Clinica Chimica Acta最新文献

{"title":"Advances in prognostic and predictive biomarkers for breast cancer: Integrating multigene assays, hormone receptors, and emerging circulating biomarkers","authors":"Sagar Mondal ,&nbsp;Subham Preetam ,&nbsp;Ravi Kumar Deshwal ,&nbsp;Shailendra Thapliyal ,&nbsp;Sarvesh Rustagi ,&nbsp;Saad Alghamdi ,&nbsp;Nayan Talukdar ,&nbsp;Richa Mishra ,&nbsp;Jutishna Bora ,&nbsp;Soham Banerjee ,&nbsp;Yachana Chakravarty ,&nbsp;Sumira Malik","doi":"10.1016/j.cca.2025.120513","DOIUrl":"10.1016/j.cca.2025.120513","url":null,"abstract":"<div><div>Breast cancer is a biologically diverse disease, and optimizing patient outcomes requires precise prognostic and predictive tools to guide treatment decisions. Over the past two decades, significant advances have been made in stratifying breast cancer risk through the integration of multigene assays, hormone receptor profiling, and emerging circulating biomarkers. This review outlines the current landscape and future direction of prognostic and predictive biomarker development. Combining specific multigene tests, biomarkers such as HER2/neu, and traditional clinicopathological prognostic factors is the most efficient way to determine prognosis. Well-established multigene assays such as Oncotype DX, MammaPrint, and uPA/PAI-1 are routinely employed to inform adjuvant treatment decisions in hormone receptor-positive, HER2-negative subtypes. Hormone receptor status (ER, PR) and HER2 expression continue to serve as cornerstone predictors of therapeutic response to endocrine and anti-HER2 therapies. Concurrently, a new generation of non-invasive biomarkers like circulating tumor DNA (ctDNA), microRNAs, and circulating tumor cells (CTCs) offers promise for real-time monitoring of treatment response and early detection of resistance, particularly in advanced disease. Notably, ESR1 mutations detected in ctDNA have emerged as potential indicators of resistance to aromatase inhibitors. Despite these advances, the identification of robust biomarkers to predict response to chemotherapy and radiotherapy remains a critical unmet need. This review synthesizes current evidence and highlights key challenges and opportunities in the clinical translation of biomarker-driven precision oncology for breast cancer.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"578 ","pages":"Article 120513"},"PeriodicalIF":2.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728329","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":"The invisible bridge: how harmonization closes the gap between impossible standardization and clinical necessity.","authors":"Kaiduo Xu, Xuanchang Bai, Haijian Zhao, Weiyan Zhou, Chuanbao Zhang","doi":"10.1016/j.cca.2025.120516","DOIUrl":"https://doi.org/10.1016/j.cca.2025.120516","url":null,"abstract":"<p><p>Clinical laboratory testing plays a pivotal role in modern medicine, yet result variability across methods remains a major challenge. This review examines current approaches for achieving standardized and harmonized test results, with particular focus on ISO 17511's calibration hierarchies and ISO 21151 harmonization protocols. While standardization through metrological traceability to higher-order references remains ideal, many analytes require harmonization when reference materials or methods are unavailable. Key international organizations including IFCC, JCTLM, and ICHCLR have developed infrastructure supporting these efforts. Successful applications demonstrate significant improvements in inter-method comparability for various clinical assays. However, substantial challenges remain in achieving widespread harmonization, particularly in markets with high platform diversity. Addressing these limitations requires expanded development of commutable reference materials, advanced calibration algorithms, and robust quality monitoring systems. Future efforts focus on scalable solutions that maintain global comparability while addressing regional testing variations.</p>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":" ","pages":"120516"},"PeriodicalIF":2.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728331","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":"Multicenter evaluation of the ProNephro AKI™ assay performance and stability in pediatric patients","authors":"Hind Malaeb ,&nbsp;Sarah Zilka ,&nbsp;Angela Jarden ,&nbsp;Ursula Klause ,&nbsp;Joe M. El-Khoury ,&nbsp;Nicholaos Tsaniklides ,&nbsp;Jessica M. Colón-Franco","doi":"10.1016/j.cca.2025.120511","DOIUrl":"10.1016/j.cca.2025.120511","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute Kidney Injury (AKI), defined by increased serum creatinine or decreased urine volume, is highly prevalent in critically ill pediatric patients. Reliance on these for AKI diagnosis is unreliable due to inaccuracy and delayed response. Neutrophil Gelatinase-Associated Lipocalin (NGAL) is a promising biomarker for early AKI detection. This study investigated the analytical performance of a new automated urine NGAL test in pediatric patients.</div></div><div><h3>Materials and methods</h3><div>The ProNephroAKI™ particle-enhanced turbidimetric immunoassay was run on the Roche cobas® c501 analyzer to measure urine NGAL in pediatric patients. The test sensitivity, specificity, and linearity were evaluated. The test reproducibility was studied in three laboratories using seven pediatric urine samples. The stability of urine NGAL was assessed in sixteen native urine pediatric samples after storage at room temperature, refrigerated, and frozen.</div></div><div><h3>Results</h3><div>The limits of blank (LoB), detection (LoD), and quantitation (LoQ) were determined as 9, 14, and 18 ng/mL, respectively. Linearity was confirmed across the range of 50–3000 ng/mL. Precision studies following CLSI EP5-03 guidelines showed coefficients of variation (CVs) for repeatability, between-run, between-day, and total precision at ≤5.0 %, ≤3.1 %, ≤1.7 %, and ≤4.9 %, respectively. Reproducibility across three laboratories was ≤6.6 %. Specificity tests showed no significant interference from high specific gravity, 15 endogenous substances, 3 contrast agents, pH variations (3.3–10.3), or 33 pharmaceutical compounds, except very high concentrations of cefepime and ceftriaxone. Cross-reactivity was not observed from 10 potential cross-reactive biomarkers. NGAL stability in urine was tested with samples from 16 patients, demonstrating stability for 2 days at ambient temperature, 4 days refrigerated, 13 months frozen (−70 °C or below), and 3 freeze/thaw cycles.</div></div><div><h3>Conclusions</h3><div>The ProNephroAKI™ assay shows excellent precision, reproducibility, sensitivity, specificity, and stability, meeting the required analytical performance for clinical use in diagnosing and managing AKI in critically ill pediatric patients.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"578 ","pages":"Article 120511"},"PeriodicalIF":3.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702835","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":"Glycated albumin is not applicable to differentiate gestational diabetes mellitus in Chinese pregnant women","authors":"Wan Peng ,&nbsp;Qin Yang ,&nbsp;Wenjuan Wang ,&nbsp;Chunmei Xie ,&nbsp;Qiulin Feng ,&nbsp;Lingli Wu ,&nbsp;Zhiqing Liang ,&nbsp;Zhijian Ling ,&nbsp;Fei Liu","doi":"10.1016/j.cca.2025.120508","DOIUrl":"10.1016/j.cca.2025.120508","url":null,"abstract":"<div><h3>Purpose</h3><div>Some studies have suggested that <span><span>Glycated albumin</span><svg><path></path></svg></span> (GA) may represent a useful biomarker in pregnant women for diagnosing and monitoring gestational diabetes mellitus (GDM). However, whether GA is a sufficiently accurate marker to screen GDM in a general population of pregnant women remains unclear. The current study aimed to investigate the role of GA in screening GDM in Chinese pregnant women.</div></div><div><h3>Methods</h3><div>In this study, 298 Chinese women between 24–28 weeks of gestation were included. A total number of 247 women with normal glucose tolerance and 51 with GDM were identified according to the glucose levels detection. GA concentrations (GA%) were measured using three different kits, all of which utilized the ketoamine oxidase method for analysis.</div></div><div><h3>Results</h3><div>Firstly, we found the GA% levels of the GDM group were significantly higher than those of healthy control. Specifically, the GA% level of the healthy control using Lucica, Maccura, Gcell was respectively 12.86 ± 0.8458, 13.40 ± 0.9344 or 10.98 ± 1.009, while that of the GDM patients was respectively 13.21 ± 1.101, 13.78 ± 1.219 and 11.44 ± 1.449. Then, the Receiving operator characteristic (ROC) curve analysis revealed that the areas under the curve (AUC) of all kits were less than 0.7 (Lucica, AUC = 0.6149; Maccura, AUC = 0.6140; Gcell, AUC = 0.6078), which do not provide support for the utilization of GA as a screening tool for GDM.</div></div><div><h3>Conclusion</h3><div>GA is not a good indicator for screening GDM initially.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"578 ","pages":"Article 120508"},"PeriodicalIF":3.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702755","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":"Electrochemical glucose sensors for detection of diabetic retinopathy","authors":"Lei Su ,&nbsp;Farzam Kiarasi","doi":"10.1016/j.cca.2025.120509","DOIUrl":"10.1016/j.cca.2025.120509","url":null,"abstract":"<div><div>Diabetic retinopathy necessitates continuous blood glucose monitoring, prompting the industry to develop affordable, rapid, and accurate glucose sensor devices, such as electrochemical glucose sensors, for clinical research. The domain of electrochemical glucose biosensing has undergone substantial expansion since the initial enzyme electrode was documented in 1962. The advancement of sensing platforms has been propelled by the creation of sophisticated nanostructures and their Nano-composites, including gold nanoparticles, carbon nanotubes, carbon/graphene quantum dots, and chitosan hydrogel composites. These nanomaterials have enhanced the immobilization process and electrocatalytic activity for glucose. This review outlines the progression of glucose biosensing, with a focus on the application of nanostructures for glucose detection, both with and without the enzyme, in diabetic retinopathy. We investigate the historical development of biosensors, advancements in surface science to improve electron transfer, and the array of sensing platforms created utilizing nanomaterials.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"578 ","pages":"Article 120509"},"PeriodicalIF":3.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706554","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":"MicroRNA-155 in neurodegeneration","authors":"Qizhen Liu ,&nbsp;Seyed Davar Siadat","doi":"10.1016/j.cca.2025.120506","DOIUrl":"10.1016/j.cca.2025.120506","url":null,"abstract":"<div><div>MicroRNA-155 (miR-155) is recognized for its multifaceted roles in neuroinflammation and neurodegeneration. This abstract explores the emerging significance of miR-155, both as an intracellular regulator and encapsulated within exosomes, as a biomarker and therapeutic target in neurodegenerative disorders. Dysregulation of miR-155 is implicated in various conditions, including Alzheimer’s disease, Parkinson’s disease, and multiple sclerosis, where it modulates key pathways involved in neuronal survival, synaptic plasticity, and immune cell activation. Specifically, miR-155 has been shown to influence microglial activation, cytokine production, and the clearance of protein aggregates, all critical processes in neurodegenerative pathogenesis. Exosomal miR-155, released by various cell types including immune cells and neurons, offers a particularly exciting avenue. These nanovesicles facilitate intercellular communication, delivering their cargo, including miR-155, to recipient cells and influencing their function. As such, exosomal miR-155 levels in biofluids like cerebrospinal fluid and blood are being investigated as potential non-invasive diagnostic and prognostic biomarkers for neurodegenerative diseases. Furthermore, the ability of exosomes to cross the blood–brain barrier makes them attractive vehicles for targeted delivery of therapeutic agents. This review highlights the dual promise of miR-155 and exosomal miR-155: first, as readily measurable indicators of disease progression and response to treatment, and second, as actionable targets for novel therapeutic strategies aimed at modulating neuroinflammation and protecting neuronal integrity.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"578 ","pages":"Article 120506"},"PeriodicalIF":3.2,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674007","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":"Electrochemical nanosensors for early detection of childhood cancer","authors":"Nafis Ahmad ,&nbsp;Shaker Al-Hasnaawei ,&nbsp;Shelesh krishna saraswat ,&nbsp;Malathi H. ,&nbsp;Samir Sahoo ,&nbsp;Vikrant Abbot ,&nbsp;Ashish Singh Chauhan ,&nbsp;Shreeya Uppal ,&nbsp;M. Dehghanipour","doi":"10.1016/j.cca.2025.120493","DOIUrl":"10.1016/j.cca.2025.120493","url":null,"abstract":"<div><div>Early detection of childhood cancer is crucial for improving treatment outcomes. Identifying biomarkers for pediatric cancers is a critical step in cancer early detection and successful treatment. Biosensors are advanced analytical tools to identify cancer-related biomarkers with high sensitivity and specificity. Nanomaterials play a transformative role in the development of biosensors, enhancing their sensitivity, specificity, and overall performance. Nanomaterial based electrochemical sensors and biosensors as a cutting-edge frontier in analytical chemistry have enormous potential for detecting pediatric cancer biomarkers. By detecting biomarkers like proteins, DNA mutations, or metabolites associated with cancer, nano electrochemical biosensors offer a non-invasive, rapid, and affordable technique for early diagnosis, and disease monitoring.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"578 ","pages":"Article 120493"},"PeriodicalIF":3.2,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674006","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":"Advances in Immunoassays for detection of pancreatitis biomarkers","authors":"Suresh Kumar Srinivasamurthy ,&nbsp;Piyush Mittal ,&nbsp;Shakir Saleem ,&nbsp;K.Benod Kumar ,&nbsp;Kavita Goyal ,&nbsp;Mohit Rana ,&nbsp;Haider Ali ,&nbsp;Sachin Kumar Singh ,&nbsp;Poonam Negi ,&nbsp;Parteek Prasher ,&nbsp;Mohamed Jaber ,&nbsp;Gaurav Gupta","doi":"10.1016/j.cca.2025.120492","DOIUrl":"10.1016/j.cca.2025.120492","url":null,"abstract":"<div><div>Pancreatitis is a predominant cause of gastrointestinal morbidity. However, the early and accurate detection of biomarkers, which is essential for guiding risk stratification and therapeutic decision-making, is constrained by the sensitivity and throughput limitations of conventional assays. This review critically examines advances in immunoassay technologies, including high-sensitivity lipase and amylase ELISAs, chemiluminescence and time-resolved fluorescence formats, label-free plasmonic sensors, digital single-molecule platforms, and multiplex bead-based and microarray systems, as applied to pancreatitis biomarker quantitation. This study synthesizes data on classical enzymatic markers, such as lipase and amylase, established proteins, including C-reactive protein and trypsinogen activation peptide, and emerging molecular targets, such as cytokines, DAMPs, and microRNAs. The focus is on evaluating analytical performance metrics, including sensitivity, specificity, dynamic range, precision, and robustness, along with preanalytical factors and clinical applications. These components are analyzed in relation to early diagnosis, assessment of severity, and evaluation of therapeutic response. Current challenges in assay standardization, head-to-head validation, and preanalytical variability are highlighted, and the potential of microfluidic “lab-on-a-chip” and point-of-care platforms is explored. This review effectively integrates advanced immunoassay modalities with the performance of pancreatitis-specific biomarkers, thereby uniquely linking technological innovation to clinical applicability. This study aims to offer a prioritized roadmap for the development and implementation of standardized multiplexed assays in personalized pancreatitis diagnostics.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"578 ","pages":"Article 120492"},"PeriodicalIF":3.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667314","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":"99 Chinese ASS1 carriers: Genetics, metabolism, and citrulline levels","authors":"Ziyan Cen ,&nbsp;Chao Zhang ,&nbsp;Pingping Ge ,&nbsp;Peiyao Wang ,&nbsp;Zhenzhen Hu ,&nbsp;Lingwei Hu ,&nbsp;Benqing Wu ,&nbsp;Xinwen Huang","doi":"10.1016/j.cca.2025.120491","DOIUrl":"10.1016/j.cca.2025.120491","url":null,"abstract":"<div><div>Citrullinemia type I is an autosomal recessive disorder caused by mutations in the ASS1 gene, whereas ASS1 mutation carriers typically have a mutation in only one allele. While carriers are usually asymptomatic, they often show mildly elevated plasma citrulline levels. This study aims to investigate the relationship between the genetic background of ASS1 carriers and plasma citrulline levels, as well as the potential mechanisms behind the elevation. The study analyzed 99 ASS1 mutation carriers identified through neonatal screening. Clinical and genetic data were collected, including plasma citrulline levels at initial and follow-up screenings. This is the first large-scale analysis of the relationship between ASS1 mutations and plasma citrulline levels in carriers. Twenty-eight distinct variants were identified, with c.1087C &gt; T (p.R363W) being the most common. Plasma citrulline levels in carriers were elevated, showing a rising then falling pattern over first six months, with a peak of 65.84 µmol/L during re-screening. Levels gradually declined thereafter and stabilized around 49.92 μmol/L, but consistently remained above the normal reference range. A citrulline threshold of 62.04 µmol/L effectively differentiated ASS1 carriers from Citrullinemia type I patients (AUC = 0.984). Elevated plasma citrulline levels are often seen in mutations affecting the monomer–monomer interface, though other mechanisms may be involved. This study identified 62.04 µmol/L as a reference threshold at the time of newborn screening to distinguish ASS1 carriers from Citrullinemia type I patients, observed a dynamic pattern of citrulline levels over the first six months in carriers, and suggested a potential role for dominant-negative effects in the underlying mechanism.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"578 ","pages":"Article 120491"},"PeriodicalIF":3.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667313","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":"Validation of free light chain reference intervals and their association with age and eGFR","authors":"Junyi Wu ,&nbsp;Xiaowen Zheng ,&nbsp;Yilin Ge ,&nbsp;Li Mu ,&nbsp;Siyu Chen ,&nbsp;Ke Chen ,&nbsp;Jiashu Yang ,&nbsp;Hui Yuan","doi":"10.1016/j.cca.2025.120494","DOIUrl":"10.1016/j.cca.2025.120494","url":null,"abstract":"<div><h3>Objectives</h3><div>To establish reference intervals (RIs) for serum free κ and λ light chains and the κ/λ ratio (FLCR) in healthy adults in China, and to evaluate the influence of age and estimated glomerular filtration rate (eGFR)</div></div><div><h3>Methods</h3><div>A total of 549 healthy adults with eGFR &gt; 90 mL/min/1.73 m² were enrolled. FLCs were measured using nephelometric assays (Goldsite Diagnostics). RIs of κ-FLC and λ-FLC were calculated based on the 2.5th to 97.5th percentiles(95 % interval),and FLCR was calculated on 100 % of this cohort. Additional subgroup analyses included individuals with reduced eGFR(60–89 mL/min/1.73 m²)to assess the association between renal function and FLC concentrations. Spearman correlation and regression analyses were used to assess relationships between FLCs, FLCR, age, and eGFR.</div></div><div><h3>Results</h3><div>This study RIs were determined: κ-FLC 4.27–35.05 mg/L, λ-FLC 12.61–34.09 mg/L, FLCR 0.15–1.58. All FLC parameters were inversely correlated with eGFR(p &lt; 0.001) and increased with age(p &lt; 0.001)</div></div><div><h3>Conclusions</h3><div>RIs derived from other assays or cohorts may not be directly applicable to all settings. The influence of age and renal function in clinical practice, FLC results should be interpreted in combination with relevant clinical and laboratory information.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"578 ","pages":"Article 120494"},"PeriodicalIF":3.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665966","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}