Journal of Clinical Laboratory Analysis最新文献

{"title":"Prognostic Value of a Novel Model for Hepatocellular Carcinoma Patients Undergoing Transarterial Chemoembolization","authors":"Cailing Ye,&nbsp;Yaqiong Chen,&nbsp;Jiahao Chen,&nbsp;Zhongcheng Chen,&nbsp;Wensi Chen,&nbsp;Suqing Zhao,&nbsp;Bo Hu,&nbsp;Zhaoxia Li","doi":"10.1002/jcla.70095","DOIUrl":"10.1002/jcla.70095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hepatocellular carcinoma (HCC) patients who underwent transarterial chemoembolization (TACE) have heterogeneous clinical outcomes. Accurate prognosis prediction and risk stratification are crucial for individualized treatment. We sought to develop a novel prognostic model for overall survival (OS) that incorporated contemporary clinical and laboratory factors for estimating individual prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 180 HCC patients treated with TACE were used to identify the risk factors and generate prognostic models by Cox regression analyses. Model performance was evaluated by comparing it with the Tumor-Node-Metastasis (TNM) and Barcelona-Clinic Liver-Cancer (BCLC) staging systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A prognosis model (PI score), which consisted of neutrophil-lymphocyte ratio (NLR), γ-glutamyl transpeptidase (GGT), alpha-fetoprotein (AFP), and TNM stage, was constructed. The PI scores of each patient were calculated, and the patients were divided into subgroups based on their PI scores. The OS rate of patients in the low-risk group (PI &lt; 0.87) was better than that of the patients in the high-risk group (PI ≥ 0.87), <i>p</i> &lt; 0.001. Patients were then further divided into four stages: early stage (PI ≤ 0.49), middle stage (0.49 &lt; PI ≤ 0.87), advanced stage (0.87 &lt; PI ≤ 1.48), and end stage (PI &gt; 1.48). There were statistically significant differences between the OS rates of the four groups (<i>p</i> &lt; 0.001). The area under the ROC curve (AUROC) for PI score (0.746, 0.643–0.783) was higher than those of TNM (0.699, 0.620–0.763) and BCLC (0.692, 0.617–0.760).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The PI score had excellent predictive value for HCC patients undergoing TACE and was superior to TNM and BCLC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 19","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000606","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":"Routine Laboratory Tests Predict 72-h Fatality in Patients With D-Dimer Levels ≥ 2 μg/mL: A Retrospective Cohort Study Comparing Statistical and Machine Learning Models","authors":"Shuma Hayashi,&nbsp;Ryoko Hayashi,&nbsp;Kayoko Nakamura,&nbsp;Kai Saito,&nbsp;Hidenori Sanayama,&nbsp;Takahiko Fukuchi,&nbsp;Tamami Watanabe,&nbsp;Kiyoka Omoto,&nbsp;Hitoshi Sugawara","doi":"10.1002/jcla.70091","DOIUrl":"10.1002/jcla.70091","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite the high prognostic value of D-dimer in various clinical conditions, limited research has addressed short-term fatality prediction across disease categories. This study aimed to develop and compare models predicting 72-h fatality in patients with D-dimer levels ≥ 2 μg/mL, using laboratory variables. This timeframe was chosen based on its clinical relevance for early triage and intervention across multiple acute conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed data from 5158 patients (241 deaths within 72 h). The primary outcome was 72-h fatality; predictors included age, sex, and 40 routine hematologic, biochemical, and coagulation tests. Traditional multivariate logistic regression analysis (MLRA) was compared with four machine learning (ML) models: Prediction One, LightGBM, XGBoost, and CatBoost. External validation was performed using a separate dataset of 5550 patients (309 deaths). D-dimer levels were recorded in any clinical setting despite limited patient medical information.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 72-h fatality rate increased with increasing D-dimer levels (overall 4.67%). Major causes of death were intracranial disease (24.9%), malignancy (17.0%), and sepsis (8.3%). MLRA identified five key predictors: advanced age, low total protein and cholesterol levels, and elevated aspartate aminotransferase and D-dimer levels. Its performance (AUC 0.829, 95% CI 0.768–0.888; sensitivity 0.762; specificity 0.809) was exceeded by LightGBM (AUC 0.987; sensitivity 0.987; specificity 0.911), which outperformed Prediction One (0.814), XGBoost (0.981), and CatBoost (0.937).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ML models, particularly LightGBM, effectively identify high-risk patients using routine laboratory tests. The model enables timely decision-making and early risk stratification in patients with high D-dimer values, even when clinical information is limited.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70091","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955921","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":"Automated Morphologic Differentiation Between Iron Deficiency Anemia and Thalassemia","authors":"Julien Guy,&nbsp;Marie-C Béné,&nbsp;Ramon Simon Lopez,&nbsp;Marc Maynadié,&nbsp;Céline Row","doi":"10.1002/jcla.70097","DOIUrl":"10.1002/jcla.70097","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Iron deficiency anemia (IDA) and hemoglobinopathies (HbP) are two frequent conditions characterized by microcytemia. Published criteria/scores discriminating these conditions with hematology analyzer parameters are not fully satisfactory. Although patients with HbP have been reported to have more red blood cells (RBC) with a target cell (TC) morphology than patients with IDA, obtaining TC percentages remains a time-consuming task since at least 1000 RBC must be examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using the Mindray CAL 8000 2.0 0111 and MC-80 module, 152 microcytic samples from 51 patients with IDA and 101 with HbP were analyzed. Data from RBC parameters used in published scores were collected, as well as the percentages of target cells automatically provided by the MC-80.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with IDA had significantly lower median hemoglobin level, red blood cell numbers, and mean corpuscular hemoglobin concentration than those with HbP, yet had more microcytes. Using TC percentages provided by the MC-80 module, receiving operator characteristic curves identified this parameter as the most discriminant to segregate patients with IDA or HbP. With a 0.4% threshold, this yielded a 74.2% sensitivity and 86.3% specificity, confirming that patients with HbP have significantly higher TC percentages.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The automated identification and enumeration of abnormal RBC performed by Mindray MC-80 rapidly provides TC percentages, allowing for a fast discrimination between IDA and HbP in samples with microcytosis, orienting early towards confirmatory tests for these disorders. Moreover, this study confirms TC, which can obviously be obtained through other methods, as a robust parameter in this context.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 19","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955890","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":"RETRACTION: Role of Matrix Metalloproteinase-9 Gene Polymorphisms in Glaucoma: A Hospital-Based Study in Chinese Patients","authors":"","doi":"10.1002/jcla.70094","DOIUrl":"10.1002/jcla.70094","url":null,"abstract":"<p>\u0000 RETRACTION: <span>Zhao, F.</span> <span>Fan, Z.</span> <span>Huang, X.</span> <span>Role of Matrix Metalloproteinase-9 Gene Polymorphisms in Glaucoma: A Hospital-Based Study in Chinese Patients</span> <i>Journal of Clinical Laboratory Analysis</i> <span>34</span> no. <span>3</span> (<span>2020</span>): e23105, https://doi.org/10.1002/jcla.23105\u0000 </p><p>The above article, published online on 12 November 2019 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Rong Fu; and Wiley Periodicals LLC. The retraction has been agreed due to scientific inconsistencies and major flaws in the statistical evaluation.</p><p>The journal received a request to retract this manuscript initially. During investigation, the authors stated that original data is no longer available and did not provide documentation for the ethical approval process of this study. Nanchong Central Hospital could not be reached for comment. Subsequently, the authors stopped responding.</p><p>The conclusions of this manuscript are considered unreliable.</p>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955965","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":"ACT001 Inhibits Tumor Progression and Modulates Immune Responses in Non-Small Cell Lung Cancer","authors":"Zhijing Shi,&nbsp;Yiman Li,&nbsp;Huijie Hou,&nbsp;Zhitao Wang,&nbsp;Hui Guo,&nbsp;Yang Yu,&nbsp;Yan Song,&nbsp;Zhe Chen","doi":"10.1002/jcla.70066","DOIUrl":"10.1002/jcla.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Advancements in non-small cell lung cancer (NSCLC) therapies have improved outcomes, but challenges like low immune response, drug resistance, and side effects persist. ACT001, a novel small-molecule inhibitor, shows promise in addressing these issues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We evaluated ACT001's anti-tumor and immunomodulatory effects in NSCLC. In vitro, its impact on proliferation, migration, invasion, and cell cycle arrest was assessed. In vivo, its effect on tumor growth in C57BL/6 mice was studied. Pull-down assays and mass spectrometry identified ACT001's interaction with STAT1/STAT3 and its regulation of PD-L1 expression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ACT001 inhibited NSCLC cell proliferation, migration, and invasion, induced cell cycle arrest, and suppressed tumor growth in vivo. It enhanced granzyme B release in CD3⁺ T cells, promoting NSCLC cell apoptosis. Mechanistically, ACT001 bound to STAT1/STAT3, suppressing their phosphorylation and reducing PD-L1 expression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ACT001 exhibits antitumoral and immunomodulatory potential by targeting STAT1/STAT3 and regulating PD-L1, offering a promising therapeutic approach for NSCLC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 17","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955927","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":"Retraction: Overexpressed miR-335-5p Reduces Atherosclerotic Vulnerable Plaque Formation in Acute Coronary Syndrome","authors":"","doi":"10.1002/jcla.70093","DOIUrl":"10.1002/jcla.70093","url":null,"abstract":"<p>\u0000 RETRACTION: <span>Sun, D.</span> <span>Ma, T.</span> <span>Zhang, Y.</span> <span>Zhang, F.</span> <span>Cui, B.</span> <span>Overexpressed miR-335-5p Reduces Atherosclerotic Vulnerable Plaque Formation in Acute Coronary Syndrome</span> <i>Journal of Clinical Laboratory Analysis</i> <span>35,</span> no. <span>2</span> (<span>2021):</span> e23608 https://doi.org/10.1002/jcla.23608\u0000 </p><p>The above article, published online on 5 December 2020 in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the authors; the journal Editor-in-Chief, Rong Fu; and Wiley Periodicals, LLC. The authors notified the journal of potential data irregularities. An investigation by the publisher confirmed that elements in Figure 7 were duplicated, and that elements of Figure 9 were duplicated from a previously published article by a different author group (Zhang et al. 2020 [https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2020.00804/full]). The retraction has been agreed due to the evidence of image duplication and manipulation which fundamentally compromises the conclusions presented in the article. The authors agree with this decision.</p>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70093","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144846586","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":"Assessment of Mortality Risk in Patients With Community-Acquired Pneumonia: Role of Novel Inflammatory Biomarkers","authors":"Burcu Baran,&nbsp;Nur Aleyna Yetkin,&nbsp;Bilal Rabahoğlu,&nbsp;Nuri Tutar,&nbsp;İnci Gülmez","doi":"10.1002/jcla.70081","DOIUrl":"10.1002/jcla.70081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pneumonia is a lung parenchyma infection with clinical presentations ranging from mild to life-threatening. Its severity depends on factors such as the causative pathogen, the host's immune response, and existing comorbidities. This study aimed to investigate the prognostic value of novel inflammatory biomarkers for predicting in-hospital mortality in patients with community-acquired pneumonia (CAP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cross-sectional study included 207 hospitalized patients diagnosed with clinically and radiologically confirmed pneumonia. Laboratory data collected upon admission included complete blood count parameters, C-reactive protein (CRP), creatinine, and albumin levels. Systemic inflammatory biomarkers such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), CRP-to-albumin ratio (CAR), CRP-to-lymphocyte ratio (CLR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), prognostic nutritional index (PNI), and C-reactive protein-albumin-lymphocyte (CALLY) index were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort was predominantly male (69%, <i>n</i> = 142) with a mean age of 62.1 ± 16.3 years. The median hospital stay was 8 days, with an 11% mortality rate. Malignancy was more frequent in the nonsurvivor group (<i>p</i> = 0.001). Nonsurvivors had significantly lower hemoglobin (<i>p</i> &lt; 0.001) and albumin (<i>p</i> = 0.004) levels, while CRP (<i>p</i> = 0.024) and creatinine (<i>p</i> = 0.002) were elevated. NLR (<i>p</i> = 0.009), CAR (<i>p</i> = 0.011), CLR (<i>p</i> = 0.006), SII (<i>p</i> = 0.013), and SIRI (<i>p</i> = 0.024) were higher in nonsurvivors, while PNI (<i>p</i> = 0.010) and CALLY (<i>p</i> = 0.003) were lower.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Novel inflammatory biomarkers, particularly the CALLY index, are valuable for mortality prediction in CAP, aiding in risk stratification and early management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 17","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835254","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":"Clinical Significance of Plasma and Peripheral Blood Mononuclear Cell EBV-DNA in Lymphoma","authors":"Lu wang,&nbsp;Guobing Xu,&nbsp;Jianjun Xu,&nbsp;Qingyun Zhang","doi":"10.1002/jcla.70092","DOIUrl":"10.1002/jcla.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Epstein Barr virus (EBV) is a ubiquitous virus that establishes latent infection in the host and plays a critical role in the development and prognosis of lymphomas. The presence of EBV-DNA in peripheral blood is a widely used tumor marker. However, there is no consensus on the preferred blood compartment for EBV-DNA testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed data from 256 lymphoma patients, including 21 with Hodgkin lymphoma, 96 with B-cell lymphoma, and 139 with T-cell or NK/T-cell lymphoma. Complete matched PBMC and plasma EBV-DNA datasets were available, allowing correlation analysis and assessment of their respective clinical significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Detectable pretreatment EBV-DNA in either plasma or PBMCs was significantly associated with worse survival outcomes (<i>p</i> &lt; 0.001), with the worst prognosis observed in patients positive in both compartments. Longitudinal monitoring demonstrated that patients with negative EBV-DNA or declining viral loads in PBMCs or plasma had significantly improved progression-free survival compared to those with persistent positivity or increasing copy numbers (<i>p</i> &lt; 0.001). Notably, changes in plasma EBV-DNA levels showed higher accuracy than PBMC EBV-DNA in reflecting treatment response. Multivariate analysis identified PBMC EBV-DNA positivity as an independent prognostic factor for inferior OS (<i>p</i> = 0.031) and PFS (<i>p</i> = 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both plasma and PBMC EBV-DNA are valuable for prognostic evaluation in lymphoma patients. Plasma EBV-DNA demonstrates superior utility for monitoring treatment response, whereas PBMC EBV-DNA provides stronger prognostic information. Selection of the appropriate sample type should be tailored to the clinical context.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70092","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835255","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":"Multimarker Approach: An Effective Tool in the Risk Stratification of Patients Admitted to the Emergency Department","authors":"Marilena Minieri,&nbsp;Carla Prezioso,&nbsp;Dolores Limongi,&nbsp;Vito N. Di Lecce,&nbsp;Maria Stella Lia,&nbsp;Alessandro Terrinoni,&nbsp;Alfredo Giovannelli,&nbsp;Gianluigi Ferrazza,&nbsp;Cartesio D'Agostini,&nbsp;Sergio Bernardini,&nbsp;Jacopo M. Legramante","doi":"10.1002/jcla.70084","DOIUrl":"10.1002/jcla.70084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The use of biomarkers in emergency room decision-making has significantly increased, particularly during the COVID-19 pandemic, due to urgent clinical needs. SARS-CoV-2 infection presents a spectrum of symptoms, from asymptomatic cases to severe pneumonia with respiratory failure. During the pandemic, various prognostic tools and biomarkers have been used to quickly guide patients to appropriate care upon admission. This study evaluated the effectiveness of a multimarker approach for early risk stratification of patients with confirmed SARS-CoV-2 infection in the Emergency Department. It aimed to determine if a combined biomarker panel could better predict COVID-19 severity than single biomarkers, aiding in clinical decision-making and resource management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective observational study analyzed data from 265 patients with suspected COVID-19 admitted to the Emergency Department at the University Hospital Tor Vergata in Rome from April to December 2020. SARS-CoV-2 infection was confirmed by RT-PCR swabs. Clinical features and biomarker levels were analyzed, and mortality prediction was assessed using ROC curve analysis to determine the AUC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Results demonstrated that the predictive power for mortality increased when multiple biomarkers were considered together. The most comprehensive panel, combining MR-proADM, CRP, D-dimer, LDH, and CT score, achieved the highest accuracy (AUC: 0.866), outperforming any individual marker.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Combining multiple biomarkers improved the prediction of disease severity over individual biomarkers. These findings suggest that using a comprehensive biomarker panel can more accurately predict SARS-CoV-2 severity, supporting its potential utility for early risk stratification in various emergency settings and aiding in the efficient allocation of healthcare resources.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"39 17","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcla.70084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784394","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":"Comparison of Univariate and Multivariate Reference Interval Methods.","authors":"Esra Kutsal Mergen, Sevilay Karahan","doi":"10.1002/jcla.70070","DOIUrl":"10.1002/jcla.70070","url":null,"abstract":"<p><strong>Background: </strong>In clinical practice, reference intervals play a pivotal role in interpreting laboratory test results. Yet, when several tests are taken into consideration simultaneously, the traditional univariate intervals might not suffice due to the elevated risk of Type 1 errors.</p><p><strong>Methods: </strong>This study introduces and evaluates two multivariate reference interval techniques: one based on Mahalanobis distance and the other an adaptation of the multivariate confidence interval (MCI). Using Monte Carlo simulations, we focused our assessments on the interplay between \"serum ferritin and transferrin saturation\" values.</p><p><strong>Results: </strong>Upon evaluation, it became evident that the multivariate methods significantly reduced false positives. They presented enhanced accuracy over traditional univariate intervals. Notably, the method involving Mahalanobis distance stood out in terms of efficacy.</p><p><strong>Contributions: </strong>Beyond presenting novel techniques, our research underscores the importance and potential of using multivariate approaches in clinical lab settings. The findings can guide better medical decision making, ensuring optimized allocation of healthcare resources.</p>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":" ","pages":"e70070"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325903","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}