Advances in laboratory medicine最新文献

{"title":"The evolving role of PSA in prostate cancer screening: revisiting the evidence in the era of personalized medicine.","authors":"Xavier Filella","doi":"10.1515/almed-2025-0187","DOIUrl":"10.1515/almed-2025-0187","url":null,"abstract":"<p><p>Prostate-specific antigen (PSA) is a widely available and analytically robust biomarker, but its role in prostate cancer (PCa) screening remains controversial due to concerns regarding limited specificity, overdiagnosis of indolent tumors, and the downstream risk of overtreatment. This review provides a critical analysis of the main randomized trials, systematic reviews, and meta-analyses that have shaped current recommendations against PSA-based screening, highlighting the substantial methodological heterogeneity that complicates interpretation of aggregated outcomes. Key limitations identified across studies include variability in PSA thresholds and screening intensity, insufficient follow-up in some cases to detect long-term mortality benefits, non-comparability of PSA assays, and extensive contamination of control groups - particularly in the PLCO trial - which undermines estimates of screening efficacy. Recent updates from the ERSPC and CAP trials show that mortality reductions associated with screening increase with longer follow-up, supporting the need to reassess earlier conclusions. Parallel to the evolving evidence base, European initiatives such as the PRAISE-U consortium and several regional pilot programs following the European Council's recommendations are implementing risk-adapted pathways that combine baseline PSA stratification with multiparametric MRI triage and selective biopsy. These programs aim to minimize overdiagnosis while improving detection of clinically significant PCa and generating real-world evidence for organized screening. Additionally, the variability among PSA assays underscores the need for greater harmonization and standardized reporting. Overall, emerging data suggest that intelligently targeted, risk-stratified PSA screening may offer a more balanced approach than the traditional dichotomy of screening vs. no screening.</p>","PeriodicalId":72097,"journal":{"name":"Advances in laboratory medicine","volume":"7 2","pages":"81-89"},"PeriodicalIF":1.1,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of the I-index as a pre-screening tool for total bilirubin testing: a retrospective study in a regional hospital.","authors":"Amanda Jiménez García, Manuel Ruiz Artero, Carmen Garcia Rabaneda, Elena Pizarro Peña, Félix Gascón Luna","doi":"10.1515/almed-2025-0161","DOIUrl":"10.1515/almed-2025-0161","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluates the efficacy of the icteric index as a pre-screening tool for hyperbilirubinemia in adult patients.</p><p><strong>Methods: </strong>The use of this index would help optimize the use of clinical laboratory resources.</p><p><strong>Results: </strong>A retrospective analysis of 3,194 serum samples revealed a strong correlation between icteric index and total bilirubin levels (r=0.972), with an area under the ROC curve of 0.90. An index cut-off value of 1.2 yielded a sensitivity of 100 % and a specificity of 87 %. This performance guarantees the detection of the totality of hyperbilirubinemia cases and the absence of false negatives, albeit with some false positives. This method would avoid around 79 % of unnecessary total bilirubin tests, resulting in estimated annual cost savings of over 1,500 Euros.</p><p><strong>Conclusions: </strong>In conclusion, the icteric index is an effective, inexpensive, and safe tool for improving the diagnostic performance of laboratory tests without compromising the quality of care.</p>","PeriodicalId":72097,"journal":{"name":"Advances in laboratory medicine","volume":"7 2","pages":"153-155"},"PeriodicalIF":1.1,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of diagnostic performance of GAAD, GALAD, and ASAP scores for detecting hepatocellular carcinoma in advanced liver fibrosis patients.","authors":"Alberto Izquierdo-Martínez, Ángela Rojas, Ricardo Rubio-Sánchez, Inmaculada Dominguez-Pascual, Manuel Romero-Gómez, Daniel Fatela-Cantillo","doi":"10.1515/almed-2025-0144","DOIUrl":"10.1515/almed-2025-0144","url":null,"abstract":"<p><strong>Objectives: </strong>Alpha-fetoprotein L3 (AFP-L3 %) and protein induced by vitamin K absence-II (PIVKA-II) are used in diagnostic scores such as GAAD, GALAD, and ASAP for hepatocellular carcinoma (HCC) detection. Advanced liver fibrosis (ALF) is diagnosable by the liver fibrosis index and could be combined with these blood biomarkers for better HCC detection.</p><p><strong>Methods: </strong>This study developed an analytical framework to address the role of GAAD, GALAD, and ASAP in ALF patients as a risk score to predict HCC. By analyzing data from 21 HCC and 30 ALF patients, this analysis assessed the diagnostic accuracy of individual biomarkers, ASAP, GAAD, and GALAD.</p><p><strong>Results: </strong>GAAD slightly outperformed AFP (sensitivity: 76.2 %, specificity: 88.5 %). The combination of AFP and PIVKA-II also surpassed AFP alone. PIVKA-II and AFP-L3 showed the worst performance for identifying HCC.</p><p><strong>Conclusions: </strong>GAAD and ASAP showed comparable or slightly superior performance to AFP, suggesting potential for screening strategies that should be confirmed in larger studies.</p>","PeriodicalId":72097,"journal":{"name":"Advances in laboratory medicine","volume":"7 1","pages":"43-51"},"PeriodicalIF":1.1,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12994706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-GBM pulmonary-renal syndrome: when the laboratory makes the difference.","authors":"Carmen Frías Ruiz, María D Martín Martínez","doi":"10.1515/almed-2025-0099","DOIUrl":"10.1515/almed-2025-0099","url":null,"abstract":"<p><strong>Objectives: </strong>Pulmonary-renal syndrome (PRS) is a serious condition characterized by concurrent alveolar hemorrhage and rapidly progressive glomerulonephritis. One of the potential causes of PRS is the presence of anti-glomerular basement membrane (anti-GBM) antibodies, which may induce Goodpasture syndrome, a rare, albeit life-threatening, condition associated with a high mortality.</p><p><strong>Case presentation: </strong>We report the case of a 31 year-old male patient with Huntington's disease who presented with dyspnea, a dry cough, and asthenia. Urgent laboratory tests demonstrated severe anemia, acute kidney failure, and additional laboratory abnormalities consistent with vasculitis. Chest CT scan revealed diffuse alveolar hemorrhage. The autoimmune panel was anti-GBM positive, thereby leading to diagnosis of Goodpasture syndrome.</p><p><strong>Conclusions: </strong>Goodpasture syndrome is a form of pulmonary-renal syndrome that requires prompt diagnosis and intensive immunosuppressive therapy. Patients may follow a severe course and progress into end-stage renal disease. Early detection of anti-GBM antibodies is essential for diagnosis. The clinical laboratory plays a major role in supporting therapeutic decision-making and treatment response monitoring.</p>","PeriodicalId":72097,"journal":{"name":"Advances in laboratory medicine","volume":"7 2","pages":"160-162"},"PeriodicalIF":1.1,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caracterización genómica de los mecanismos de adaptación de <i>Pseudomonas aeruginosa</i> en pacientes con bronquiectasias.","authors":"Alba Muñoz Santa, Xavier Gómez-Arbonés, Ricardo Pifarré Teixidó, Mercè García-González, Alba Bellés Bellés","doi":"10.1515/almed-2025-0173","DOIUrl":"10.1515/almed-2025-0173","url":null,"abstract":"","PeriodicalId":72097,"journal":{"name":"Advances in laboratory medicine","volume":"6 4","pages":"484-491"},"PeriodicalIF":1.1,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12744366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145859514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An algorithm to predict intrathecal IgM synthesis in multiple sclerosis patients: optimizing the use of oligoclonal band testing.","authors":"Jordi Tortosa-Carreres, Laura Cubas-Núñez, Jéssica Castillo-Villalba, Lorena Forés-Toribio, Mónica Piqueras, Raquel Gasque-Rubio, Sara Carratalà-Boscà, Carlos Quintanilla-Bordás, David Gorriz-Romero, Bonaventura Casanova, Begoña Laiz-Marro, Francisco Carlos Pérez-Miralles","doi":"10.1515/almed-2025-0098","DOIUrl":"10.1515/almed-2025-0098","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to develop a simple, cost-effective algorithm to predict the presence of oligoclonal IgM bands (OCMB) in patients with multiple sclerosis (MS), using surrogate markers such as the IgM Index (IgMi) and the Free Kappa Light Chains Index (FKLCi), with the aim of reducing the need for OCMB testing while maintaining high diagnostic accuracy.</p><p><strong>Methods: </strong>A retrospective study was conducted using paired serum and cerebrospinal fluid samples from patients diagnosed with MS at disease onset at Hospital Universitari i Politècnic La Fe. Receiver operating characteristic (ROC) curve analyses were performed for IgMi and FKLCi to evaluate their ability to predict OCMB positivity. Several combinations of cutoff values prioritizing high specificity and positive predictive value (PPV) were tested, and the best-performing threshold combination was selected.</p><p><strong>Results: </strong>A total of 97 patients were included. The optimal model defined OCMB positivity as having either IgMi≥0.2 or FKLCi≥250. Applying this algorithm reduced the need for OCMB testing by 33 %, while achieving a specificity of 90 % and a PPV of 85 %.</p><p><strong>Conclusions: </strong>IgMi and FKLCi may serve as reliable predictors of OCMB positivity in MS, potentially reducing unnecessary testing and laboratory workload.</p>","PeriodicalId":72097,"journal":{"name":"Advances in laboratory medicine","volume":"7 2","pages":"148-152"},"PeriodicalIF":1.1,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aplicaciones y retos de ChatGPT en la medicina de laboratorio.","authors":"Zhili Niu, Xiandong Kuang, Juanjuan Chen, Xin Cai, Pingan Zhang","doi":"10.1515/almed-2025-0158","DOIUrl":"10.1515/almed-2025-0158","url":null,"abstract":"","PeriodicalId":72097,"journal":{"name":"Advances in laboratory medicine","volume":"6 4","pages":"397-410"},"PeriodicalIF":1.1,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12744373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145859496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive comparative study of HLA genotyping between urinary and blood DNA using sequencing-based typing and third-generation sequencing.","authors":"Cheng Yan Fan, Yu Jie Wen, Dong Mei Li, Yuan Yuan Jing, Na Liu, Jie Wang, Li Jun Wang, Xue Lian, Yan Jun Jia, Tie Cheng Sun","doi":"10.1515/almed-2025-0087","DOIUrl":"10.1515/almed-2025-0087","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the feasibility of urinary DNA as a noninvasive alternative for high-resolution HLA genotyping and validate its concordance with conventional blood-based methods.</p><p><strong>Methods: </strong>Matched urine and blood samples were collected from 11 healthy volunteers. Urinary DNA was extracted using an optimized column-based protocol, while blood DNA was processed via an automated system. High-resolution HLA typing for HLA-A, -B, -C, -DRB1, and -DQB1 loci was performed using sequencing-based typing (SBT) and third-generation sequencing (TGS), with concordance rates assessed between sample types.</p><p><strong>Results: </strong>The average concentration of urinary DNA exhibited significantly lower concentrations than blood DNA (9.74 ± 10.52 vs. 33.13 ± 26.78 ng/μL, p = 0.001) but comparable purity (OD 260/280 ratio: 1.65 ± 0.4 vs. 1.81 ± 0.13, p = 0.068). Remarkably, both SBT and TGS achieved 100 % concordance between urine- and blood-derived genotypes across five classical HLA loci, with TGS resolving full-length HLA sequences (5'UTR-3'UTR) at ≥30× coverage.</p><p><strong>Conclusions: </strong>Urinary DNA achieves blood-comparable accuracy in noninvasive HLA genotyping. Our optimized protocol overcomes DNA yield and purity limitations through dual-platform validation (SBT/TGS), establishing urine as a clinically viable alternative for HLA profiling, especially where blood sampling is unfeasible.</p>","PeriodicalId":72097,"journal":{"name":"Advances in laboratory medicine","volume":"7 1","pages":"52-58"},"PeriodicalIF":1.1,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12994691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacogenetics and laboratory medicine: from individual genes towards integral genetic testing.","authors":"Mercè Brunet Serra, María Isidoro-García","doi":"10.1515/almed-2025-0182","DOIUrl":"10.1515/almed-2025-0182","url":null,"abstract":"","PeriodicalId":72097,"journal":{"name":"Advances in laboratory medicine","volume":"6 4","pages":"377-380"},"PeriodicalIF":1.1,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12744368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145859591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laboratory based quantitative scoring system for pre-analytical quality indicators in arterial blood gas analysis.","authors":"Tushar Sethi, Mohit Mehndiratta, Shiba Ansari, Ankita Gupta, Shashank Tripathi","doi":"10.1515/almed-2025-0179","DOIUrl":"10.1515/almed-2025-0179","url":null,"abstract":"<p><strong>Objectives: </strong>Arterial blood gas (ABG) analysis is vital in emergency care setting for assessing respiratory and metabolic status, but its reliability is highly jeopardized by pre-analytical errors, which constitute up to 70 % of laboratory errors. This study evaluated pre-analytical quality indicators (QIs) of ABG testing by reviewing requisition forms and ABG samples at the emergency laboratory of a tertiary care hospital in Delhi, India.</p><p><strong>Methods: </strong>In this descriptive, questionnaire-based study, 205 ABG requisition forms and their corresponding samples collected over one year were assessed manually using a predefined checklist of pre-analytical quality indicators. Parameters included patient identification, requisition completeness, syringe type, tip sealing, labeling, sample volume, sample integrity, presence of clots, red cell sedimentation, and transport time (<30 min). Descriptive statistics were then applied.</p><p><strong>Results: </strong>The study results revealed major deficiencies. Documentation gaps included omission of collection time (97.07 % of all samples), ventilator/oxygen status mentioning (98.04 %), gender (9.27 %), age (6.34 %), and hospital unit (32.68 %). All samples were collected in inappropriate syringes; 89.27 % had inadequately sealed tips and 95.61 % lacked labeling. Transport delays (>30 min) occurred in 23.41 %, with clotting (14.15 %) and sedimentation (17.07 %) also noted. Inadequate volume (<0.3 mL) was found in 20 % of the total samples. Scores clustered at 8.5-10.5 (81 %), with mean=9.44 (SD=1.04); low (<8.0, 5 %) and outlier (>11.0, 3 %) scores were uncommon.</p><p><strong>Conclusions: </strong>Significant pre-analytical errors undermine ABG reliability, especially in documentation, collection, and transport. Standardized requisition forms, staff training, adherence to transport timelines, quality monitoring, and use of appropriate ABG syringes are essential to improve result accuracy and patient safety.</p>","PeriodicalId":72097,"journal":{"name":"Advances in laboratory medicine","volume":"7 1","pages":"26-33"},"PeriodicalIF":1.1,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12994704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}