Journal of Clinical Laboratory Analysis最新文献

{"title":"Inductively Coupled Plasma Mass Spectrometry Performance for the Measurement of Key Serum Minerals: A Comparative Study With Standard Quantification Methods.","authors":"Kosuke Kojo, Tomoko Oguri, Takazo Tanaka, Atsushi Ikeda, Takuya Shimizu, Shunsuke Fujimoto, Ayumi Nakazono, Yoshiyuki Nagumo, Shuya Kandori, Hiromitsu Negoro, Hiroyuki Nishiyama","doi":"10.1002/jcla.25140","DOIUrl":"https://doi.org/10.1002/jcla.25140","url":null,"abstract":"<p><strong>Background: </strong>Inductively coupled plasma mass spectrometry (ICP-MS) is widely used for the accurate measurement of minerals. However, its application to serum essential mineral measurement has not been fully evaluated. The present study aimed to assess the performance of ICP-MS for serum minerals by comparing its measurements to those obtained using standard quantification methods.</p><p><strong>Methods: </strong>Cross-sectional data were collected from 282 participants from a single facility in Japan. Serum concentrations of eight key minerals, namely sodium, potassium, calcium, phosphorus, magnesium, iron, zinc, and copper, measured via ICP-MS and standard methods were compared using Passing-Bablok regression and Bland-Altman plots.</p><p><strong>Results: </strong>All minerals, except phosphorus, exhibited good agreement with standard methods, with more stable regression coefficients observed for minerals with greater interindividual variability. After systematically filtering outliers, the mean relative errors were approximately -3% for sodium, potassium, calcium, and magnesium; +5% for iron; 0% for zinc; and -19% for copper. The outliers for iron were primarily due to mild hemolysis, whereas those for zinc were largely attributed to nonhemolysis factors. For phosphorus, the serum total phosphorus concentration measured using ICP-MS was approximately 3.5 times higher than the serum inorganic phosphorus concentration measured using standard methods, with a weak correlation observed between the two methods.</p><p><strong>Conclusion: </strong>This study provides a practical foundation for future research. Understanding ICP-MS characteristics will facilitate the development of new approaches in clinical diagnostics.</p>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":" ","pages":"e25140"},"PeriodicalIF":2.6,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Thromboelastography and Coagulation for Disease Severity Evaluation in Patients With Lower Extremity Arteriosclerosis Obliterans.","authors":"Zhen Huang, Zibo Feng, Xiangli Bai, Xingxing Wang, Pengyun Wang, Liang Xiong","doi":"10.1002/jcla.25138","DOIUrl":"https://doi.org/10.1002/jcla.25138","url":null,"abstract":"<p><strong>Background: </strong>Thromboelastography (TEG) and coagulation tests can be used to detect hypercoagulability to assess thrombus formation. This study explored the association between TEG and coagulation in evaluating disease severity in elderly patients with lower extremity arteriosclerotic occlusive disease (LEASO), aimed to provide surgical treatment guideline.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical characteristics, laboratory biomarkers, TEG and coagulation parameters of 233 elderly LEASO patients treated between 2020 and 2023. Among them, 86 underwent surgical amputation, 51 received vascular intervention, and the remaining were treated conservatively. Differences in TEG and coagulation among the three groups were assessed using Spearman's correlation. Multivariate logistic regression and receiver operating characteristic curves analyzed the relationships among TEG, fibrinogen (FIB), and D-dimer (D-D) levels for surgical evaluation.</p><p><strong>Results: </strong>Inflammatory factors, platelet counts, and Fontaine stages III-IV differed significantly between the surgery and conservative groups (p < 0.05). The surgery group had higher α-angle, maximum amplitude (MA), coagulation comprehensive index (CI), FIB, and D-D, whereas lower clotting time (K) compared to the conservative group (p < 0.05), correlated with a lower ankle brachial index (ABI), indicating more severe clinical presentation. Spearman's analysis identified positive associations between α-angle, MA with FIB and D-D levels in surgical patients. Area under curve analysis indicated that combining MA, α-angle, FIB, and D-D could enhance accuracy in evaluating surgical necessity in LEASO.</p><p><strong>Conclusion: </strong>In elderly LEASO patients, TEG and coagulation analysis revealed a positive association between thrombus intensity and disease severity. Increased MA, α-angle, FIB, and D-D levels serve as predictors for surgical treatment necessity in LEASO.</p>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":" ","pages":"e25138"},"PeriodicalIF":2.6,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ATP-Binding Cassette Transporter Genes and microRNAs in Pediatric B-Cell ALL: Expression Insights.","authors":"Reza Nekouian, Pooya Faranoush, Fatemeh Khesali, Parisa Shams, Mohammad Reza Foroughi-Gilvaee, Negin Sadighnia, Dorsa Fallah Azad, MohammadAli Ehsani, Mohammad Faranoush","doi":"10.1002/jcla.25134","DOIUrl":"https://doi.org/10.1002/jcla.25134","url":null,"abstract":"<p><strong>Background: </strong>Acute lymphocytic leukemia (ALL), characterized by uncontrolled growth of abnormal lymphocytes, predominantly affects children. Genetic analysis focusing on genes and microRNAs reveals important information about the biology of ALL, enabling accurate diagnosis and treatment. This study examines gene and microRNA expression in B cell ALL to improve early diagnosis and personalized treatment.</p><p><strong>Methods: </strong>Bone marrow samples were collected from patients both before and after the induction phase of chemotherapy. Comprehensive diagnostic techniques including flow cytometry, molecular assays, real-time PCR for common translocations, karyotyping, and complete blood count (CBC) analysis were employed. These methods were utilized to determine the type and risk assessment of ALL, identify specific gene and microRNA expressions, and measure blood cell counts.</p><p><strong>Results: </strong>The study comprised 12 patients, all under the age of 18. Post-treatment RT-PCR analysis revealed significant reductions in the expression of the ABCB1 gene, miR-129-5p, and miR-9-5p following the induction phase of chemotherapy. Karyotype analysis indicated that two patients were hypodiploid; unfortunately, both of these patients did not survive.</p><p><strong>Conclusion: </strong>MicroRNAs and ABC genes serve as predictive and prognostic biomarkers in Acute Lymphoblastic Leukemia (ALL) and should be carefully reconsidered. It is more accurate to state that while microRNAs and ABC genes may potentially influence treatment response in ALL, further research is crucial to fully understand their roles in determining treatment outcomes.</p>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":" ","pages":"e25134"},"PeriodicalIF":2.6,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Prognostic Value of Glomerular Filtration Rate, Serum Cystatin C, Beta-2-Microglobulin and Albuminuria for Death and Chronic Kidney Disease Progression.","authors":"Isis Cerezo, Barbara Cancho, Jorge Alberto Rodriguez Sabillon, Alberto Jorge, Alvaro Alvarez Lopez, Julian Valladares, Juan Lopez Gomez, Jorge Romero, Nicolas Roberto Robles","doi":"10.1002/jcla.25139","DOIUrl":"https://doi.org/10.1002/jcla.25139","url":null,"abstract":"<p><strong>Aims: </strong>Serum creatinine and albuminuria are the core of most CKD prediction and progression risk models. Several biomarkers have been introduced to improve these results such as beta-2-microglobulin (B2M) and cystatin C (CysC). Nevertheless, few clinical comparisons of these biomarkers are available. We have compared serum B2M levels with albuminuria, CysC levels, and the CKD-EPI GFR equations.</p><p><strong>Designs and methods: </strong>A sample of 434 patients were studied: 234 males and 200 females, the mean age was 58.3 ± 15.0 years, and 33.4% have diabetes mellitus. In all patients, plasma B2M, CysC, creatinine, and urinary albumin excretion were analyzed. EGFR was calculated using CKD-EPI equations for creatinine, CysC, and creatinine-CysC. The risk of death and CKD progression was evaluated using ROC curves and Cox proportional hazards survivorship models.</p><p><strong>Results: </strong>For mortality, the highest area under the curve (AUC) was for CysC (0.775, 0.676-0.875). The lowest sensitivity was shown by eGFR (creatinine) (0.298, 0.195-0.401, p < 0.001), eGFR (CysC) (0.216, 0.118-0.314, p < 0.001), and eGFR (creatinine + CysS) (0.218, 0.124-0.312, p < 0.001). For progression to advanced CKD, the highest AUC was for CysC (0.908, 0.862-0.954). The lowest sensitivity was shown by eGFR (creatinine) (0.184, 0.106-0.261, p < 0.001), eGFR (CysC) (0.095, 0.048-0.14, p < 0.001), and eGFR (creatinine+ CysC) (0.087, 0.040-0.134, p < 0.001). CysC, after age, was the second-best marker of life risk. Contrariwise, for CKD progression, CysC, and albuminuria were the best markers.</p><p><strong>Conclusions: </strong>The best biomarker of mortality and risk of progression to CKD was CysC. Albuminuria and B2M were the next best options to be used. The lowest sensitivity was shown by estimated eGFR.</p>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":" ","pages":"e25139"},"PeriodicalIF":2.6,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of Circulating Tumor Cells in the Prognostic Significance of Patients With Breast Cancer: A Retrospective Study.","authors":"Wanwen Xu, Feng Yuan","doi":"10.1002/jcla.25126","DOIUrl":"https://doi.org/10.1002/jcla.25126","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer (BC) is an aggressive tumor. Circulating tumor cells (CTCs) are a potential biomarker for the prognosis of cancer patients. This study aimed to explore the prognostic significance of CTCs in patients with BC.</p><p><strong>Methods: </strong>Retrospectively, 108 BC patients were collected between January 2011 and December 2019, while 10 patients with benign nodules were included as controls. CTCs with different phenotypes of patients were isolated using CanPatrol and tricolor RNA in situ hybridization (RNA-ISH) methods. Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER-2) levels were measured by immunohistochemistry (IHC). The progression-free survival (PFS) was calculated using the Kaplan-Meier method. Independent risk factors for BC recurrence were determined by Cox proportional risk regression analysis.</p><p><strong>Results: </strong>The higher the cancer stage (p = 0.00), the higher the ki-67 expression level (p < 0.01), and the lower the histologic grade (p < 0.01), the higher the number of CTCs. The PFS of patients with high CTCs was shorter than that of patients with low CTCs (p < 0.05). Total CTCs (≥ 6) and positive mesenchymal CTCs (MCTCs) were also associated with recurrence and metastasis.</p><p><strong>Conclusions: </strong>Total CTCs in BC patients have an independent influence on PFS reduction. Higher total CTCs and MCTCs in peripheral blood are biomarkers for predicting the prognosis of BC patients. HER-2 high expression is also associated with the prognosis of the disease.</p>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":" ","pages":"e25126"},"PeriodicalIF":2.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Imaging of Peripheral Blood Smear With MC-80 as a Screening Tool for Thalassemia.","authors":"Peempol Chokchaipermpoonphol, Satana Lamtanthong, Sathaporn Nokkaew","doi":"10.1002/jcla.25135","DOIUrl":"https://doi.org/10.1002/jcla.25135","url":null,"abstract":"<p><strong>Background: </strong>Thalassemia, a genetic blood disorder, poses significant global health challenges, emphasizing the importance of accurate screening methods. Traditional diagnostic tools, such as osmotic fragility and dichlorophenolindophenol tests, along with blood indices, such as mean corpuscular volume and mean corpuscular hemoglobin, have limitations. Digital microscopy of peripheral blood smears is a promising alternative for objective quantification and standardization.</p><p><strong>Methods: </strong>Blood samples from 81 thalassemia screening-negative and 41 screening-positive individuals were analyzed using Mindray MC-80 Digital Morphology.</p><p><strong>Results: </strong>Pre-classification of red blood cell (RBC) morphology using Mindray MC-80 revealed significant differences between the screening-positive and screening-negative groups. Various RBC morphologies demonstrated statistically significant variance, including hypochromic cells, schistocytes, elliptocytes, target cells, teardrop cells (p < 0.001), and ovalocytes (p = 0.002). However, the area under the receiver operating characteristic curve of these parameters was < 0.8, indicating a limited discriminatory power.</p><p><strong>Conclusion: </strong>RBC morphology showed promise in detecting subtle changes associated with thalassemia. However, it may not be sufficient for accurate screening alone, highlighting the need for complementary diagnostic approaches.</p>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":" ","pages":"e25135"},"PeriodicalIF":2.6,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Genetic and Clinical Characteristics of Fetuses With Chromosome 16 Short-Arm Microdeletions/Microduplications","authors":"Meiying Cai,&nbsp;Na Lin,&nbsp;Nan Guo,&nbsp;Hailong Huang,&nbsp;Xiangqun Fan,&nbsp;Meimei Fu,&nbsp;Min Zhang,&nbsp;Liangpu Xu","doi":"10.1002/jcla.25132","DOIUrl":"10.1002/jcla.25132","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The short arm of chromosome 16 is highly susceptible to homologous recombination through nonallelic genes. This results in microdeletions/microduplications that can lead to neurodevelopmental disorders. However, incomplete penetrance and phenotypic diversity after birth exacerbate the uncertainty in prenatal genetic counseling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 24,000 cases with prenatal diagnoses were retrospectively analyzed. Chromosome microarray analysis (CMA) was performed on 17,000 cases, of which 81 (0.48%) had chromosome 16 short-arm microdeletions/microduplications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 81 fetuses with chromosome 16 short-arm microdeletions/microduplications, 36 and 28 had 16p11.2 and 16p13.11 microdeletions/microduplications, respectively. Ten, four, and three fetuses had 16p12.2, 16p13.12p13.11, and 16p13.12p1.3 microdeletions, respectively. Among the 36 fetuses with 16p11.2 microdeletions/microduplications, 33 had abnormal intrauterine ultrasound phenotypes, the most common being skeletal system abnormalities. Among the 28 fetuses with 16p13.11 microdeletions/microduplications, 19 had abnormal intrauterine ultrasound phenotypes, including 15 with abnormal ultrasonic soft markers. Among the 10 fetuses with the 16p12.2 microdeletions, six had abnormal ultrasound findings, and four had skeletal system abnormalities. After genetic counseling, 44 patients were selected and tested for family verification, of which 22 were de novo, while 22 were inherited from phenotypically normal parents. Among the 47 live births, 39 had no abnormalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>All fetuses with the 16p13.11 microdeletions/microduplications, and 16p12.2, 16p13.12p13.11, and 16p13.12p1.3 microdeletions were healthy after birth. Hence, chromosome 16 short-arm microdeletions/microduplications should not be the sole basis for abandoning pregnancy, and clinicians should consider prenatal diagnostic data to maximize diagnostic accuracy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"38 24","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.25132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The β-Chain Mutation p.Arg17Stop Impairs Fibrinogen Synthesis and Secretion: A Nonsense Mutation Associated With Hypofibrinogenemia","authors":"Chen Qian,&nbsp;Chaoyu Huang,&nbsp;Qinghui Luo,&nbsp;Kaili Qin,&nbsp;Yangyang Wu,&nbsp;Lin Liao,&nbsp;Qian Zhang,&nbsp;Liqun Xiang,&nbsp;Jie Yan","doi":"10.1002/jcla.25123","DOIUrl":"10.1002/jcla.25123","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Congenital hypofibrinogenemia, a quantitative fibrinogen disorder, is characterized by abnormally low levels of both functional and antigen fibrinogen. We identified a heterozygous nonsense mutation, p.Arg17Stop, in the fibrinogen Bβ chain of a three-month-old female infant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Coagulation testing, gene analysis, in vitro plasmid construction, and functional analyses were conducted to investigate the underlying pathogenic mechanisms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Plasma fibrinogen levels showed decrease in the proband. DNA sequencing of the proband revealed a heterozygous point mutation (c.139C&gt;T) in exon 2 of the FGB gene causing Arg → Stop substitution. Human Arg17 was found to be highly conserved. In vitro expression analyses indicated that the mutation impacts both the transcription and translation of the FGB gene, subsequently affecting the synthesis and secretion of fibrinogen.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The p.Arg17Stop mutation in the fibrinogen Bβ chain disrupts fibrinogen production and secretion, contributing to hypofibrinogenemia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"38 24","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.25123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution of HPV Types in Cervical Cancer in Pakistan: Implications for Screening and Vaccination Programs.","authors":"Hafsa Aziz, Humera Mehmood, Sarosh Arif, Khadija Afzal, Saba Hanif, Muhammad Adnan Saeed, Mohammad Faheem","doi":"10.1002/jcla.25130","DOIUrl":"https://doi.org/10.1002/jcla.25130","url":null,"abstract":"<p><strong>Background: </strong>HPV plays a key role in the development of cervical cancer. This study aims to investigate the prevalence of HPV genotypes in patients with Squamous cell carcinoma (SSC) and Adenocarcinoma (ADC) at NORI cancer Hospital Pakistan, with the aim of improving screening and prevention strategies.</p><p><strong>Method: </strong>Cervical scrapings were collected from 129 diagnosed cervical cancer patients. HPV typing was performed using a real-time PCR assay and sequencing.</p><p><strong>Result: </strong>Among the patients, 73.6% (90/129) were HPV positive. Proportion of HPV positivity was observed within each group. The highest incidence of HPV was observed in the 50-60 years age group (80.9%), followed by the 40-to-50-year group (75.8%). The positivity rate declined in the 60-to-70-year-old (63.6%) and further in the 70-80 years (62.5%). Eight different HPV subtypes were identified, with HPV 16 being the most prevalent (80.0%), followed by HPV 18 (9.5%), HPV 45 in 2 (2.1%), HPV 31 in 1 (1.1%), HPV 35 in 1 (1.1%), HPV 59 in 1 (1.1%), HPV 66 in 1 (1.1%), and HPV 89 in 1 (1.15). Histologically, 89.2% of the cases were Squamous cell carcinoma (SCC) and 10.8% were Adenocarcinomas. In SCC patients, HPV 16 was found in 80.9% of cases, while in Adenocarcinoma patients, HPV 16 was detected in 66.7% of cases.</p><p><strong>Conclusion: </strong>The prevalence of high-risk HPV types, both vaccine and non-vaccine, targeted in Pakistan highlights the urgent need for widespread screening and vaccination programs. Tailored public health strategies are essential to effectively reduce cervical cancer rates and mortality.</p>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":" ","pages":"e25130"},"PeriodicalIF":2.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Impact of D-Dimer on Stroke Diagnosis Within 24 h","authors":"I-Shiang Tzeng,&nbsp;Giou-Teng Yiang,&nbsp;Meng-Yu Wu,&nbsp;Mao-Liang Chen","doi":"10.1002/jcla.25133","DOIUrl":"10.1002/jcla.25133","url":null,"abstract":"&lt;p&gt;We read with interest the laboratory analysis and meta-analysis performed by Ahmad et al. [&lt;span&gt;1&lt;/span&gt;]. Using a review of the published literature, the study included controlled/randomized clinical trials (RCTs), retrospective or prospective cohorts, and case-controlled studies with five or more patients. These studies separated stroke groups from stroke mimic/control groups and reported D-Dimer values within the 24 h. The analysis revealed a positive effect size for D-Dimer in the stroke group.&lt;/p&gt;&lt;p&gt;However, we would like to highlight several methodological concerns presented in this paper. First, the estimates of variance among studies may lack precision, especially when a small number of studies are included in the meta-analysis. This uncertainty was overlooked when applying a conventional normal approximation for random-effects models, potentially impacting the accuracy of the inferences drawn. The issue of imprecise variances estimates becomes critical when the sample size of included studies is small. Neglecting this uncertainty when integrating the random effects can have detrimental consequences for statistical inferences. To address this concern, the Hartung and Knapp (HK)-adjusted method should be used to estimate random effects and their confidence intervals (CIs), rather than relying on the standard approach [&lt;span&gt;2, 3&lt;/span&gt;]. A previous meta-analysis compared D-Dimer levels (ng/ml) between stroke groups and stroke mimics/controls within 6 hours, reporting a standard mean difference (SMD) of 0.49; 95% confidence interval (CI) = [0.29, 0.69]; and &lt;i&gt;p&lt;/i&gt; &lt; 0.00001 [&lt;span&gt;1&lt;/span&gt;]. We reanalyzed the data using random effects models with the HK adjustment. The updated results showed SMD = 0.49; 95% CI = [0.03, 0.95]; and &lt;i&gt;p&lt;/i&gt; = 0.045 (Figure 1). After the HK adjustment, the &lt;i&gt;p&lt;/i&gt; value of the overall effect approached the borderline for statistical significance (&lt;i&gt;p&lt;/i&gt; = 0.05) for D-Dimer levels in the stroke group compared with the control group. Caution is advised regarding potential small-study bias when performing meta-analyses. It is important to note that the 95% CI for the random effect became wider after the HK adjustment, likely due to a decrease in statistical power for the test [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;From a clinical perspective, it is essential to recognize that correlation does not imply causation, particularly in nonexperimental studies [&lt;span&gt;5&lt;/span&gt;]. When two events, A and B, are related, several possibilities exist: (1) A causes B; (2) B causes A; (3) both A and B have no causal relationship but are influenced by a third factor; or (4) the relationship is coincidental. Confirming true causal relationships between events is a significant challenge and requires empirical evidence to validate hypotheses. Data-driven analysis can deepen our understanding of disease mechanisms and offer evidence to address clinical challenges. With advanced data-driven architectures, it is possible to establish stron","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"38 24","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.25133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}