American journal of clinical pathology最新文献_第3页

Clinicopathologic features and prognosis of steatohepatitic hepatocellular carcinoma based on varying cutoffs of tumoral steatohepatitic changes. 根据肿瘤脂肪性肝病变的不同临界值确定脂肪性肝癌的临床病理特征和预后。

IF 2.3 4区医学

American journal of clinical pathology Pub Date : 2025-03-08 DOI: 10.1093/ajcp/aqae136

Tao Zhang, Na Niu, Tamar Taddei, Dhanpat Jain, Xuchen Zhang

{"title":"Clinicopathologic features and prognosis of steatohepatitic hepatocellular carcinoma based on varying cutoffs of tumoral steatohepatitic changes.","authors":"Tao Zhang, Na Niu, Tamar Taddei, Dhanpat Jain, Xuchen Zhang","doi":"10.1093/ajcp/aqae136","DOIUrl":"10.1093/ajcp/aqae136","url":null,"abstract":"Objectives: Steatohepatitic hepatocellular carcinoma (SH-HCC) is currently recognized as a distinct histologic subtype of HCC. The prognosis and specific criteria for determining the amount of steatohepatitis required to define SH-HCC are still unclear.Methods: After excluding all recognized HCC subtypes from 505 HCC cases (2010-2019), the remaining cases were categorized as conventional HCC (CV-HCC) (n = 223). The cases classified as SH-HCC (n = 171) were further divided into groups based on the percentage of steatohepatitis: 5% or more, 30% or more, and 50% or more.Results: Hepatitis C virus infection was the predominant underlying liver disease in both the CV-HCC and SH-HCC groups. Metabolic dysfunction-associated steatotic liver disease (formerly nonalcoholic fatty liver disease) was more prevalent in all cases of SH-HCC with different steatohepatitic cutoffs than in cases of CV-HCC. There were no differences in the stage of fibrosis of the background liver between the CV-HCC and SH-HCC groups. SH-HCC with different cutoffs exhibited a notable increase in the presence of glycogenated nuclei, Mallory-Denk bodies, and hyaline globules in tumor cells. Survival analysis did not reveal substantial differences in overall survival between the CV-HCC and SH-HCC groups and among patients with SH-HCC with different steatohepatitis cutoffs.Conclusions: The degree of intratumoral steatohepatitis in patients with SH-HCC does not appear to be a notable prognostic factor. The presence of steatohepatitis in the tumor is better recognized as 1 of the histopathologic patterns of HCC.","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"411-418"},"PeriodicalIF":2.3,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455903","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}

引用次数: 0

Diagnostic incidence and pitfalls of rete testis hyperplasia and hyaline globules in a multi-institutional study of 348 testicular germ cell tumors. 对 348 例睾丸生殖细胞瘤进行的多机构研究中，齿状睾丸增生和透明小球的诊断率和误区。

IF 2.3 4区医学

American journal of clinical pathology Pub Date : 2025-03-08 DOI: 10.1093/ajcp/aqae140

Susan K Potterveld, Mahmut Akgul, Richard Pacheco, Robert M Humble, Aysha Mubeen, Sean R Williamson, Hailey Gosnell, Ankur R Sangoi

{"title":"Diagnostic incidence and pitfalls of rete testis hyperplasia and hyaline globules in a multi-institutional study of 348 testicular germ cell tumors.","authors":"Susan K Potterveld, Mahmut Akgul, Richard Pacheco, Robert M Humble, Aysha Mubeen, Sean R Williamson, Hailey Gosnell, Ankur R Sangoi","doi":"10.1093/ajcp/aqae140","DOIUrl":"10.1093/ajcp/aqae140","url":null,"abstract":"Objectives: The concept of rete hyperplasia with hyaline globules simulating testicular yolk sac tumor was first reported in a mostly retrospective review over 30 years ago. Nonetheless, we continue to encounter examples where this scenario resulted in misdiagnosis. Herein, we sought to investigate the incidence of rete hyperplasia/hyaline globules in germ cell tumors and their associated subtypes and hypothesize an etiology.Methods: A consecutive series of 348 germ cell tumor orchiectomies was evaluated for the presence of rete hyperplasia and hyaline globules, with clinicopathologic features recorded.Results: The incidence of rete hyperplasia and/or hyaline globules in our cohort was 30%, with 56% of specimens with rete hyperplasia containing concomitant hyaline globules. Hyaline globules were more often identified in specimens with nonfocal rete hyperplasia (78%) vs focal rete hyperplasia (22%). Absence of a yolk sac tumor component was seen in over half (61%) of orchiectomies with concurrent rete hyperplasia/hyaline globules (n = 105), inclusive of tumors with \"pure\" subtypes (ie, pure seminoma, pure teratoma, or pure embryonal carcinoma). Of these 105 specimens, rete invasion was seen in only 48%; notably, Paneth cell-like metaplasia was identified in efferent ductules/epididymis in 13%.Conclusions: Rete hyperplasia and hyaline globules are not uncommon findings in the setting of germ cell tumors (including occurrences in various pure/mixed germ cell tumors) and can show striking overlap with yolk sac tumor. We hypothesize that these histologic pitfalls evolve secondary to testicular obstruction by the tumor mass. Recognition of and distinguishing this morphologic mimicry is fundamental to guide appropriate clinical management.","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"439-446"},"PeriodicalIF":2.3,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492855","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}

引用次数: 0

Measuring the impact: Severity of harm from laboratory errors in 195 tests. 衡量影响：195 项检验中实验室错误造成伤害的严重程度。

IF 2.3 4区医学

American journal of clinical pathology Pub Date : 2025-03-08 DOI: 10.1093/ajcp/aqae144

Hikmet Can Çubukçu, Murat Cihan, Hamit Hakan Alp, Serkan Bolat, Oğuzhan Zengi, Kamil Taha Uçar, Deniz İlhan Topcu, Muhammed Fevzi Kılınçkaya, Habib Özdemir, Murat Gülşen, Hayri Canbaz, Doğan Yücel, Muhittin Abdulkadir Serdar

{"title":"Measuring the impact: Severity of harm from laboratory errors in 195 tests.","authors":"Hikmet Can Çubukçu, Murat Cihan, Hamit Hakan Alp, Serkan Bolat, Oğuzhan Zengi, Kamil Taha Uçar, Deniz İlhan Topcu, Muhammed Fevzi Kılınçkaya, Habib Özdemir, Murat Gülşen, Hayri Canbaz, Doğan Yücel, Muhittin Abdulkadir Serdar","doi":"10.1093/ajcp/aqae144","DOIUrl":"10.1093/ajcp/aqae144","url":null,"abstract":"Objectives: This study aimed to objectively assess the potential severity of harm associated with erroneous results in 195 laboratory tests by surveying 514 specialist physicians and medical biochemistry experts.Methods: The survey obtained participants' (75 medical biochemists, 439 clinicians) opinions on severity of harm for the erroneous results of 195 tests. The comprehensive list of errors and their effects on test results were obtained from the literature, and then matched with severity of harm scores, from 1 (negligible effect) to 5 (life-threatening injury/death), obtained from the survey responses.Results: Participants perceived tests such as cardiac biomarkers, blood gases, coagulation parameters (activated partial thromboplastin time, prothrombin time, international normalized ratio, and dimerized plasmin fragment D), critical ions (potassium, sodium), toxic trace elements (lead, mercury), and specific serum drug levels (lithium, digoxin) to have a greater potential for patient harm in case of errors. Medical biochemistry specialists assigned higher severity scores to some laboratory tests, including total bilirubin, pseudocholinesterase, platelet indices, and some drug levels (cyclosporine, methotrexate, vancomycin).Conclusions: A substantial agreement (91%) was observed between medical biochemists and clinicians in terms of the most frequently chosen severity of harm score. The study provided objective severity scores and identified high-risk tests for targeted quality improvement.","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"453-463"},"PeriodicalIF":2.3,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492856","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}

引用次数: 0

Pilomatrix-like breast carcinoma: A mammary analog of pilomatrix-like high-grade endometrioid carcinoma (PiMHEC). 皮瘤样乳腺癌：皮瘤样高级别子宫内膜样癌（PiMHEC）的乳腺类似物。

IF 2.3 4区医学

American journal of clinical pathology Pub Date : 2025-03-08 DOI: 10.1093/ajcp/aqae132

Jin Xu, Molly A Accola, William M Rehrauer, Paul S Weisman

{"title":"Pilomatrix-like breast carcinoma: A mammary analog of pilomatrix-like high-grade endometrioid carcinoma (PiMHEC).","authors":"Jin Xu, Molly A Accola, William M Rehrauer, Paul S Weisman","doi":"10.1093/ajcp/aqae132","DOIUrl":"10.1093/ajcp/aqae132","url":null,"abstract":"Objectives: To describe what is, to our knowledge, the first recognized case of a triple-negative breast carcinoma (TNBC) with a PiMHEC-like phenotype. Pilomatrix-like high-grade endometrioid carcinoma (PiMHEC) is a high-grade carcinoma with divergent differentiation resembling cutaneous pilomatrix carcinoma that was recently described in the endometrium and ovary. For reference, pertinent features of PiMHEC include (1) high-grade basaloid to squamoid morphology with the presence of ghost cells; (2) only focal p63 and/or p40 expression despite a squamoid appearance; (3) CTNNB1 mutation, accompanied by diffusely aberrant β-catenin expression and LEF1 and/or CDX2 expression; and (4) loss of site-specific markers (ie, PAX8, ER).Methods: Here we report the histologic, immunophenotypic and molecular genetic features of a case of a triple-negative breast carcinoma (TNBC) with a PiMHEC-like phenotype.Results: The tumor developed immediately adjacent to a HER2+, androgen receptor (AR)+, GATA3+ conventional grade 3 invasive ductal carcinoma (IDC) with only membranous β-catenin expression. The PiMHEC-like component had all of the above-noted morphologic and immunophenotypic features of endometrial PiMHEC but with loss of GATA3 and AR rather than PAX8 and ER. Molecular analysis performed on both tumor components demonstrated a shared TP53 point mutation and an exon 3 CTNNB1 mutation restricted to the PiMHEC-like component, implying a clonal relationship with secondary acquisition of CTNNB1. Following neoadjuvant chemotherapy, the HER2+ conventional component had completely resolved, but the PiMHEC-like component had very little response.Conclusions: This case demonstrates that a PiMHEC-like phenotype may be seen as a form of TNBC that can develop from conventional IDC, with loss of site-specific biomarkers, acquisition of CTNNB1 mutation, and resistance to conventional chemotherapy.","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"388-394"},"PeriodicalIF":2.3,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142405905","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}

引用次数: 0

Reply to "Extragenital self-collection testing for gonorrhea and chlamydia: a feasibility study for expanding STI screening in the Veterans Health Administration". 答复“淋病和衣原体的生殖器外自我收集检测：在退伍军人健康管理局扩大性传播感染筛查的可行性研究”。

IF 2.3 4区医学

American journal of clinical pathology Pub Date : 2025-03-08 DOI: 10.1093/ajcp/aqae172

Maria E Navas, J Stacey Klutts

引用次数: 0

Assessing CellaVision peripheral blood and advanced RBC application software's impact on hematologic morphology reporting: Real-world implementation experience in a large Veterans Affairs hospital. 评估 CellaVision 外周血和高级红细胞应用软件对血液学形态报告的影响：一家大型退伍军人事务医院的实际实施经验。

IF 2.3 4区医学

American journal of clinical pathology Pub Date : 2025-03-08 DOI: 10.1093/ajcp/aqae146

Cory R Lundgren

{"title":"Assessing CellaVision peripheral blood and advanced RBC application software's impact on hematologic morphology reporting: Real-world implementation experience in a large Veterans Affairs hospital.","authors":"Cory R Lundgren","doi":"10.1093/ajcp/aqae146","DOIUrl":"10.1093/ajcp/aqae146","url":null,"abstract":"Objectives: This quality improvement study, conducted at the Kansas City Veterans Affairs Medical Center in Kansas City, Missouri, examined the change in patient reporting after transitioning from manual to CellaVision software-guided differentials and slide reviews. The primary focus was blasts and schistocytes, given their clinical significance.Methods: Three months of manual and CellaVision patient data were examined between May 2022 and February 2023. Blast and schistocyte patients were standardized to the total specimens performed and compared using 2-sample proportion testing. Other red blood cell (RBC) morphologies were also compared using this statistical analysis.Results: Blast and schistocyte reporting after technologist review statistically increased after implementing the CellaVision software. This finding was most prevalent for low-percentage blasts. In addition, both morphologies experienced varying degrees of false-positive reporting, with 33% for low-percentage blasts and 91.7% for schistocytes. Other RBC morphologies displayed different levels of change, which could be clinically significant.Conclusions: The CellaVision software's increased sensitivity to blasts and schistocytes may benefit patient care, especially those with hematologic disorders. The software's high false-positive rate can be reduced by implementing quality metrics that prioritize clinically significant cells. This can be accomplished by implementing a CellaVision Champion to monitor reporting changes, perform patient lookbacks through the software, and provide technologist education. In addition, adopting a more stringent grading scale for schistocytes could also improve the high false-positive rate. Overall, CellaVision provides the ability to enhance hematology quality metrics by providing access to how patient cells are categorized and offering prompt education.","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"473-481"},"PeriodicalIF":2.3,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492852","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}

引用次数: 0

Revision of interpretation criteria to define microsatellite instability in mismatch repair-deficient neoplasms with subtle electropherogram changes.

IF 2.3 4区医学

American journal of clinical pathology Pub Date : 2025-03-06 DOI: 10.1093/ajcp/aqaf011

Ming-Tseh Lin, Eric Christenson, Suping Chen, Emily Adams, Matthew Bayes, James R Eshleman

{"title":"Revision of interpretation criteria to define microsatellite instability in mismatch repair-deficient neoplasms with subtle electropherogram changes.","authors":"Ming-Tseh Lin, Eric Christenson, Suping Chen, Emily Adams, Matthew Bayes, James R Eshleman","doi":"10.1093/ajcp/aqaf011","DOIUrl":"https://doi.org/10.1093/ajcp/aqaf011","url":null,"abstract":"Objectives: To improve analytic performance characteristics of a microsatellite instability (MSI-V1.2) assay in endometrial cancers (ECs).Methods: Nonneoplastic and neoplastic DNA from colorectal cancers (CRCs) and ECs were compared to define MSI by calculating base shifting of the highest peak and the 5% peak (the leftmost peak with a peak height >5% of the highest peak).Results: We first demonstrated highly precise sizing by capillary electrophoresis. However, relative intensity of multiple peaks, characteristic for microsatellite amplicons, might show a 1-base, but not a 2-base or more, shift of the highest or 5% peak among duplicate runs of nonneoplastic DNA. This inherent bias of the polymerase chain reaction-based MSI assay may lead to false-positive interpretation if MSI was defined by a 1-base shift or more. Subsequently, MSI was evaluated by a 2-base shift or more of the highest peak (original criteria) or a 2-base shift or more of either the highest or 5% peak (revised criteria) without subjective interpretation of a subtle change of electropherogram configuration (the so-called shoulder pattern). While both criteria were highly sensitive in CRCs, the revised criteria improved sensitivity (83% vs 67%) and accuracy (89% vs 79%) and maintained 100% specificity in ECs.Conclusions: The revised criteria provided sensitive, specific, and objective interpretation to examine subtle changes of MSI.","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571763","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}

引用次数: 0

Clinicopathologic and molecular characterization of low-grade, early-stage, and HER2-positive invasive breast carcinoma.

IF 2.3 4区医学

American journal of clinical pathology Pub Date : 2025-03-05 DOI: 10.1093/ajcp/aqaf010

Natasha Hunter, Lisa Han, Haley Corbin, Eric Q Konnick, William R Gwin, Shaveta Vinayak, Hannah Linden, William Audeh, Lavanya Samraj, Andrea R Menicucci, T Rinda Soong

{"title":"Clinicopathologic and molecular characterization of low-grade, early-stage, and HER2-positive invasive breast carcinoma.","authors":"Natasha Hunter, Lisa Han, Haley Corbin, Eric Q Konnick, William R Gwin, Shaveta Vinayak, Hannah Linden, William Audeh, Lavanya Samraj, Andrea R Menicucci, T Rinda Soong","doi":"10.1093/ajcp/aqaf010","DOIUrl":"https://doi.org/10.1093/ajcp/aqaf010","url":null,"abstract":"Objectives: Breast carcinomas overexpressing human epidermal growth factor receptor 2 (HER2) are typically associated with higher tumor grade and faster progression. HER2 positivity is rare in low-grade breast carcinomas with unclear biological implications. We aimed to characterize their clinicopathologic and molecular profiles in this study.Methods: There were 2 cohorts of Nottingham grade 1, HER2-positive invasive breast carcinomas examined: (1) an institutional series (n = 14) and (2) tumors from patients (n = 59) enrolled in the FLEX multicenter clinical registry with MammaPrint and BluePrint profiling.Results: Most (79%) in the case series were both estrogen receptor (ER) and progesterone receptor (PR)-positive. Over half were pathologic or clinical T1N0 tumors. In the 9 cases with adequate material for next-generation sequencing, the majority (66%) demonstrated ERBB2 copy number variations. Most (66%) received HER2-targeted therapy. No recurrences were observed, with a median follow-up time of 43 months. In the FLEX cohort, most tumors were ER-positive (86%) and PR-positive (68%), and over half were clinical T1. Most (70%) were of the luminal phenotype, and over half (54%) were low-risk on MammaPrint.Conclusions: Low-grade HER2-positive breast carcinomas constitute mostly low-stage, luminal-type, and apparently low-risk tumors, warranting investigation into whether therapy de-escalation could achieve favorable outcomes with less toxicity in this population.","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565766","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}

引用次数: 0

Histopathologic and genetic distinction of well-differentiated grade 3 neuroendocrine tumor versus poorly-differentiated neuroendocrine carcinoma in high-grade neuroendocrine neoplasms.

IF 2.3 4区医学

American journal of clinical pathology Pub Date : 2025-03-04 DOI: 10.1093/ajcp/aqaf013

Belinda L Sun, Hongxu Ding, Xiaoguang Sun

{"title":"Histopathologic and genetic distinction of well-differentiated grade 3 neuroendocrine tumor versus poorly-differentiated neuroendocrine carcinoma in high-grade neuroendocrine neoplasms.","authors":"Belinda L Sun, Hongxu Ding, Xiaoguang Sun","doi":"10.1093/ajcp/aqaf013","DOIUrl":"https://doi.org/10.1093/ajcp/aqaf013","url":null,"abstract":"Objectives: The classification of neuroendocrine neoplasms has evolved significantly. In the current World Health Organization (WHO) classification, well-differentiated grade 3 neuroendocrine tumors (G3-NETs) are distinguished from poorly-differentiated neuroendocrine carcinomas (NECs) based on morphology despite using the same proliferation indices, which poses diagnostic challenges. This review aims to assist pathologists in making an accurate diagnosis, which is crucial for patient management as G3-NETs and NECs have different prognoses and chemotherapy responses.Methods: A literature review and meta-analyses were conducted to summarize current knowledge of G3-NETs and NECs, focusing on histopathologic and genetic characteristics.Results: Grade 3 neuroendocrine tumors and NECs are distinct entities with differences in histopathology, genetics, and clinical presentations. Grade 3 neuroendocrine tumors have a lower Ki-67 proliferation index and tumor mutational burden compared to NECs. Distinct gene mutations and pathways have been identified in G3-NETs and NECs, offering potential for developing a diagnostic gene panel. The 2022 WHO classification recognizes the use of immunohistochemistry for somatostatin receptors 2/5, TP53, Rb, Menin, P27, ATRX, and DAXX to distinguish G3-NETs and NECs. In particular, TP53 and ATRX immunohistochemistry may be useful in routine diagnostics.Conclusions: Specific immunohistochemistry and genetic tests should be developed and incorporated into the classification to reliably distinguish G3-NETs from NECs.","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555530","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}

引用次数: 0

Haptoglobin in pregnancy: Trimester-specific reference intervals.

IF 2.3 4区医学

American journal of clinical pathology Pub Date : 2025-03-04 DOI: 10.1093/ajcp/aqaf012

M Natalia Chaves Rivera, Ibrahim Choucair, Michael A Vera, Edward S Lee, Joe M El-Khoury, Cristina A Figueroa Villalba

{"title":"Haptoglobin in pregnancy: Trimester-specific reference intervals.","authors":"M Natalia Chaves Rivera, Ibrahim Choucair, Michael A Vera, Edward S Lee, Joe M El-Khoury, Cristina A Figueroa Villalba","doi":"10.1093/ajcp/aqaf012","DOIUrl":"https://doi.org/10.1093/ajcp/aqaf012","url":null,"abstract":"Objectives: Pregnancy induces physiologic changes that can affect serologic and immunologic markers, potentially resulting in lower haptoglobin values than nonpregnant counterparts. Such variations may lead to concern for hemolysis in pregnancy. This study aims to analyze reference intervals (RIs) for haptoglobin in each trimester of pregnancy.Methods: We employed a quality improvement project to analyze a total of 401 remnant serum samples (BD Vacutainer SST) collected from routine outpatient pregnancy patients. Roche Cobas 8000 (c 502) systems were used to examine at least 80 samples per trimester: first trimester (86 samples), second trimester (230 samples), and third trimester (80 samples). Haptoglobin between trimesters was compared using the Mann-Whitney test.Results: Nonparametric RIs were calculated to be 27 to 196 mg/dL for the first trimester, 27 to 178 mg/dL for the second trimester, 34 to 191 mg/dL for the third trimester, and 30 to 185 mg/dL for the entire sample population. The distribution of second-trimester haptoglobin (median, 98 mg/dL) was significantly different compared to the first trimester (median, 113.5 mg/dL; P < .05) and the third trimester (median, 112.5 mg/dL; P < .05).Conclusions: Although overall haptoglobin RI during pregnancy aligned with the nonpregnant population, our study revealed a significant shift during the second trimester. This finding suggests that pregnant individuals in the second trimester may have lower haptoglobin values and potentially be misdiagnosed with intravascular hemolysis when consequent added factors further decrease haptoglobin below the level of detection without hemolysis.","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555526","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}

引用次数: 0