.110909","url":null,"abstract":"<div><h3>Objectives</h3><div>Phosphatidylethanol (PEth) is a long-term marker of alcohol consumption used clinically for evaluating abstinence in patients including transplant candidates. Packed red blood cell (pRBC) transfusion can introduce exogenous PEth to recipients, complicating interpretation. This study evaluated the kinetics and duration of PEth 16:0/18:1 positivity post-transfusion.</div></div><div><h3>Design &amp; methods</h3><div>This study evaluated liver transplant recipients (n = 76) who received ≥ 1 pRBC during transplantation surgery. PEth 16:0/18:1 concentrations were monitored up to 2 weeks post-transfusion to determine clearance kinetics.</div></div><div><h3>Results</h3><div>Post-transfusion PEth was ≥ 10 ng/mL (range 10.0 – 79.7 ng/mL [0.014–0.113 µmol/L]) in 37 (48.7 %) recipients. Approximately 24 h after transfusion, pRBC-derived PEth decreased by a mean of 19 %, consistent with pRBC turnover post-transfusion. After 24–36 h, the apparent half-life of PEth was 6.6 d but was highly variable (SD 3.6 d). Correction for hemoglobin or hematocrit improved variability, with mean half-life estimated at 4.9 d (SD 1.6 d) and 4.6 d (SD 1.4 d), respectively. Time to clearance of PEth &lt; 10 ng/mL ([&lt;0.014 µmol/L]) ranged from &lt; 1 d to &gt; 19 d; 15 (40.5 %) pRBC recipients cleared PEth within 5 d post-transfusion. Using the consensus cutoff for PEth interpretation, only 10 had PEth &gt; 20 ng/mL (&gt;0.028 µmol/L) at 5 d and all had 14 d values &lt; 20 ng/mL (&lt;0.028 µmol/L).</div></div><div><h3>Conclusions</h3><div>These findings suggest that PEth positivity after pRBC transfusion might be more common than previously recognized, and that higher decision-making thresholds (e.g., 20 ng/mL [&lt;0.028 µmol/L]) are appropriate. Post-transfusion kinetics are not identical to clearance of endogenously-produced PEth after alcohol consumption (half-life 5–8 d), likely due to both patient and pRBC characteristics. Transplant care teams should recognize the risk for pRBC transfusion to impact PEth concentrations in recipients, and interpret PEth cautiously for 2–3 weeks after transfusion.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"137 ","pages":"Article 110909"},"PeriodicalIF":2.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac troponin I is associated with ICU admission in pediatric patients with RSV","authors":"Meghan Brown,&nbsp;Sydney Lawless,&nbsp;Brittany Roemmich,&nbsp;Stephen M Roper,&nbsp;Christopher W. Farnsworth","doi":"10.1016/j.clinbiochem.2025.110896","DOIUrl":"10.1016/j.clinbiochem.2025.110896","url":null,"abstract":"<div><h3>Background</h3><div>Respiratory syncytial virus (RSV) is associated with morbidity and mortality in pediatric patients, but limited tools exist for prognostication of outcomes that may facilitate more rapid treatment. We assessed the utility of cardiac troponin I (cTnI) to prognosticate intensive care unit (ICU) length of stay (LOS) and bronchiolitis in pediatric patients.</div></div><div><h3>Methods</h3><div>Remnant EDTA plasma from 114 patients 6 months-18 years positive for RSV were enrolled. Forty-five patients with other respiratory infections were included as controls. The electronic medical record was assessed for demographic information. High sensitivity cTnI was assessed on an Abbott ARCHITECT i2000 within 24 h of collection. Proportions were compared using Fisher’s exact test and multivariable logistic regression performed.</div></div><div><h3>Results</h3><div>Of patients admitted to ICU with RSV, 56.9 % had cTnI ≥ the limit of detection (LOD) compared to 27.0 % of patients not admitted to the ICU. Receiver operator characteristic analysis revealed an area of 0.62 (0.53–0.72) for predicting ICU admission. At the limit of quantitation, cTnI had a sensitivity of 25.8 %, a specificity of 88.9 %, and a positive likelihood ratio of 2.32 for ICU admission. Multivariable logistic regression revealed that log2 increases in cTnI (doubling) was associated with an odds ratio (OR) of 1.34 (95 % CI: 1.03–1.78) for ICU admission. cTnI &gt; the LOD was associated with an OR of 2.37 (1.03–5.57) for ICU admission and bronchiolitis (2.78, 1.09–7.83).</div></div><div><h3>Conclusions</h3><div>Elevated cTnI above the LOD was associated with ICU admission and bronchiolitis in pediatric patients presenting with RSV. Further studies are needed to verify this finding.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"136 ","pages":"Article 110896"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing an in-house quality control program for nine autoantibody assays using donor sera","authors":"Mary Kathryn Bohn ,&nbsp;Lusia Sepiashvili","doi":"10.1016/j.clinbiochem.2025.110900","DOIUrl":"10.1016/j.clinbiochem.2025.110900","url":null,"abstract":"<div><h3>Background</h3><div>Clinical laboratories performing semi-quantitative autoantibody testing face challenges in developing quality systems to assure performance. Careful consideration is required to evaluate assay imprecision, including quality control (QC) matrix, autoantibody titer targets, and performance goals. The objective of this study was to evaluate the performance of a novel patient-based QC solution relative to vendor-provided QC for nine autoantibodies over a four-year period at a tertiary pediatric care centre.</div></div><div><h3>Methods</h3><div>Internal QC data were extracted over a 4-year period for nine autoantibodies measured via chemiluminescent immunoassays (anti-double stranded DNA (dsDNA), anti-ribonuclear protein, anti-Ro52, anti-Ro60, anti-La, anti-Smith, anti-proteinase 3, anti-myeloperoxidase, and anti-tissue transglutaminase IgA). QC evaluated during study period included vendor-based QC and third-party patient-based QC using defibrinated plasma specimens from autoantibody positive single donors. Lot-specific QC coefficients of variation (CV), titer means, and standard deviations were calculated and compared across QC matrices.</div></div><div><h3>Results</h3><div>Approximately 500 QC values per autoantibody were evaluated. Mean CV across lots ranged from 8.2 to 14.4% for negative vendor-based QC, 8.2–14.5% for positive vendor-based QC, and 9.8–17.8% for positive patient-based QC across evaluated autoantibodies. Imprecision estimates were similar between positive vendor and patient-based QC for all autoantibodies with the exception of anti-dsDNA (vendor: 4.8–13.2%, patient-based: 14.3–21.6%) and anti-Ro52 (vendor: 6.9–12.4%; patient-based: 9.7–18.9%).</div></div><div><h3>Conclusions</h3><div>This study characterizes imprecision across different QC matrices for nine autoantibodies measured semi-quantitatively using chemiluminescent immunoassays. Results may serve as a benchmark tool to assess imprecision goals for commonly measured autoantibodies in clinical laboratories and as a framework for utilizing third-party patient-based QC solutions.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"136 ","pages":"Article 110900"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge about globin genetics for precision diagnosis of hemoglobinopathies: A case Study","authors":"Bárbara Braga Vieira Marques ,&nbsp;Ingrid Souza Dias ,&nbsp;Amanda Cristina Meneguetti Berti ,&nbsp;Vanessa da Silveira Ramos de Castro ,&nbsp;Elisângela de Souza Miranda Muynarsk ,&nbsp;Taís Pires Terra Araújo ,&nbsp;Eduardo dos Santos Itacaramby ,&nbsp;Lucas Gazarini ,&nbsp;Danilo Grünig Humberto da Silva ,&nbsp;Edis Belini-Júnior","doi":"10.1016/j.clinbiochem.2025.110901","DOIUrl":"10.1016/j.clinbiochem.2025.110901","url":null,"abstract":"<div><div>More than 1,800 changes in the synthesis and structure of hemoglobin (Hb) are estimated to exist. Many of them can be identified by chromatographic and electrophoretic analyses. However, in some cases, critical interpretation, accompanied by molecular techniques and gene sequencing, is necessary for diagnosis. This case demonstrates how important is understanding the genetics of globin chains to diagnose complex cases of hemoglobinopathies through the report of a newborn with Hb C/Beta0 thalassemia and heterozygous Hb B2 co-inheritance. A sample from the proband (a 25-day-old girl) was received with an FC hemoglobin profile for confirmatory diagnosis, accompanied by samples from her parents. The chromatographic and electrophoretic analysis confirmed the suggested profile. However, the absence of Hb A2 in the mother raised suspicions about the presence of a delta-chain Hb variant. In addition, high Hb A2 levels of the father sample suggested beta-thalassemia. Considering all possible genotypes that lead to the patient’s profile, we conducted molecular analyses that confirmed heterozygosity for Hb C in the proband and mother, as well as the presence of an allele for beta0-thalassemia (CD39) in the father and child. Furthermore, the presence of Hb B2 or A2‘, a delta chain variant, was detected in homozygosity in the mother and heterozygosity in the patient. Subsequently, the diagnosis was confirmed by sequencing the <em>HBB</em> and <em>HBD</em> genes of the proband and mother, respectively. Confirmation of the diagnosis required specific knowledge about the genetics of globins and refined laboratory methodologies to validate the suspicions raised by chromatographic and electrophoretic investigations.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"136 ","pages":"Article 110901"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CA19-9, CEA and PIVKA-Ⅱ as a novel panel of serum markers for diagnosis of pancreatic cancer","authors":"Meifang Wang ,&nbsp;Hongying Bu ,&nbsp;Weijia Luo ,&nbsp;Xi Zeng ,&nbsp;Guodong Chen ,&nbsp;Yingchun He ,&nbsp;Deliang Cao","doi":"10.1016/j.clinbiochem.2025.110902","DOIUrl":"10.1016/j.clinbiochem.2025.110902","url":null,"abstract":"<div><h3>Aim</h3><div>This retrospective study was aimed to evaluate the diagnostic value of a combination of carbohydrate antigen 19–9 (CA19-9), carcinoembryonic antigen (CEA) and protein induced by vitamin K absence or antagonist-Ⅱ (PIVKA-II) in pancreatic cancer.</div></div><div><h3>Methods</h3><div>Clinical data were collected from 111 pancreatic cancer patients and 158 patients with benign pancreatic diseases (BPD). Serum CA19-9, CEA and PIVKA-II were subjected to receiver operating characteristic curve (ROC) analysis alone and in combination for the diagnosis of pancreatic cancer.</div></div><div><h3>Results</h3><div>Serum CA19-9, CEA, and PIVKA-II were higher in pancreatic cancer patients than in BPD patients (<em>P</em> &lt; 0.001). ROC analysis indicated that the cutoff values were 99.390 for CA19-9, 3.065 for CEA, and 42.965 for PIVKA-II, at which the positive rate in pancreatic cancer was 78.38 % for CA19-9, 43.24 % for CEA and 48.65 % for PIVKA-Ⅱ. When serum CA19-9, CEA, and PIVKA-II were used alone, the areas under the curves (AUC), sensitivity and specificity were 0.821, 68.47 % and 89.24 % for CA19-9, 0.763, 61.26 % and 85.44 % for CEA, and 0.681, 45.95 % and 87.34 % for PIVKA-II. When serum CA19-9, CEA, and PIVKA-II were used in combination, the positivity rate was 94.59 % in pancreatic cancer with AUC of 0.903, sensitivity of 81.10 % and specificity of 88.00 %.</div></div><div><h3>Conclusion</h3><div>PIVKA-II is a potential serum marker of pancreatic cancer and the combination of CA19-9, CEA, and PIVKA-II is a novel panel of serum markers with promising diagnostic value for pancreatic cancer.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"137 ","pages":"Article 110902"},"PeriodicalIF":2.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secretoneurin is not associated with cardiovascular events or mortality in patients treated with hemodialysis: A prospective multicenter cohort study","authors":"Caroline Liboriussen ,&nbsp;Louis Nygaard ,&nbsp;Magnus Nakrem Lyngbakken ,&nbsp;Sara Marie Engelsvold Bakkan ,&nbsp;Jens Dam Jensen ,&nbsp;Rie Io Glerup ,&nbsp;Torbjørn Omland ,&nbsp;Helge Røsjø ,&nbsp;My Hanna Sofia Svensson","doi":"10.1016/j.clinbiochem.2025.110899","DOIUrl":"10.1016/j.clinbiochem.2025.110899","url":null,"abstract":"<div><h3>Introduction</h3><div>Secretoneurin (SN) is a novel cardiac biomarker with an upper reference limit of ∼60 pmol/L in healthy individuals. High SN concentrations have been associated with an increased risk of mortality in various cardiac diseases. We investigated the association between SN and the risk of cardiovascular (CV) events and all-cause mortality in patients treated with maintenance hemodialysis (HD).</div></div><div><h3>Materials and Methods</h3><div>Prospective multicenter cohort study with five years of follow-up. Serum SN (pmol/L) was measured at baseline. Outcomes were CV events (composite outcome) and all-cause mortality. The population was divided into tertiles according to SN concentrations: tertile 1 &lt; 110.7 pmol/L, tertile 2 110.7–143 pmol/L, and tertile 3 &gt; 143 pmol/L. The association between SN tertiles and outcomes was examined using Cox regression analysis.</div></div><div><h3>Results</h3><div>The study included 336 patients treated with HD. Median SN concentration was 126 (100–153) pmol/L. During a median follow-up of 5.05 (5.02–5.07) years, 42 % had a CV event and 60 % died. Despite overall high SN concentrations, neither SN tertile 2 nor SN tertile 3 was associated with the risk of CV events (HR_tertile2 1.27 (95 % CI 0.84–1.93) and HR_tertile3 1.20 (95 % CI 0.76–1.90)) or all-cause mortality (HR_tertile2 0.84 (95 % CI 0.60–1.18) and HR_tertile3 0.90 (95 % CI 0.62–1.31)), when compared to tertile 1.</div></div><div><h3>Conclusions</h3><div>Patients treated with HD have high SN concentrations; however, SN was not associated with CV events or all-cause mortality after five years of follow-up. High concentrations of SN, possibly explained by both impaired renal clearance and a high prevalence of cardiomyopathy, may limit its prognostic relevance in patients treated with maintenance HD.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"136 ","pages":"Article 110899"},"PeriodicalIF":2.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of breath tests based on volatile organic compounds for cancer: A systematic review and meta-analysis","authors":"Ming-Jun Jin ,&nbsp;En-Min Li ,&nbsp;Li-Yan Xu","doi":"10.1016/j.clinbiochem.2025.110898","DOIUrl":"10.1016/j.clinbiochem.2025.110898","url":null,"abstract":"<div><div>Exhaled volatile organic compounds (VOCs) are being extensively studied for the purposes of noninvasive cancer diagnoses. This systematic review and <em>meta</em>-analysis aims to evaluate the diagnostic accuracy of breath tests based on VOCs for cancer detection, and to propose potential cancer biomarkers. This study was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Relevant studies up to February 2024 were retrieved from public databases, including PubMed, EMBASE, and Web of Science. A total of 114 articles were included, covering 125 non-duplicate studies involving 8768 cancer patients. Meta-analysis showed that the VOC breath test demonstrated a sensitivity of 87% and a specificity of 81% in cancer diagnosis, with an area under the receiver operating characteristic curve (AUC) of 0.93. Subgroup analyses based on cancer types and breath detection techniques also showed high sensitivity and specificity in diagnosing cancer patients. These suggest that breath analysis for VOCs has excellent diagnostic accuracy for cancer. The breath test based on VOCs, as a non-invasive detection method, shows great potential for cancer diagnosis.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"136 ","pages":"Article 110898"},"PeriodicalIF":2.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerated diagnostic pathways for myocardial infarction using a Siemens High-Sensitivity cardiac troponin I assay","authors":"Hiroyuki Azuma ,&nbsp;Masafumi Tada ,&nbsp;Hideyuki Matano ,&nbsp;Naoki Yamada ,&nbsp;Hiroyasu Uzui ,&nbsp;Koji Maeno ,&nbsp;Yoshimitsu Shimada ,&nbsp;Hiroyuki Yoshida ,&nbsp;Hajime Murahashi ,&nbsp;Masaki Ando ,&nbsp;Kenta Hachiya ,&nbsp;Shun Tanaka ,&nbsp;Tomonori Hattori ,&nbsp;Akira Kuriyama ,&nbsp;Takeshi Fujisawa ,&nbsp;Andrew R. Chapman ,&nbsp;Nicholas L. Mills ,&nbsp;Hiroyuki Hayashi ,&nbsp;Norio Watanabe ,&nbsp;Toshi A Furukawa","doi":"10.1016/j.clinbiochem.2025.110897","DOIUrl":"10.1016/j.clinbiochem.2025.110897","url":null,"abstract":"<div><h3>Background</h3><div>Few studies have comprehensively examined high-sensitivity cardiac troponin I (hs-cTnI) based diagnostic pathways for myocardial infarction (MI) in early presenters using a Siemens ADVIA Centaur hs-cTnI assay.</div></div><div><h3>Methods</h3><div>We conducted a prospective multicenter cohort study in Emergency Departments involving 414 patients suspected of MI within 6 h of symptom onset. We evaluated three hs-cTnI-based pathways (High-STEACS, ESC 0/1-h, 0/2-h); and four pathways incorporating medical history and physical findings (ADAPT, EDACS, HEART, GRACE). We evaluated negative predictive value (NPV) and sensitivity as safety measures, and percentage ruled out as an efficiency measure for a primary outcome of type 1 myocardial infarction or cardiac death within 30 days.</div></div><div><h3>Results</h3><div>Median age was 72 years (interquartile range 58–82), and 30.4 % (126/414) of patients were over 80. Females comprised 44.2 % (183/414) of patients, 87.7 % (363/414) had chest pain, and the primary outcome occurred in 9.2 % (38/414). The High-STEACS pathway ruled out 62.0 % of patients without missing a case of an MI. The ESC 0/1-h and 0/2-h pathways showed high NPV and sensitivities; however, they ruled out fewer patients (35.9 % and 45.2 %, respectively). The ADAPT, EDACS, and HEART pathways demonstrated high NPV and sensitivities but ruled out fewer patients (15–27 %). The GRACE pathway missed 2 cases with primary clinical outcomes. Among patients over 80 without MI, initial hs-cTnI concentration was ≥ 3 ng/L in 99.1 % and ≥ 5 ng/L in 84.1 %.</div></div><div><h3>Conclusions</h3><div>The High-STEACS pathway was the most efficient among the hs-cTnI-based pathways while maintaining excellent safety performance in early presenters.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"136 ","pages":"Article 110897"},"PeriodicalIF":2.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The expression of canopy FGF signaling regulator 2 serves as a diagnostic and prognostic indicator for NSCLC","authors":"Xiao Jiang ,&nbsp;Jun Chen ,&nbsp;Shujun Ding ,&nbsp;Jun Yin ,&nbsp;Jiying Gu ,&nbsp;Xiangming Fang","doi":"10.1016/j.clinbiochem.2025.110895","DOIUrl":"10.1016/j.clinbiochem.2025.110895","url":null,"abstract":"<div><h3>Background</h3><div>Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. The identification of new biomarkers is crucial for enhancing early detection and treatment outcomes. This study explores the role of Canopy FGF Signaling Regulator 2 (CNPY2) in NSCLC progression and its potential as a diagnostic and prognostic biomarker.</div></div><div><h3>Methods</h3><div>CNPY2 expression was analyzed in 228 NSCLC tumor samples and adjacent normal tissues using quantitative RT-PCR and ELISA. Serum CNPY2 levels were also measured in 160 healthy controls and NSCLC patients. The relationship between CNPY2 expression and clinicopathological features, including epithelial-mesenchymal transition (EMT) markers, was assessed. Receiver operator curve analysis was used to evaluate the diagnostic potential of serum CNPY2, while Kaplan-Meier survival analysis assessed its prognostic significance.</div></div><div><h3>Results</h3><div>CNPY2 levels were significantly elevated in NSCLC tissues compared to adjacent normal tissues. Higher CNPY2 expression was associated with larger tumor size, advanced T stage, and higher N stage. Furthermore, CNPY2 expression was positively correlated with Vimentin and N-cadherin, and negatively correlated with E-cadherin. Elevated serum CNPY2 levels in NSCLC patients demonstrated moderate diagnostic accuracy, with an area under the curve of 0.78. High CNPY2 expression was also linked to reduced overall survival (p = 0.001).</div></div><div><h3>Conclusions</h3><div>CNPY2 is markedly overexpressed in NSCLC and is associated with increased tumor aggressiveness and EMT. Serum CNPY2 shows promise as a non-invasive biomarker for NSCLC diagnosis, and elevated expression is correlated with a poorer prognosis. Thus, CNPY2 may serve as both a valuable biomarker and a potential therapeutic target in NSCLC.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"136 ","pages":"Article 110895"},"PeriodicalIF":2.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}