Clinica Chimica Acta最新文献

{"title":"Harmonization of anti-nuclear antibody testing (ANA) by indirect immunofluorescence assay: Results from ten years of UK NEQAS external quality assessment","authors":"Maria Infantino ,&nbsp;Teresa Carbone ,&nbsp;Dina Patel ,&nbsp;Ravishankar Sargur ,&nbsp;Carol Stanley ,&nbsp;Amina Bhayat-Cammack ,&nbsp;Emirena Garrafa ,&nbsp;Silvia Pancani ,&nbsp;Mariangela Manfredi ,&nbsp;Luis E.C. Andrade ,&nbsp;Nicola Bizzaro","doi":"10.1016/j.cca.2024.120088","DOIUrl":"10.1016/j.cca.2024.120088","url":null,"abstract":"<div><div>External quality assurance (EQA) programs play a pivotal role in monitoring laboratory practices, allowing each laboratory to evaluate the consistency of results across different methods as well the ability of individual laboratories to compare and improve over time their own performance.</div><div>The objective of our study was to analyze the UK NEQAS EQA reports for the “Antibodies to Nuclear and Related Antigens” program from 2013 to 2023, to assess the overall level of harmonization of the responses for anti-nuclear antibody (ANA) testing by indirect immunofluorescence (IIF), in terms of both pattern and titer consensus. As a second aim, we analyzed the impact of the introduction in UK NEQAS EQA reports of the International Consensus on ANA Patterns (ICAP) nomenclature and of digital image recognition on the harmonization of the ANA HEp-2 IIF test.</div><div>The percentage of consensus for positive/negative results was significantly higher (90.9 ± 1.4) in 2023 than in 2013 (64.0 ± 7.8, p &lt; 0.001). Common to all years in the investigated period, consensus on pattern recognition was significantly lower for the homogenous pattern (70.5 ± 16.0) compared to the centromere (84.9 ± 14.9), the speckled (90.3 ± 12.3), and the negative (84.5 ± 18.6, p &lt; 0.001) samples, while it was significantly higher for titers 1:80–1:320 than for titers &gt; 1:320 (p &lt; 0.001).</div><div>The difference between manual reading and digital reading was not significant (93.8 % <em>vs</em>. 92.4 %; p = 0.078), but it was significant between the pre- and post-use of the ICAP nomenclature (82.6 % <em>vs</em>. 93.8 %; p &lt; 0.001).</div><div>This study shows that the variability in ANA recognition and reporting is pattern (homogeneous &gt; speckled &gt; centromere) and titer (high titer &gt; low titer) dependent. While we did not find any difference between the use of manual reading compared to digital reading, the adoption of the ICAP nomenclature greatly improved the harmonization of ANA reporting.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"567 ","pages":"Article 120088"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817471","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":"High-sensitivity cardiac troponin T and N-terminal b-type natriuretic propeptide are associated with cardiac and all-cause mortality in older adults – A population-based ten-year follow-up study","authors":"Elisa Heikkilä ,&nbsp;Taina Katajamäki ,&nbsp;Marika Salminen ,&nbsp;Kerttu Irjala ,&nbsp;Anna Viljanen ,&nbsp;Marja-Kaisa Koivula ,&nbsp;Kari Pulkki ,&nbsp;Matti Viitanen ,&nbsp;Tero Vahlberg ,&nbsp;Laura Viikari","doi":"10.1016/j.cca.2024.120116","DOIUrl":"10.1016/j.cca.2024.120116","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac troponin T (cTnT) and N-terminal B-type natriuretic propeptide (proBNP) are mainly used as biomarkers to diagnose specific conditions of the heart, but they also have predictive ability. Our aim was to study their associations with cardiovascular and all-cause mortality in an older population in non-acute conditions.</div></div><div><h3>Methods</h3><div>A population-based study with a ten-year follow-up. The data comes from a community-based representative sample of an older population with 1260 participants (participation rate 82 %). Associations were analyzed using Cox proportional hazard models.</div></div><div><h3>Results</h3><div>Altogether, 467 (37%) subjects died during the 10-year follow-up period, and 149 of those of a cardiovascular disease. Both elevated cTnT and proBNP concentrations were statistically significantly associated with cardiovascular and all-cause mortality in older adults.</div></div><div><h3>Conclusions</h3><div>Our study shows that older population with higher cTnT and proBNP concentrations have an increased risk of cardiovascular and all-cause mortality. Acknowledging the elevated risk may aid in targeting follow-up, prevention, and treatment adequately and more individually.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"567 ","pages":"Article 120116"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892572","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":"Corrigendum to “Serum levels of visfatin and vaspin in healthy and complicated pregnancies and their association with anthropometric measures of their offspring” [Clinica Chimica Acta 568 (2025) 1–8]","authors":"Patricia Cortés Salim ,&nbsp;Alma Patricia González ,&nbsp;Armando Gómez Ojeda ,&nbsp;Emmanuel Gilberto Martínez Morales ,&nbsp;Juan Carlos Barrera de León ,&nbsp;Alejandro Gugliucci ,&nbsp;Ma Eugenia Garay Sevilla ,&nbsp;Gloria Patricia Sosa-Bustamante","doi":"10.1016/j.cca.2025.120159","DOIUrl":"10.1016/j.cca.2025.120159","url":null,"abstract":"","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"569 ","pages":"Article 120159"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078758","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":"Osteocalcin: A bone protein with multiple endocrine functions","authors":"William Determe ,&nbsp;Sabina Chaudhary Hauge ,&nbsp;Justine Demeuse ,&nbsp;Philippe Massonnet ,&nbsp;Elodie Grifnée ,&nbsp;Loreen Huyghebaert ,&nbsp;Thomas Dubrowski ,&nbsp;Matthieu Schoumacher ,&nbsp;Stéphanie Peeters ,&nbsp;Caroline Le Goff ,&nbsp;Pieter Evenepoel ,&nbsp;Ditte Hansen ,&nbsp;Etienne Cavalier","doi":"10.1016/j.cca.2024.120067","DOIUrl":"10.1016/j.cca.2024.120067","url":null,"abstract":"<div><div>Bones are now recognised as endocrine organs with diverse functions. Osteocalcin, a protein primarily produced by osteoblasts, has garnered significant attention. Research into osteocalcin has revealed its impact on glucose metabolism and its unexpected endocrine role, particularly in its undercarboxylated form (ucOC). This form influences organs, affecting insulin sensitivity and even showing correlations with conditions like type 2 diabetes and cardiovascular diseases. However, analytical challenges are impeding advances in clinical research.</div><div>Various immunoassays like RIA, EIA, ECLIA, IRMA, and ELISA have been developed to analyse osteocalcin. Recent innovations include techniques like OS-ELISA and OS phage Immuno-PCR, enabling fragment analysis. Advancements also encompass porous silicon for detection and ECLIA for rapid measurements. The limitations of immunoassays lead to ucOC measurement discrepancies, prompting the development of mass spectrometry-based techniques. Mass spectrometry increasingly quantifies carboxylated, undercarboxylated, and fragmented forms of osteocalcin.</div><div>Mass spectrometry improves routine and clinical analysis accuracy. With heightened specificity, it identifies carboxylation status and serum fragmentations, boosting measurement reliability as a reference method. This approach augments analytical precision, advancing disease understanding, enabling personalised medicine, and ultimately benefiting clinical outcomes.</div><div>In this review, the different techniques for the analysis of osteocalcin will be explored and compared, and their clinical implications will be discussed.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"567 ","pages":"Article 120067"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779475","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":"Elevated neurofilament light chain associated with cobalt/chromium metal neurotoxicity in a patient with a failed hip implant","authors":"Danting Liu ,&nbsp;Joshua R. Miller ,&nbsp;Jason S. Lipof ,&nbsp;Dan J. Figdore ,&nbsp;Susan L. Ashrafzadeh Kian ,&nbsp;Sarah A. Erdahl ,&nbsp;Alicia Algeciras-Schimnich ,&nbsp;Paul J. Jannetto ,&nbsp;Joshua A. Bornhorst","doi":"10.1016/j.cca.2024.120118","DOIUrl":"10.1016/j.cca.2024.120118","url":null,"abstract":"<div><h3>Background</h3><div>It is known that the heavy metals cobalt and chromium are associated with neurotoxicity. Chromium (Cr) and Cobalt (Co) are both components of metal-on-metal (MoM) implants which can be degraded/fragmented and released into the bloodstream. Neurofilament Light Chain (NfL) is a neuron-specific protein that increases in serum following axonal damage. Here, we report a novel case of a patient with neurotoxic concentrations of serum Co and Cr stemming from fragments of a Metal on Metal (MoM) hip implant exhibiting elevated serum NfL concentrations.</div></div><div><h3>Case presentation</h3><div>A 56-year-old female patient with ceramic and metal fragments left in her body after hip arthroplasty revision presented with symptoms consistent with Co/Cr neurotoxicity. Serum Co, Cr and NfL concentrations were measured to assess metal ion exposure and its potential link to her neurological symptoms. Over four months following two revision surgeries, her serum Co and Cr concentrations decreased significantly from their peak levels, along with a concomitant decrease in NfL concentrations. During this period, the patient’s pathological neurological symptoms gradually resolved, with serum Co, Cr, and NfL concentrations approaching normal ranges.</div></div><div><h3>Conclusion</h3><div>Serum NfL is elevated in a patient exhibiting neurotoxicity from Co/Cr implant exposure. The potential utility of serum NfL as a biomarker for metal associated neurotoxicity should be further explored.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"567 ","pages":"Article 120118"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906695","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":"Feasibility evaluation of big data algorithms for establishing serum protein electrophoresis reference intervals using Hoffmann and refineR methods","authors":"Chaochao Ma ,&nbsp;Lihua Guan ,&nbsp;Pengchang Li ,&nbsp;Lian Hou ,&nbsp;Liangyu Xia ,&nbsp;Wei Su ,&nbsp;Ling Qiu","doi":"10.1016/j.cca.2024.120114","DOIUrl":"10.1016/j.cca.2024.120114","url":null,"abstract":"<div><h3>Background</h3><div>Serum protein electrophoresis (SPE) is essential for diagnosing monoclonal gammopathies and a variety of other diseases. Despite its importance, there is a scarcity of SPE parameter reference intervals (RIs) derived from large datasets. This study seeks to fill this gap by establishing sex-specific RIs using Hoffmann and refineR algorithms and assessing the feasibility of these methods.</div></div><div><h3>Method</h3><div>We utilized two health check-up population databases to create a reference and a validation set. The reference set included 52,293 individuals with outlier removal via the Tukey method. Variance component analysis was used to evaluate the impact of sex and age on SPE parameters. The Hoffmann and refineR algorithms were applied to establish RIs, with the bias ratio method comparing RI differences. Validation data from differing timeframes helped assess the RIs’ reliability and utility. Moreover, we juxtaposed our RIs with previous studies to identify potential disparities.</div></div><div><h3>Results</h3><div>Sex-specific RIs were established using the Hoffmann and refineR algorithms, with high consistency between the two algorithms, except for a slight difference in upper limits (ULs) of α1-globulin and β1-globulin. Additionally, there are sex differences in RIs for α2-globulin, β2-globulin, γ-globulin, and Albumin. In the validation analysis, all established RIs passed verification, except for RIs determined by refineR for female α1-globulin and male β2-globulin.</div></div><div><h3>Conclusion</h3><div>This research highlights the critical impact of sex on SPE RIs and the need for tailored RIs in distinct clinical environments. The utility and feasibility of the Hoffmann and refineR algorithms for creating these customized intervals are effectively demonstrated.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"567 ","pages":"Article 120114"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906704","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":"Biosensors for early stroke detection","authors":"Firoozeh Alavian ,&nbsp;Fatemeh Khodabakhshi ,&nbsp;Fatemeh Heidary Chenary","doi":"10.1016/j.cca.2024.120079","DOIUrl":"10.1016/j.cca.2024.120079","url":null,"abstract":"<div><div>This article aims to provide a comprehensive review of the latest advances in biosensor technology for early stroke diagnosis. Analyzing current research from authoritative databases highlights the significance of biosensors in improving stroke detection and treatment outcomes, discusses their diagnostic capabilities, and addresses the challenges that must be overcome for broader clinical application. This review utilizes updated information and valid research from ISI, Google Scholar, Science Direct, Scopus, and PubMed to examine recent developments in biosensors applicable to early stroke diagnosis. The results indicate that biosensors are crucial for the early detection of strokes, and enhance treatment efficacy. The biosensors studied in this research serve as rapid and non-intrusive diagnostic instruments with exceptional precision and detection capabilities. Cutting-edge biosensors can identify distinct stroke-related biomarkers, offering rapid and non-invasive diagnostic solutions to improve stroke care outcomes. Despite these advancements, significant challenges remain regarding the sensitivity, specificity, and reliability of biosensors. These issues must be resolved to facilitate their widespread implementation in clinical settings.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"567 ","pages":"Article 120079"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791275","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":"Targeted and non-targeted proteomics to identify the urinary protein biomarkers for Wilson disease","authors":"Simin Dong ,&nbsp;Xixi Wang ,&nbsp;Huiling Zhou ,&nbsp;Huan Xu ,&nbsp;Liqian Su ,&nbsp;Linshen Xie ,&nbsp;Yongxin Li","doi":"10.1016/j.cca.2024.120090","DOIUrl":"10.1016/j.cca.2024.120090","url":null,"abstract":"<div><h3>Background</h3><div>Wilson disease (WD) is a genetic disorder of copper metabolism. Early diagnosis of WD is inherently challenging due to the absence of typical symptoms. This study aimed to identify urinary protein biomarkers for WD using targeted and nontargeted mass spectrometry-based approaches.</div></div><div><h3>Methods</h3><div>Exploratory urinary proteomic research on WD patients was initially conducted and revealed some potential biomarkers (alpha-2-macroglobulin, alpha-1-antitrypsin, complement C3, prothrombin, and complement factor B). A multiple reaction monitoring (MRM) assay was subsequently developed and applied to an independent WD cohort for protein candidate validation. Finally, a Random Forest (RF) model constructed with five proteins was evaluated for its diagnostic capacity.</div></div><div><h3>Results</h3><div>The linear range of the MRM assay extended from 0.025 ng/L to 155 ng/L and the limit of quantification (LOQ) ranged from 0.0095 ng/L to 9.2308 ng/L. Alpha-2-macroglobulin, alpha-1-antitrypsin, and complement C3 exhibited significant increases (<em>p</em> &lt; 0.05) in WD patients compared to the controls, whereas prothrombin and complement factor B only showed variations in concentration. The physiology reference intervals (RIs) for alpha-2-macroglobulin, alpha-1-antitrypsin, complement C3, prothrombin, and complement factor B were estimated as 0–12.50, 0–123.08, 0–5.20, 0–16.59, 0–4.85 ng/mol Cr, while the pathology RIs were 0–114.86, 0–600.98, 0–12.62, 0–22.16, and 0–10.83 ng/mol Cr, respectively. The RF model demonstrated an area under the curve (AUC) of 0.99 for the training data and 0.83 for the testing data.</div></div><div><h3>Conclusions</h3><div>Based on the proteomic results, the quantitative method was successfully applied for the validation of protein candidates in WD. Using supervised machine learning, the five-protein panel exhibited excellent accuracy in non-invasive diagnosis of WD.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"567 ","pages":"Article 120090"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821981","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":"Recent advances in lateral flow assays for MicroRNA detection","authors":"Nasim Barzegar Nafari ,&nbsp;Majid Zamani ,&nbsp;Bashir Mosayyebi","doi":"10.1016/j.cca.2024.120096","DOIUrl":"10.1016/j.cca.2024.120096","url":null,"abstract":"<div><div>Lateral flow assays (LFAs) have emerged as pivotal tools for the rapid and reliable detection of microRNAs (miRNAs). It is believed that these biomarkers are crucial for the diagnosis and prognosis of various diseases, particularly cancer. Traditional miRNA detection techniques, such as quantitative PCR, are highly sensitive but have limited efficacy due to their complexity, high cost, and technical requirements. LFAs are valuable due to their simplicity, affordability, and portability, making them ideal for point-of-care testing in low-resource environments. However, challenges remain in developing highly sensitive and accurate LFA devices for miRNA detection. This review explores recent advancements in LFAs to improve miRNA detection sensitivity and specificity. Key innovations include signal amplification using isothermal methods, the application of CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats)/Cas systems for direct targeting of miRNAs, and the incorporation of nanomaterials, such as gold nanoparticles and nanorods, to enhance signal intensity. Using artificial intelligence (AI) algorithms enables precise, automated, and rapid quantification of miRNAs. Moreover, this review examines the ability of LFA-based devices to detect multiple miRNAs simultaneously. One of the most significant advancements is the detection of miR-21 levels as low as 20 pM and let-7a levels as low as 40 pM within ten minutes. This highlights the potential of these devices for clinical diagnostics.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"567 ","pages":"Article 120096"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834170","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":"Liquid biopsies and exosomal ncRNA: Transforming pancreatic cancer diagnostics and therapeutics","authors":"Ashok Kumar Balaraman ,&nbsp;Ehssan Moglad ,&nbsp;Muhammad Afzal ,&nbsp;M Arockia Babu ,&nbsp;Kavita Goyal ,&nbsp;R. Roopashree ,&nbsp;Irwanjot Kaur ,&nbsp;Sachin Kumar ,&nbsp;MRavi Kumar ,&nbsp;Ashish Singh Chauhan ,&nbsp;S. Hemalatha ,&nbsp;Gaurav Gupta ,&nbsp;Haider Ali","doi":"10.1016/j.cca.2024.120105","DOIUrl":"10.1016/j.cca.2024.120105","url":null,"abstract":"<div><div>Pancreatic cancer is a highly fatal malignancy due to poor early detection rate and resistance to conventional therapies. This review examines the potential for liquid biopsy as a transformative technology to identify diagnostic and therapeutic targets in pancreatic cancer. Specifically, we explore emerging biomarkers such as exosomal non-coding RNAs (ncRNAs), circulating tumor DNA (ctDNA), and circulating tumor cells (CTCs). Tumor-derived exosomes contain nucleic acid and protein that reflect the unique molecular landscape of the malignancy and can serve as an alternative diagnostic approach vs traditional biomarkers like CA19-9. Herein we highlight exosomal miRNAs, lncRNAs, and other ncRNAs alongside ctDNA and CTC-based strategies, evaluating their combined ability to improve early detection, disease monitoring and treatment response. Furthermore, the therapeutic implications of ncRNAs such as lncRNA UCA1 and miR-3960 in chemoresistance and progression are also discussed via suppression of EZH2 and PTEN/AKT pathways. Emerging therapeutic strategies that target the immune response, epithelial-mesenchymal transition (EMT) and drug resistance are explored. This review demonstrates a paradigm shift in pancreatic cancer management toward personalized, less invasive and more effective approaches.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"567 ","pages":"Article 120105"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871637","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}