Diagnostics最新文献

{"title":"<i>Tropheryma whipplei</i> as the Dominant Organism in Bronchoalveolar-Lavage Metagenomic Next-Generation Sequencing: A Single-Centre Case Series of 28 Patients.","authors":"Xi Zhang, Jingdong He, Zhinan Zhai, Xie Zhaoyifan, Xiang Pei, Yi Li, Min Hou","doi":"10.3390/diagnostics16193230","DOIUrl":"10.3390/diagnostics16193230","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) increasingly reports <i>Tropheryma whipplei</i> (<i>T. whipplei</i>) in patients without classical Whipple disease, but the significance of these detections is often uncertain. We aimed to quantify relative sequencing abundance, characterise the accompanying clinical, radiological, and routine laboratory phenotype, and develop a structured framework for interpretation. <b>Methods</b>: We retrospectively reviewed 944 consecutive BALF-mNGS tests performed at Tianjin Chest Hospital between October 2022 and March 2026. <i>T. whipplei</i> was detected in 47 tests; the primary analytic cohort comprised the 28 patients in whom it was the most abundant detected microorganism. Demographics, comorbidities, symptoms, chest computed tomography findings, co-detected organisms, species-level read counts, and routine laboratory indicators were summarised descriptively. <b>Results</b>: <i>T. whipplei</i> was detected in 47/944 tests (4.98%) and was the predominant (most abundant) detected microorganism in 28/47 (59.6%). In these 28 patients, the mean age was 60.2 ± 12.3 years and 15 (53.6%) were women. Cough (18/28, 64.3%) and expectoration (14/28, 50.0%) predominated, whereas fever occurred in 4/28 (14.3%); pulmonary nodules were the most common CT finding (15/28, 53.6%). <i>T. whipplei</i> was the sole microorganism in 11/28 (39.3%) and was co-detected in 17/28 (60.7%); it was sole or ≥10-fold more abundant than the strongest co-detected organism in 25/28 (89.3%). Leukocyte counts were within reference in 26/28, C-reactive protein was ≤5 mg/L in 19/25, and procalcitonin was at or below the assay limit in 12/14. <b>Conclusions</b>: Predominant (most-abundant) BALF-mNGS detection of <i>T. whipplei</i> commonly accompanied nonspecific respiratory presentations and a relatively indolent laboratory phenotype. Because sequence dominance cannot by itself distinguish infection from heavy carriage, interpretation should integrate read burden, orthogonal confirmation, competing pathogens and diagnoses, and systemic features.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191377","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 a Novel Chemiluminescent Immunoassay for <i>Strongyloides stercoralis</i> in a Non-Endemic Clinical Setting.","authors":"Sara Roose, Lorenza Sanfilippo, Stefano Tais, Sara Negrelli, Eleonora Rizzi, Giulia Gambini, Francesca Tamarozzi, Francesca Perandin, Dora Buonfrate","doi":"10.3390/diagnostics16193227","DOIUrl":"10.3390/diagnostics16193227","url":null,"abstract":"<p><p><b>Background/Objectives:</b><i>Strongyloides stercoralis</i> is a soil-transmitted helminth that can cause severe disease in immunocompromised individuals. In non-endemic clinical settings, recommended diagnostic strategies rely on serology alone or in combination with a sensitive fecal test, maximizing sensitivity to avoid missed infections. The <i>S. stercoralis</i> VirClia^® IgG monotest (Vircell, Spain) is a novel automated chemiluminescent immunoassay (CLIA) that detects IgG antibodies against the recombinant NIE and SsIR antigens. This study evaluated its diagnostic accuracy (sensitivity and specificity) in a non-endemic clinical setting. <b>Methods:</b> In this monocentric retrospective study, 245 serum samples from the Tropica Biobank of a referral centre for parasitic diseases in Italy were analyzed. Samples originated from individuals from Africa (n = 85), America (n = 31), Asia (n = 53), and Europe (n = 76). Diagnostic accuracy was estimated using Bayesian latent class analysis based on a model including five routinely used diagnostic tests. <b>Results:</b> The <i>S. stercoralis</i> VirClia^® IgG monotest showed a sensitivity of 95.0% (95% credible interval [CrI]: 90.1-98.2%) and a specificity of 90.8% (95% CrI: 85.1-96.0%) for the tested population. <b>Conclusions:</b> In immunocompetent individuals with a risk of previous exposure to <i>S. stercoralis</i>, the <i>S. stercoralis</i> VirClia^® IgG monotest showed high diagnostic accuracy. Its high sensitivity supports current recommendations favouring highly sensitive serological assays for screening and diagnosis in non-endemic clinical settings.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191805","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":"Reference Standards in Artificial Intelligence Detection of Apical Periodontitis: A Narrative Review of What Reported Accuracy Measures.","authors":"Omar R Alkhattab, Abdullah Bokhary","doi":"10.3390/diagnostics16193225","DOIUrl":"10.3390/diagnostics16193225","url":null,"abstract":"<p><p>The accuracy reported for detecting apical periodontitis using artificial intelligence (AI) is generally interpreted as accuracy against the disease; however, this is usually not the case. Compared with histopathology, single-view periapical radiography detects 16 to 27% of confirmed lesions and 38% with parallax, with a pooled digital sensitivity of 61.0% and a negative predictive value of 41.6%. Two blinded specialists reading 1717 radiographs disagreed on 22% of teeth. Detection depended on lesion size and site: simulated cancellous-bone lesions were invisible below 1 mm in incisors and 3 mm in molars. Of the 44 primary studies identified, 34 (77%) used a label that was a reading of the index image or was unascertainable; eight (18%) used an independent reference-six (14%) suited to contemporaneous detection and two to later treatment outcomes. No cone-beam computed tomography (CBCT) input study had a reference independent of its volume. One commercial platform reported 92.3% sensitivity against same-image consensus and 47.9% against blinded CBCT. The reported accuracy is thus in agreement with a noisy rater; recognising this changes what meta-analyses pool. A model that reproduces human labels would have a lower sensitivity against disease than reported; for real-world models, the direction depends on error dependence that the study design cannot identify.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192019","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":"Splenic Volume Changes After Left Nephrectomy: A Retrospective Computed Tomography-Based Morphometric Study.","authors":"Süniye Bilgiç Sal, Keziban Karacan, Alper Karacan, Mehtap Erdoğan","doi":"10.3390/diagnostics16193226","DOIUrl":"10.3390/diagnostics16193226","url":null,"abstract":"<p><p><b>Background/Objective</b>: Spleen volume can vary depending on physiological conditions, systemic diseases, and various clinical factors. However, the relationship between the anatomical changes resulting from the surgical removal of an organ adjacent to the spleen and spleen volume has not been sufficiently studied. The aim of this study was to evaluate changes in spleen volume following left nephrectomy and to investigate the associations of sex and the time interval between preoperative and postoperative computed tomography (CT) examinations with these changes. <b>Methods</b>: In this retrospective study, preoperative and postoperative abdominal CT images of 62 patients (30 women, 32 men; age range 37-85 years) who underwent left radical nephrectomy were evaluated. Spleen volume was calculated by manually delineating the spleen borders on axial CT slices and using the TeraRecon imaging system. Preoperative and postoperative spleen volumes were compared; furthermore, the relationship between volume change and sex, as well as the time interval between the two CT scans, was evaluated. <b>Results</b>: The mean spleen volume was 238.41 ± 80.99 cm³ before surgery and was found to be 259.81 ± 104.40 cm³ after surgery. An average increase of 9.0% in spleen volume was observed following nephrectomy, and this increase was statistically significant (<i>p</i> = 0.005). Although spleen volume increased in both women and men, the change in volume did not show a significant difference based on sex (14.07 ± 53.69 cm³ in women; 28.28 ± 62.32 cm³ in men; <i>p</i> = 0.339). No statistically significant difference in splenic volume change was detected between the predefined CT-interval groups (<i>p</i> = 0.633). Postoperative imaging time was not significantly correlated with splenic volume change when analyzed continuously (Spearman's ρ = -0.128, <i>p</i> = 0.320). <b>Conclusions</b>: Mean CT-derived splenic volume was higher on postoperative than on preoperative examinations. However, because the study lacked a control group and longitudinal data on relevant clinical confounders, this difference cannot be attributed specifically to left nephrectomy or interpreted as definitive evidence of true splenic hypertrophy.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191914","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":"Comparative Immunohistochemical Analysis of FAP and c-MET Expression Across Renal Cell Carcinoma Subtypes: Preliminary Results and Potential Theranostic Implications.","authors":"Lena M Unterrainer, Adrien Holzgreve, Sophie C Siegmund, Magdalena Schöll, Julia Schwenke, Rudolf A Werner, Frederick Klauschen, Michael Staehler, Stephan T Ledderose","doi":"10.3390/diagnostics16193228","DOIUrl":"10.3390/diagnostics16193228","url":null,"abstract":"<p><p><b>Background</b>: Renal cell carcinoma (RCC) comprises multiple histopathological subtypes with distinct biological characteristics and clinical behavior. Despite advances in conventional imaging, the detection of small RCC lesions or distant metastases remains challenging and the prognosis of advanced RCC is still poor. Theranostic approaches are promising tools combining diagnostic imaging and targeted radionuclide-based cancer therapy. The identification of suitable molecular targets in tumor tissue is a major focus of current research. Fibroblast activation protein (FAP) and hepatocyte growth factor receptor (c-MET) have been proposed as theranostic targets in several solid cancers, including RCC. However, available data are limited and inconsistent, particularly regarding expression patterns across different RCC subtypes. <b>Methods</b>: In this study, we evaluated the expression patterns of FAP and c-MET immunohistochemically across major RCC subtypes (clear cell RCC [ccRCC], papillary RCC [pRCC], and chromophobe RCC [cpRCC]). Staining intensity was assessed semi-quantitatively and correlated with histological RCC subtypes. <b>Results</b>: FAP expression differed substantially among RCC subtypes, being highest in ccRCC, significantly lower in pRCC, and largely absent in cpRCC. In contrast, c-MET was ubiquitously expressed across all three RCC subtypes but showed a lower specificity for tumor cells. <b>Conclusions</b>: Our results provide a rationale for further evaluating FAP and c-MET as potential theranostic targets across RCC subtypes and establishing a foundation for future RCC-subtype-specific imaging-pathology correlation studies. Validation in larger multicenter cohorts including paired molecular imaging data is required before their clinical translation can be considered.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191789","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":"Prognostic Significance of p53 Immunohistochemical Expression and Molecular Characterization of TP53 Variants in Triple-Negative Breast Cancer After Neoadjuvant Chemotherapy.","authors":"Juan Ramón Berenguer-Marí, Luis Álvarez, Julia Sierra-Roca, Raquel Bosch-Romeu, Irene Tadeo-Cervera, Juan Pardo, Antonella Locascio, Juan Bautista Laforga, Antonio Falcó, Juan Manuel Gasent-Blesa, Joan Climent","doi":"10.3390/diagnostics16193229","DOIUrl":"10.3390/diagnostics16193229","url":null,"abstract":"<p><p><b>Background:</b> The prognostic significance of p53 immunohistochemical expression in triple-negative breast cancer (TNBC) remains controversial, particularly following neoadjuvant chemotherapy (NAC). The relationship between p53 immunohistochemical expression, TP53 sequence variants, and clinical outcome following neoadjuvant chemotherapy remains incompletely understood. This study evaluated the relationship between p53 expression, TP53 variant profiles, longitudinal changes in TP53 variant detection and allele frequency, and clinical outcome in patients with TNBC treated with NAC. <b>Methods:</b> Forty-three patients with TNBC treated with NAC were retrospectively analyzed. p53 immunohistochemistry performed on tumor samples collected before NAC was evaluated using binary (<10% vs. ≥10%) and three-tier (<10%, 10-50%, >50%) classifications. We performed targeted sequencing on tumors before treatment and available matched post-treatment samples to characterize TP53 variants and longitudinal changes in variant detection and variant allele frequency (VAF). We assessed associations with pathological complete response (pCR), recurrence, disease-free survival (DFS), and overall survival (OS). <b>Results:</b> High p53 expression assessed before NAC (≥10%) was significantly associated with improved DFS and OS among patients achieving pCR, whereas no significant prognostic association was observed in patients with residual disease. This differential association according to pathological response was supported by formal interaction analyses. TP53 variant status and baseline variant burden were not significantly associated with clinical outcome, and patient-level TP53 VAF did not significantly differ among prognostic groups. Longitudinal TP53 sequencing identified shared and timepoint-specific variants and changes in VAF between baseline and post-treatment samples. These molecular findings were considered exploratory and descriptive. <b>Conclusions:</b> p53 immunohistochemical expression assessed before NAC showed prognostic associations that differed according to pathological response, whereas TP53 sequencing provided descriptive molecular characterization and did not demonstrate independent prognostic stratification. These findings support further investigation of p53 IHC as a potential response-contextual prognostic marker and provide exploratory insight into longitudinal changes in TP53 variant detection and VAF following NAC.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192084","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":"Bilateral Lung Consolidation with Static and Dynamic Air Bronchograms on Transesophageal Echocardiography.","authors":"Aibek E Mirrakhimov","doi":"10.3390/diagnostics16193224","DOIUrl":"10.3390/diagnostics16193224","url":null,"abstract":"<p><p>Transesophageal echocardiography (TEE) is performed primarily for cardiac indications, but the acoustic window frequently includes portions of the lung, particularly once normal aeration is lost. We present the intraoperative TEE findings in a 56-year-old woman with ischemic cardiomyopathy who underwent delayed sternal closure after exchange of a durable left ventricular assist device (LVAD) for pump thrombosis. In addition to the expected assessment of device position, flow profiles, interventricular septal position, and right ventricular systolic function, the examination incidentally demonstrated bilateral lung consolidation containing multiple punctate and branching hyperechoic structures. On qualitative assessment of the recorded clips, some structures appeared relatively stationary, whereas others showed apparent movement, suggestive of static and dynamic air bronchograms. Bronchogram displacement was not measured, and no synchronized respiratory tracing was available to confirm inspiratory timing. The coexistence of these appearances may have reflected heterogeneous regional pulmonary pathology and did not, by itself, establish a single diagnosis. The patient subsequently required reintubation, frequent pulmonary toileting, and tracheostomy. These images illustrate that pulmonary abnormalities may appear within the transesophageal window when TEE is otherwise indicated, while emphasizing the limitations of qualitative assessment of bronchogram motion.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191925","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":"Can Routine Preoperative Endoscopy and Colonoscopy Be Meaningful for the Surgery and Postoperative Course of Patients with Advanced Ovarian Cancer? A Single-Centre Retrospective Cohort Study.","authors":"Göktürk Han Doğan, Göksever Akpınar, Anıl Doğukan Tutal, Ceren Sağlam Purut, Ayşe Berin Acar, Mehmet Gökçü, Serhat Sarıkaya, Yunus Emre Purut","doi":"10.3390/diagnostics16193221","DOIUrl":"10.3390/diagnostics16193221","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Bowel resection is often required for complete cytoreduction in advanced ovarian cancer, and some units perform upper gastrointestinal endoscopy and colonoscopy beforehand. We compared the endoscopic biopsy findings with the histopathology of the resected bowel and examined determinants of survival. <b>Methods</b>: Eighty-three consecutive women with FIGO stage III-IV serous ovarian cancer cytoreduced to no macroscopic residual disease between 2015 and 2021 were reviewed retrospectively; all had undergone both examinations and completed adjuvant carboplatin-paclitaxel. <b>Results</b>: Bowel resection was performed in 20 women (24.1%). Serosal involvement was reported in 15 specimens and no tumour in four; mucosal invasion was reported in none (95% CI 0-16.8%). Eighteen patients (21.7%) were biopsied endoscopically; no biopsy was malignant. Over a median follow-up of 72 months, 50 women (60.2%) developed recurrence (28 confirmed histologically and 22 diagnosed from imaging and CA-125; recurrence was ascertained retrospectively, which limits the interpretation of disease-free survival) and 44 (53.0%) died. Recurrence was no more frequent in biopsied than in non-biopsied patients (8/18 vs. 42/65, <i>p</i> = 0.174) or after resection (10/20 vs. 40/63, <i>p</i> = 0.306). Age showed an exploratory association with disease-free (HR 1.03/year, 95% CI 1.00-1.06) and overall survival (HR 1.04, 1.00-1.07). <b>Conclusions</b>: In this cohort, no preoperative endoscopic biopsy was malignant and no resected specimen was reported to show mucosal invasion, supporting a limited role for routine endoscopy in assessing bowel wall involvement; its diagnostic accuracy and its value for excluding a gastrointestinal primary could not be assessed.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191767","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":"Development and Patient-Level Internal Validation of an MRI-Based Radiomics Machine Learning Model for Preoperative Prediction of Cervical Lymph Node Metastasis in Oral Squamous Cell Carcinoma: A Pilot Study.","authors":"İrem Öztürk, Ferhat Erişir, Kaan Orhan, Gürkan Ünsal","doi":"10.3390/diagnostics16193220","DOIUrl":"10.3390/diagnostics16193220","url":null,"abstract":"<p><p><b>Background</b>/<b>Objectives</b>: Cervical lymph node metastasis (LNM) is the main prognostic factor in oral squamous cell carcinoma (OSCC) and guides the extent of neck treatment. This retrospective pilot study aimed to develop MRI-based radiomics machine learning models for the preoperative prediction of LNM in OSCC and to validate them internally at the patient level. <b>Methods</b>: Preoperative MRI of 74 patients (32 LNM-positive, 42 LNM-negative on histopathology) was analysed. In each patient the largest morphologically suspicious cervical lymph node was segmented volumetrically on axial contrast-enhanced T1-weighted images, and 1409 IBSI-compliant radiomic features were extracted. Performance was estimated by 10 repeats of 5-fold nested cross-validation with the patient as the unit of partitioning; standardisation, correlation pruning, LASSO selection, hyperparameter tuning and threshold choice were confined to the training folds. Six classifiers were compared. <b>Results</b>: LASSO retained a median of nine features (range 6-13). SVM performed best, with an AUC of 0.781 (95% CI 0.667-0.884), a sensitivity of 0.72, a specificity of 0.76 and a balanced accuracy of 0.74; XGBoost (AUC 0.774) and logistic regression (AUC 0.769) performed comparably. A slice-level analysis of the same data, in which slices from the same patient could fall into both training and test sets, gave an apparent AUC of 0.878 but a specificity of only 0.33. <b>Conclusions</b>: MRI radiomic features of cervical lymph nodes carry moderate patient-level information on LNM in OSCC, and slice-level designs can substantially misrepresent performance. External validation in larger multicentre cohorts is required before clinical use.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191851","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":"Limited Incremental Value of Six Haemogram-Derived Inflammatory Indices for Detecting Endometrial Carcinoma and Intraepithelial Neoplasia in Abnormal Uterine Bleeding: A Case-Control Study.","authors":"Senem Karacabey Cakmak, Busra Seker Atas, Ezgi Gungor, Kubra Sevim Pehlivan","doi":"10.3390/diagnostics16193219","DOIUrl":"10.3390/diagnostics16193219","url":null,"abstract":"<p><p><b>Background</b><b>/Objectives:</b> Haemogram-derived inflammatory indices are proposed as inexpensive markers of endometrial neoplasia, but almost all supporting evidence is prognostic, from women already known to have carcinoma. We compared six indices head-to-head and asked whether any improved discrimination beyond a clinical model of age, menopausal status, endometrial thickness and metabolic comorbidity. <b>Methods:</b> In this single-centre retrospective case-control study, all women with endometrial intraepithelial neoplasia (EIN) or uterine malignancy on curettage for abnormal uterine bleeding (January 2021-June 2026) were identified (136 cases); 272 benign controls were drawn at a fixed 1:2 ratio. Indices were recalculated de novo from raw differential counts. Each log-transformed index was added singly to the fixed model; the likelihood-ratio test was the primary test and the change in C-statistic (ΔC) the effect measure, with ΔC ≥ 0.02 taken as clinically relevant, and performance was internally validated by bootstrapping and cross-validation. <b>Results:</b> Cases were 93 carcinomas and 43 EINs. Age (AUC 0.792, 95% CI 0.744-0.841) and endometrial thickness (0.749, 0.697-0.800) discriminated better than any index; SIRI was best (0.621, 0.564-0.678) and PLR did not discriminate (0.510). The clinical model reached a C-statistic of 0.882 (0.844-0.919), inflated by design; optimism-corrected calibration slope 0.963. No index remained significant after adjustment (smallest <i>p</i> = 0.141); the largest ΔC was +0.0042 (-0.0027 to +0.0111). The six log-indices are algebraically dependent, so the joint model used an identifiable four-index basis; it added +0.0064 (χ²₄ = 4.48, <i>p</i> = 0.345), an increment that vanished on validation (optimism-corrected -0.0001; cross-validated +0.0010, -0.0076 to +0.0097). Accuracy at the Youden cut-off was 83.5% (clinical) and 81.7-84.2% (index models). Twelve sensitivity analyses agreed. <b>Conclusions:</b> None of the six indices provided detectable incremental discrimination once age, menopausal status and endometrial thickness were accounted for; their univariable associations reflect the clinical profile of affected women rather than an independent biological signal.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192009","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}