American journal of clinical pathology最新文献

{"title":"Quality control and maintenance of intraoperative cell salvage instruments.","authors":"Jae Won Lee, Suk Won Seo, Yousun Chung, Hyungsuk Kim, Sang-Hyun Hwang, Heung-Beom Oh, Han Joo Kim, Dae-Hyun Ko","doi":"10.1093/ajcp/aqaf027","DOIUrl":"10.1093/ajcp/aqaf027","url":null,"abstract":"<p><strong>Objectives: </strong>Intraoperative cell salvage (ICS) is broadly used in high-risk surgical procedures to facilitate rapid autologous red blood cell transfusion, minimizing the need for allogeneic blood and its associated risks. However, standardized guidelines are lacking for the quality control of ICS devices.</p><p><strong>Methods: </strong>We retrospectively assessed biannual quality control tests performed on 8 ICS devices at our institution between 2017 and 2023. The quality control assessments included visual inspection for hemolysis, albumin levels, potassium (K+) levels, and free hemoglobin levels, as well as microbial cultures.</p><p><strong>Results: </strong>Among 90 quality control tests, albumin and K+ levels were consistently within acceptable ranges. However, visual inspections revealed 14 and 20 instances of unacceptable hemolysis and free hemoglobin levels, respectively. Two devices exhibited higher frequencies of these unacceptable outcomes. Most microbial cultures identified contaminants, with Klebsiella pneumoniae being the only notable pathogen. Follow-up simulations demonstrated acceptable performance, indicating equipment reliability.</p><p><strong>Conclusions: </strong>Our findings highlight the need for standardized quality control protocols for ICS devices. Although current guidelines are limited, our biannual quality control standard is both practical and effective. We hope our findings provide a framework for other institutions aiming to optimize ICS device performance.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"920-925"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959952","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":"Implementing AI in clinical microbiology: Key challenges ahead.","authors":"Diyna Altrmanini, Ibrahim Hassan, Andrés Pérez-López, Mohammed Suleiman","doi":"10.1093/ajcp/aqaf003","DOIUrl":"10.1093/ajcp/aqaf003","url":null,"abstract":"","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"947"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472095","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":"Feasibility and potential impact of a local proficiency testing program in Accra, Ghana.","authors":"Yembur Ahmad, Kwabena A N Sarpong, Lois Y Bansah, Ruth Adafia, Felix Asare, Timothy K Amukele","doi":"10.1093/ajcp/aqaf007","DOIUrl":"10.1093/ajcp/aqaf007","url":null,"abstract":"<p><strong>Objectives: </strong>To implement a pilot proficiency testing (PT) program in Accra, Ghana, using locally produced PT materials and to explore the relationship between laboratory test costs and laboratory quality in Accra, Ghana.</p><p><strong>Methods: </strong>Remnant serum samples from a local laboratory were pooled, aliquoted, and distributed to a convenience sample of 23 laboratories in Accra, Ghana, 2 of which had International Organization for Standardization (ISO) accreditation. One of the ISO-accredited laboratories was designated as the reference/target, and the range for passing was based on international criteria. Test cost, test results, and testing instruments used were compiled.</p><p><strong>Results: </strong>Of the 23 laboratories, 18 submitted results. Total testing costs ranged from 80 to 312 Ghanaian cedi (GH₵) (7-26 USD). Overall accuracy (pass rate) was calculated per laboratory and per analyte. The mean laboratory accuracy was 61% (15%-92%). The pass rate for individual analytes ranged from 18% to 94% (mean, 72%). There was no correlation between test cost and pass rate.</p><p><strong>Conclusions: </strong>The pass rates of clinical laboratories in Accra, Ghana, varied from 15% to 92%, and there was no relationship to test cost. A PT program to objectively evaluate each laboratory's performance is needed. Making the PT material locally, as in this study, is a financially sustainable approach.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"847-853"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389878","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":"Reply to \"Implementing AI in clinical microbiology\": Key challenges ahead.","authors":"Erin Graf, Amr Soliman, Mohamed Marouf, Anil V Parwani, Preeti Pancholi","doi":"10.1093/ajcp/aqaf005","DOIUrl":"10.1093/ajcp/aqaf005","url":null,"abstract":"","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"950"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472103","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":"Biomarkers of response to antibody-drug conjugates (TROP2 and nectin-4) and the immune microenvironment (NKG7, PD-L1, and B7-H3) in penile squamous cell carcinoma.","authors":"Burak Tekin, John C Cheville, Fabrice Lucien, Michael McCarthy, Haidong Dong, Karla J Kopp, Nate R Torell, Roxane R Lavoie, Ava Farrell, Brandy L Jaszewski, Carin Y Smith, Sarah M Jenkins, Surendra Dasari, Santosh Menon, Rumeal D Whaley, Stephen A Boorjian, Lance C Pagliaro, Lori A Erickson, Ruifeng Guo, Sounak Gupta","doi":"10.1093/ajcp/aqaf022","DOIUrl":"10.1093/ajcp/aqaf022","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to assess the expression of biomarkers of response to antibody-drug conjugates (TROP2 and nectin-4) and immune microenvironment (NKG7, PD-L1, and B7-H3) in penile squamous cell carcinoma (pSCC).</p><p><strong>Methods: </strong>Our archive was queried for patients who had a penectomy for pSCC between 2000 and 2022. Primary tumors were immunostained for B7-H3 and NKG7, while metastatic specimens were immunostained for TROP2 and nectin-4. Expression of PD-L1, TROP2, and nectin-4 in primary tumors was previously characterized. H-scores (0-300) were used to quantify expression. Associations between biomarkers, tumor-infiltrating lymphocytes (TILs), and clinicopathologic and outcome parameters were evaluated.</p><p><strong>Results: </strong>For both TROP2 and nectin-4, H-scores within the lymph node metastases were higher compared to those within the primary tumors (mean, 264.5 vs 244.8, P = .0003; mean, 170.6 vs 146.7, P = .05, respectively; 33 paired specimens). For B7-H3 (n = 107), 32.7% of the primary tumors had an H-score of more than 0. In 34.8% of the cases, NKG7 expression was observed in 25% to 50% of the TILs. A significant association was noted between TIL density, B7-H3, NKG7, and PD-L1 expression.</p><p><strong>Conclusions: </strong>Therapeutic strategies targeting TROP2 and nectin-4 hold promise for patients with advanced pSCC. The potential of PD-L1, B7-H3, and NKG7 for predicting response to immunomodulatory treatment warrants further research.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"898-908"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958528","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":"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":"10.1093/ajcp/aqaf011","url":null,"abstract":"<p><strong>Objectives: </strong>To improve analytic performance characteristics of a microsatellite instability (MSI-V1.2) assay in endometrial cancers (ECs).</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>The revised criteria provided sensitive, specific, and objective interpretation to examine subtle changes of MSI.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"866-876"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","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}

{"title":"Use of neuroendocrine immunostains in the evaluation of atrophic gastritis.","authors":"Saryn Doucette","doi":"10.1093/ajcp/aqaf019","DOIUrl":"10.1093/ajcp/aqaf019","url":null,"abstract":"","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"951"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802158","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":"Quantitative EBV detection from whole blood on the COBAS 6800 system in response to Song J, Kim S, Kwak E, Park Y. Applicability of the cobas 6800 System for Epstein-Barr viral load quantitation using whole-blood specimens. Am J Clin Pathol. 2024 Mar 1;161(3):273-282. doi: 10.1093/ajcp/aqad146. PMID: 37936258.","authors":"Radhika Nagappan, Sarah Sarah, Saed Miri Nargesi, Gary McAuliffe, Erasmus Smit","doi":"10.1093/ajcp/aqaf004","DOIUrl":"10.1093/ajcp/aqaf004","url":null,"abstract":"","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"948-949"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958416","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":"Expression of CD47 protein in hematolymphoid neoplasms: Implications for CD47-mediated cancer immunotherapy.","authors":"Jingjing Zhang, Philip L Bulterys, Sebastian Fernandez-Pol, Sheren F Younes, Shuchun Zhao, Adnan Mansoor, Yasodha Natkunam","doi":"10.1093/ajcp/aqaf018","DOIUrl":"10.1093/ajcp/aqaf018","url":null,"abstract":"<p><strong>Objectives: </strong>Recent studies show that blocking CD47-SIRPα interactions is a promising target in checkpoint inhibition for cancer immunotherapy. However, to date, the expression of CD47 is not well characterized in various hematolymphoid neoplasms.</p><p><strong>Methods: </strong>This study evaluates CD47 expression in a wide range of hematolymphoid neoplasms using immunohistochemistry on 834 cases.</p><p><strong>Results: </strong>Results show variable but widespread CD47 expression among tumor types and within individual samples in both intensity and percentage. The highest CD47 expressions in both percentage of positive lymphoma cells and intensity was seen in small B-cell lymphomas, particularly chronic lymphocytic leukemia/small lymphocytic lymphoma, mantle cell, marginal zone, and follicular lymphomas. T and B lymphoblastic, diffuse large B-cell, peripheral T-cell, γδ T-cell, angioimmunoblastic T-cell lymphomas and myelodysplastic syndrome showed moderate CD47 expression. Acute and chronic myeloid leukemia as well as classic Hodgkin, anaplastic large cell, and natural killer/T-cell lymphomas showed low expression. Burkitt lymphoma is a notable standout, with little to no CD47 expression in all 14 cases examined.</p><p><strong>Conclusions: </strong>Understanding the prevalence of CD47 expression in hematolymphoid neoplasms is crucial for identifying potential therapeutic targets and selecting patients who may benefit from CD47-targeted therapies. Additionally, CD47 may serve as a valuable diagnostic marker in neoplasms such as Burkitt lymphoma.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"883-897"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603486","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":"Coagulation abnormalities following brown recluse spider (Loxosceles reclusa) envenomation: A description of 2 cases and review of the literature.","authors":"Stephanie A Hart, David Gailani, Lorin A Bibb, Jeffrey P Zwerner, Garrett S Booth, Jeremy W Jacobs","doi":"10.1093/ajcp/aqaf001","DOIUrl":"10.1093/ajcp/aqaf001","url":null,"abstract":"<p><strong>Objective: </strong>Hemostatic abnormalities, including disseminated intravascular coagulation (DIC), are often cited as a common finding in patients following Loxosceles spider envenomation (ie, loxoscelism). The prevalence and severity of coagulopathy, however, particularly following L reclusa (ie, brown recluse) envenomation, is not well described. This study aimed to characterize coagulation laboratory parameters and coagulopathy in patients following L reclusa envenomation.</p><p><strong>Methods: </strong>We evaluated the coagulation laboratory parameters (eg, prothrombin time, partial thromboplastin time, coagulation factor activity levels, lupus anticoagulant [LA] testing) of 2 patients seen at our institution following brown recluse spider envenomation. We also comprehensively reviewed the literature for all reported cases of brown recluse spider envenomation and assessed patient demographics, clinical presentations, coagulation laboratory parameters, and outcomes.</p><p><strong>Results: </strong>We identified 2 patients with loxoscelism (1 cutaneous only, 1 systemic with hemolysis) with prolonged partial thromboplastin times but with normal clotting factor levels following envenomation. Literature review identified 263 patients: 12 patients had at least 1 prolonged clotting time, 31 reported a platelet count below 150 × 109/L, and there was clinical concern for DIC in 12 cases. The odds of death were statistically significantly higher in patients with clinical concern for DIC than in cases without concern for DIC or coagulopathy (odds ratio, 82.9 [95% CI, 12.6-433.8]; P < .001).</p><p><strong>Conclusions: </strong>Following brown recluse spider envenomation, hemostatic perturbations are infrequent and clinical coagulopathy is uncommon, but the odds of death following a brown recluse spider bite are statistically significantly greater if DIC develops, even when compared to individuals with hemolysis without DIC.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"822-836"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063238","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}