Clinical chemistry and laboratory medicine最新文献

{"title":"Understanding the circulating forms of cardiac troponin: insights for clinical practice.","authors":"Panpan Lv, Peng Zhang, Yuxiang Dai, Junbo Ge","doi":"10.1515/cclm-2024-1236","DOIUrl":"https://doi.org/10.1515/cclm-2024-1236","url":null,"abstract":"<p><p>Ischemic heart disease remains the leading cause of death globally, with acute coronary syndrome (ACS) being the main reason for emergency hospital admissions and thus representing a significant health care issue worldwide. Cardiac troponin I (cTnI) and cardiac troponin T (cTnT) are widely recognized biomarkers of cardiomyocyte injury and the gold-standard biomarkers for diagnosing myocardial infarction (MI). High-sensitivity cardiac troponin (hs-cTn) assays have the ability to accurately detect low cTn concentrations and document minor increases. However, in addition to MI, various other pathophysiological states can trigger elevated cardiac troponin levels, thus creating potential challenges in the diagnostic process. As cTn released into the bloodstream exists in heterogeneous forms, improving our understanding and accurately characterizing these forms across various etiologies might hold clinical significance. In this review, we add to the field by offering an overview of research on possible circulating forms of cTn, the mechanisms of cTn elevation, and the clinical significance of cTn following conditions such as MI, endurance exercise, and chronic kidney disease, thus highlighting the importance and challenge of understanding of the circulating forms of cTn and possible strategies for cTn immunodetection.</p>","PeriodicalId":10390,"journal":{"name":"Clinical chemistry and laboratory medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regulating the future of laboratory medicine: European regulatory landscape of AI-driven medical device software in laboratory medicine.","authors":"Hikmet Can Çubukçu, Guilaine Boursier, Solveig Linko, Francisco A Bernabeu-Andreu, Pika Meško Brguljan, Katerina Tosheska-Trajkovska, Duilio Brugnoni, Neda Milinkovic, Andrea Padoan, Marc Thelen","doi":"10.1515/cclm-2025-0482","DOIUrl":"https://doi.org/10.1515/cclm-2025-0482","url":null,"abstract":"<p><p>Artificial intelligence (AI) is rapidly transforming laboratory medicine, impacting medical devices and healthcare practices. Despite these advancements, AI-based medical device software (MDSW) introduces a new layer of complexity in regulatory compliance. This paper outlines the regulatory landscape for MDSW and AI-driven MDSW, clarifying the responsibilities of laboratory professionals and manufacturers under the <i>In Vitro</i> Diagnostic Regulation (IVDR), ISO 15189:2022, and the Artificial Intelligence Act. An analysis of 89 MDSWs approved under the IVDR, derived from the European Database on Medical Devices (EUDAMED) reveals a diverse landscape of applications, ranging from digital pathology and molecular diagnostics to laboratory automation and clinical decision support. While Germany currently dominates the EU market for these devices, and the majority of approved MDSW remain non-AI driven and classified as low-risk, the increasing presence of AI-powered Class C devices underscores the growing potential of software in complex diagnostic scenarios. However, realizing the full potential of AI in laboratory medicine requires careful navigation of the evolving regulatory landscape. Key challenges persist, including defining intended use, ensuring robust clinical evidence, mitigating data bias, and establishing rigorous post-market surveillance. Balancing regulatory oversight with innovation is critical to fostering the development of trustworthy AI systems without stifling progress. As regulatory frameworks continue to evolve, establishing clear validation methodologies and transparent compliance pathways will be essential to unlocking the full potential of AI in laboratory medicine while ensuring the highest standards of safety and clinical effectiveness.</p>","PeriodicalId":10390,"journal":{"name":"Clinical chemistry and laboratory medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of analytical bias on machine learning models for sepsis prediction using laboratory data.","authors":"Meryem Rumeysa Yesil, Ilaria Talli, Michela Pelloso, Chiara Cosma, Elisa Pangrazzi, Mario Plebani, Yasemin Ustundag, Andrea Padoan","doi":"10.1515/cclm-2025-0491","DOIUrl":"https://doi.org/10.1515/cclm-2025-0491","url":null,"abstract":"<p><strong>Objectives: </strong>Machine learning (ML) models, using laboratory data, support early sepsis prediction. However, analytical bias in laboratory measurements can compromise their performance and validity in real-world settings. We aimed to evaluate how analytically acceptable bias may affect the validity and generalizability of ML models trained on laboratory data.</p><p><strong>Methods: </strong>A support vector machine model (SVM) for sepsis prediction was developed using complete blood count and erythrocyte sedimentation rate data from outpatients (CS, n=104) and patients from acute inflammatory status wards (SS, n=107). Twenty-six combinations were derived by white blood cells (WBC), platelets (PLT), and erythrocyte sedimentation rate (ESR) biases from analytical performance specifications (APS). The diagnostic performances of the 26 conditions tested were compared to the original dataset.</p><p><strong>Results: </strong>SVM performance of the original dataset was AUC 90.6 % [95 %CI: 80.6-98.7 %]. Minimum, desirable and optimum acceptable biases for WBC were 7.7 , 5.1 and 2.6 %, respectively, for PLT were 6.7 , 4.5 and 2.2 %, respectively and for ESR were 31.6 , 21.1 and 10.5 %, respectively. Across all conditions, AUC varied from 89.8 % [95 %CI: 79.0-97.7 %] (for PLT bias -6.7 %), to 89.5 % [95 %CI: 79.1-98.0 %] (for ESR Bias +31.6 %) to 90.4 % [95 %CI: 79.3-98.4 %] (for WBC Bias -5.1 %). Using a combination of biases, the lowest AUC was 87.8 % [95 %CI: 75.9-96.6 %]. No statistically significant differences were observed for AUC (p>0.05).</p><p><strong>Conclusions: </strong>Bias can influence model performance depending on the parameters and their combinations. Developing new validation strategies to assess the impact of analytical bias on laboratory data in ML models could improve their reliability.</p>","PeriodicalId":10390,"journal":{"name":"Clinical chemistry and laboratory medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum biomarkers as early indicators of outcomes in spontaneous subarachnoid hemorrhage.","authors":"Anna Maria Auricchio, Giulia Napoli, Giovanni Maria Ceccarelli, Renata Martinelli, Grazia Menna, Marco Obersnel, Luca Scarcia, Andrea Urbani, Alessandro Olivi, Giuseppe Maria Della Pepa, Silvia Baroni","doi":"10.1515/cclm-2025-0309","DOIUrl":"https://doi.org/10.1515/cclm-2025-0309","url":null,"abstract":"<p><strong>Objectives: </strong>Spontaneous subarachnoid hemorrhage (sSAH) is a life-threatening neurological event with high morbidity and mortality. Predicting patient outcomes remains challenging, necessitating novel prognostic tools. This study evaluates the prognostic value of central and systemic serum biomarkers, including S100, neuron-specific enolase (NSE), glial fibrillary acidic protein (GFAP), ubiquitin carboxy-terminal hydrolase L1 (UCHL-1), soluble suppression of tumorigenicity 2 (sST2), and soluble urokinase plasminogen activator receptor (suPAR) in acute sSAH.</p><p><strong>Methods: </strong>A prospective observational study was conducted on 91 sSAH patients admitted to the Emergency Department. Biomarkers were measured 24 h post-admission and correlated with clinical severity using the modified Rankin Scale (mRS) at 24 h and 3 months. Statistical analyses included correlation tests, receiver operating characteristic (ROC) curves, and partial least squares discriminant analysis with 10-fold cross-validation (PLS-DA) to assess predictive accuracy.</p><p><strong>Results: </strong>Patients with unfavorable outcomes (mRS 3-6) exhibited significantly higher median levels of all biomarkers. GFAP (ρ=0.74, p<0.0001) and S100 (ρ=0.65, p<0.0001) strongly correlated with hemorrhage volume. ROC analysis confirmed GFAP and S100 as the most effective central biomarkers (AUC=0.951), while sST2 demonstrated the highest prognostic sensitivity (97.1 %). PLS-DA further validated the prognostic relevance of sST2, GFAP, and S100.</p><p><strong>Conclusions: </strong>Early biomarker assessment enhances sSAH prognosis, complementing neuroimaging. GFAP and S100 strongly correlate with brain injury severity, while sST2 predicts 3-months outcomes. Integrating these biomarkers into routine practice may improve early risk stratification and patient management.</p>","PeriodicalId":10390,"journal":{"name":"Clinical chemistry and laboratory medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An isotope dilution-liquid chromatography-tandem mass spectrometry-based candidate reference measurement procedure for the quantification of 17β-estradiol in human serum and plasma.","authors":"Myriam Ott, Tobias Santner, Neeraj Singh, Friederike Bauland, Daniel Köppl, Alexander Gaudl, Andrea Geistanger, Uta Ceglarek, Manfred Rauh, Christian Geletneky, Judith Taibon","doi":"10.1515/cclm-2024-1255","DOIUrl":"https://doi.org/10.1515/cclm-2024-1255","url":null,"abstract":"<p><strong>Objectives: </strong>A new candidate isotope dilution-liquid chromatography-tandem mass spectrometry (ID-LC-MS/MS)-based reference measurement procedure (RMP) has been developed for the accurate and precise quantification of 17β-estradiol (E2) in human serum and plasma covering a measurement range from 0.400 to 5,000 pg/mL (1.47-18,357 pmol/L). To address this broad range, two separate methods were created: a high sensitivity (HS) method for concentrations between 0.400 and 5.00 pg/mL (1.47-18.4 pmol/L) and a standard range (SR) method for concentrations between 5.00 and 5,000 pg/mL (18.4-18,357 pmol/L).</p><p><strong>Methods: </strong>As the primary reference material, E2 (CRM 6004-a) from the National Metrology Institute of Japan was used to ensure traceability to the international system (SI). A two-dimensional heart-cut LC approach was utilized for LC-MS/MS analysis, employing a supported liquid extraction sample preparation protocol for the SR method and a liquid-liquid extraction protocol followed by derivatization for the HS method. Assay validation was conducted following current guidelines. Selectivity and specificity were assessed using spiked serum samples, while potential matrix effects were evaluated through a post-column infusion experiment and comparison of standard line slopes. Precision, accuracy, and trueness were determined using an extensive 5-day protocol. Standard measurement uncertainty was evaluated according to the Guide to the Expression of Uncertainty in Measurement (GUM), with three individual sample preparations performed on at least two different days. Equivalence with higher-order RMPs was demonstrated through participation in the CDC Steroid Hormones Standardization (HoSt) program.</p><p><strong>Results: </strong>The RMP enabled the quantification of E2 within the range of 0.400-5,000 pg/mL (1.47-18,357 pmol/L), demonstrating no interference from structurally related compounds and no evidence of matrix effects. The relative mean bias of the SR method ranged from -2.4 to 1.9 % across all levels, including secondary reference materials and spiked samples, whereas the HS method exhibited a mean bias ranging from -3.0 to 2.9 %. Expanded measurement uncertainties (k=2) for target value assignment ranged from 1.7 to 4.4 % for the SR method and were found to be ≤6.1 % for the HS method. The method's transferability was demonstrated in a comparison study at a second laboratory. Additionally, the candidate RMP exhibited excellent correlation and equivalence to JCTLM-listed RMPs through the CDC HoSt program.</p><p><strong>Conclusions: </strong>In summary, the ID-LC-MS/MS-based RMP accurately quantifies E2. Its robust performance makes it suitable for standardizing routine assays and measuring individual patient samples, ensuring traceability.</p>","PeriodicalId":10390,"journal":{"name":"Clinical chemistry and laboratory medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Macroprolactinaemia - some progress but still an ongoing problem.","authors":"Michael N Fahie-Wilson","doi":"10.1515/cclm-2025-0586","DOIUrl":"https://doi.org/10.1515/cclm-2025-0586","url":null,"abstract":"","PeriodicalId":10390,"journal":{"name":"Clinical chemistry and laboratory medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Candidate reference measurement procedure based on isotope dilution-two dimensional-liquid chromatography-tandem mass spectrometry for the quantification of androstenedione in human serum and plasma.","authors":"Myriam Ott, Friederike Bauland, Vanessa Fischer, Daniel Köppl, Alexander Gaudl, Andrea Geistanger, Uta Ceglarek, Manfred Rauh, Judith Taibon","doi":"10.1515/cclm-2024-1135","DOIUrl":"https://doi.org/10.1515/cclm-2024-1135","url":null,"abstract":"<p><strong>Objectives: </strong>Androstenedione (ASD) is a biomarker used in the diagnosis of hyperandrogenism and adrenal hyperplasia. Therefore, accurate measurement of serum ASD is pivotal in clinical settings. We aimed to develop a novel highly selective reference measurement procedure (RMP) based on isotope dilution-two dimensional-liquid chromatography-tandem mass spectrometry (ID-2D-LC-MS/MS) for the quantification of ASD in human serum/plasma.</p><p><strong>Methods: </strong>To achieve high selectivity and sensitivity, a two-dimensional heart-cut LC approach for LC-MS/MS and a supported liquid extraction sample preparation protocol were employed. Matrix effects were evaluated through a post-column infusion experiment and comparison of standard line slopes. Precision and accuracy were determined via a multi-day validation experiment. Reproducibility was assessed by comparing results from two independent laboratories, and measurement uncertainty (MU) was evaluated in compliance with current guidelines.</p><p><strong>Results: </strong>Our novel RMP proved effective for measuring ASD concentrations ranging from 0.00800 ng/mL to 12.0 ng/mL (0.0279 nmol/L to 41.9 nmol/L) and demonstrated matrix-independence. The relative mean bias varied between 0.6 and 2.2 % across different matrices and concentration levels. Intermediate precision was observed to be between 1.2 and 1.9 %. The expanded measurement uncertainty for ASD target value assignment ranged from 1.7 to 2.5 %, irrespective of sample concentration. Equivalence to the JCTLM-listed RMP was evaluated through a method comparison study, revealing a high degree of agreement (r≥0.997). Additionally, by comparing results from two independent laboratories, the transferability and reproducibility of the RMP were confirmed.</p><p><strong>Conclusions: </strong>This isotope dilution two-dimensional LC-MS/MS method can be used for the evaluation and standardization of routine assays and for measuring individual patient samples, ensuring traceability.</p>","PeriodicalId":10390,"journal":{"name":"Clinical chemistry and laboratory medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical handling of hemolytic, icteric and lipemic samples for coagulation testing in European laboratories. A collaborative survey from the European Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM).","authors":"Ann Helen Kristoffersen, Martine J Hollestelle, Janne Cadamuro, Andreas Hillarp, Ian Jennings, Rachel Marrington, Gro Gidske, Dagmar Kesseler, Piet Meijer","doi":"10.1515/cclm-2025-0319","DOIUrl":"https://doi.org/10.1515/cclm-2025-0319","url":null,"abstract":"<p><strong>Objectives: </strong>Coagulation test results may be affected by hemolysis, icterus and/or lipemia (HIL). Detailed guidelines for HIL-management are missing, both for manual and automatic HIL-checks. The aim of this survey was to provide an overview of the practical procedures for the detection and handling of HIL-samples used by laboratories in Europe in the context of coagulation testing.</p><p><strong>Methods: </strong>A SurveyMonkey questionnaire was sent from the Haemostasis Working Group in the European Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM) to European external quality assurance organizers, who in turn forwarded the link to their participating laboratories. Questions were asked regarding detection and handling of HIL-samples, comment- and reject-levels, and the guidance used by the laboratories.</p><p><strong>Results: </strong>A written procedure for HIL-management was available in 55-67 % of laboratories, and each sample was checked for HIL in 73-83 % (lowest percentage for icterus, highest for hemolysis). Manual visual inspection as the only method to detect HIL was used by up to 38 % of laboratories, with most relying on personal experience for HIL-level classification. All other laboratories used some type of automated HIL-detection, alone or in combination with visual check. The terms used for classification and the HIL comment- and reject-levels varied widely, even among laboratories using the same manufacturer. Most laboratories state that they use the manufacturer's guidance.</p><p><strong>Conclusions: </strong>There is wide heterogeneity in HIL-detection, handling and reporting among European laboratories, which calls for an urgent collaboration among laboratories and manufacturers to harmonize the HIL-management in coagulation testing.</p>","PeriodicalId":10390,"journal":{"name":"Clinical chemistry and laboratory medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analytical validation of hemolysis detection on GEM Premier 7000.","authors":"Laura Pighi, Gian Luca Salvagno, Filippo Marcazzan, Mariateresa Rizza, Giuseppe Lippi","doi":"10.1515/cclm-2025-0525","DOIUrl":"https://doi.org/10.1515/cclm-2025-0525","url":null,"abstract":"","PeriodicalId":10390,"journal":{"name":"Clinical chemistry and laboratory medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histamine metabolite to basal serum tryptase ratios in systemic mastocytosis and hereditary alpha tryptasemia using a validated LC-MS/MS approach.","authors":"Abdulrazzaq Alheraky, Claude P Van Der Ley, Martijn Van Faassen, Saskia K Klein, Hanneke N G Oude Elberink, Caroline Roozendaal, Michel J Vos, André B Mulder, Ido P Kema","doi":"10.1515/cclm-2025-0189","DOIUrl":"https://doi.org/10.1515/cclm-2025-0189","url":null,"abstract":"<p><strong>Objectives: </strong>Histamine, mainly produced in mast cells (MC), plays a key role in allergy and inflammation. Measuring its urinary metabolites, N-methylhistamine (NMH) and 1-methyl-4-imidazoleacetic acid (MIMA), is essential in assessing histamine-related pathologies. Patients with concurrent systemic mastocytosis (SM) and hereditary alpha tryptasemia (HαT) may show increased MC mediator-related symptom severity. We developed and validated a liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay to quantify histamine, NMH, and MIMA, and explored their correlation with basal serum tryptase (BST) levels.</p><p><strong>Methods: </strong>Using an in-matrix double derivatization, enhancing extraction, we analyzed urinary histamine, NMH, and MIMA with an online solid-phase extraction LC-MS/MS system. Analytical method validation assessed recovery, imprecision, and detection limits. For clinical validation, correlation analysis between BST levels, NMH, and MIMA in SM and HαT patients was performed.</p><p><strong>Results: </strong>The assay demonstrated recoveries>98 %, imprecision<3 %, and limits of quantification at 2.0 nmol/L for histamine, 0.53 nmol/L for NMH, and 0.011 μmol/L for MIMA. Patients with a combination of SM and HαT showed a 2.6-3.6 fold increase in BST compared to those with SM alone. A BST/NMH ratio>0.129 predicted HαT with 91.3 % sensitivity and 85.6 % specificity, and a BST/MIMA ratio>7.46 predicted HαT with 89.9 % sensitivity and 86.0 % specificity, independent of SM status.</p><p><strong>Conclusions: </strong>Our LC-MS/MS method provides highly accurate and efficient quantification of histamine, NMH, and MIMA. Integrating BST/NMH and BST/MIMA ratios in diagnostic protocols enhances detection of HαT in MC-related disorders, supporting improved diagnostics and tailored patient management.</p>","PeriodicalId":10390,"journal":{"name":"Clinical chemistry and laboratory medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}