Archives of pathology & laboratory medicine最新文献

{"title":"Histopathologic Progression of Autoimmune Atrophic Gastritis: A Retrospective Review of 180 Specimens From 32 Patients.","authors":"Xi Wang, Jingjing Jiao, Won Jae Huh, Xuchen Zhang","doi":"10.5858/arpa.2025-0030-OA","DOIUrl":"https://doi.org/10.5858/arpa.2025-0030-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Autoimmune atrophic gastritis (AIAG) is a chronic, immune-mediated inflammation restricted to the gastric body. Despite well-defined histologic features, the pathologic progression is still not fully understood.</p><p><strong>Objective.—: </strong>To evaluate the pathologic progression of AIAG.</p><p><strong>Design.—: </strong>AIAG cases with at least 2 follow-up biopsies were reviewed. Clinical data, including anemia and autoimmune antibody status, were collected. Gastric samples were analyzed to assess inflammation, atrophy, enterochromaffin-like cell hyperplasia, and the development of neuroendocrine tumors (NETs) or carcinoma.</p><p><strong>Results.—: </strong>The cohort included 180 cases from 32 patients (21 females, 11 males), with an average follow-up of 6.8 years and 5.7 biopsies per patient. Inflammation, atrophy, and intestinal metaplasia remained stable in 59.4% (19 of 32), 78.1% (25 of 32), and 50% (16 of 32) of follow-up biopsies, respectively. Six patients had NETs in the AIAG index cases, with 5 experiencing recurrence after endoscopic excision. During follow-up, 6 additional patients developed NETs, half of whom had recurrence following endoscopic excision. The NETs were well differentiated with a Ki-67 index less than 3%. Two patients were initially diagnosed with adenocarcinoma in the background of AIAG, and 2 more developed adenocarcinoma during follow-up. No significant changes were observed in the antrum during follow-up, which consistently showed minimal to mild inflammation and reactive gastropathy.</p><p><strong>Conclusions.—: </strong>Long-term follow-up indicates that AIAG is linked to the pathologic progression of NETs and gastric adenocarcinoma. The NETs arising in the background of AIAG are well differentiated and show no evidence of metastasis. These findings may provide guidance on optimal endoscopic surveillance intervals for patients with AIAG.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Interferon γ to Interleukin 10 Ratio as a Biomarker for Stability and Severity in Vitiligo: A Clinical and Histopathologic Correlation.","authors":"Geet Bhuyan, Minakshi Narah, Rajashree Khound, Toshiba Dutta","doi":"10.5858/arpa.2025-0099-OA","DOIUrl":"https://doi.org/10.5858/arpa.2025-0099-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Vitiligo is a chronic autoimmune depigmenting disorder characterized by the selective destruction of epidermal melanocytes. Proinflammatory and anti-inflammatory cytokines, such as interferon γ (IFN-γ) and interleukin 10 (IL-10), play a pivotal role in its pathogenesis. Quantifying these cytokines and assessing their ratio may aid in disease prognosis and therapeutic monitoring.</p><p><strong>Objective.—: </strong>To evaluate the association between the IFN-γ:IL-10 ratio and the clinical as well as histopathologic characteristics of stable and unstable vitiligo.</p><p><strong>Design.—: </strong>A hospital-based prospective case-control study was conducted during 1 year (2023-2024) on 70 patients with active vitiligo and 30 healthy controls. Serum levels of IFN-γ and IL-10 were quantified, and their correlations with clinical severity, disease stability, and histopathologic grading were analyzed.</p><p><strong>Results.—: </strong>Unstable vitiligo cases demonstrated significantly higher histopathologic scores (≥3 in 39.62% versus 0% in stable cases, P = .002). IFN-γ levels were markedly elevated in unstable vitiligo (11.9 ± 2.56 versus 10.58 ± 1.04 pg/mL, P = .003) and in patients with a histopathologic score 3 or higher (13.35 ± 3.21 versus 10.84 ± 1.34 pg/mL, P = .002). The IFN-γ:IL-10 ratio was also significantly higher in these groups.</p><p><strong>Conclusions.—: </strong>Differentiating stable from unstable vitiligo is essential for optimal disease management. Cytokine profiling, particularly IFN-γ and IL-10 levels, offers a minimally invasive biomarker for assessing disease activity and monitoring therapeutic response.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinically Relevant Cutoffs for Anti-Extractable Nuclear Antigen Line Immunoassays.","authors":"Adrian Y S Lee, Sheng-Lun Jason Yan, David McDonald, Ming Wei Lin","doi":"10.5858/arpa.2025-0061-OA","DOIUrl":"https://doi.org/10.5858/arpa.2025-0061-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Anti-extractable nuclear antigens (ENAs) are a form of antinuclear antibody test in the diagnostic laboratory that plays a crucial role in the diagnosis of systemic autoimmune diseases. The line immunoassay (LIA) is one of the most popular assays used to measure these autoantibodies. However, LIAs suffer from limited diagnostic specificity, and numerous attempts have been made to improve the cutoffs.</p><p><strong>Objective.—: </strong>To readjust LIA autoantibody cutoffs, using the clinical diagnoses of a large and heterogeneous group of patients.</p><p><strong>Design.—: </strong>During a 12-month period, 667 discrete patients received an LIA test that had adequate clinical records to determine a diagnosis. Autoantibodies on the Euroimmun LIA (anti-Ro52, anti-Ro60, anti-dsDNA, anti-La, anti-mitochondrial antibodies, anti-Sm, anti-RNP, anti-histone, anti-nucleosome, anti-ribosomal P, anti-centromere protein B, and anti-Scl70) were evaluated. Two laboratory physicians independently rated whether the LIA density for each autoantibody was consistent or not consistent with the diagnosis. Receiver operating characteristic curves were constructed for each autoantibody and cutoffs were reestablished to maximize diagnostic specificities of 85% to 90%.</p><p><strong>Results.—: </strong>New cutoffs were proposed at the diagnostic specificities of 85% and 90%. Overall, there were similar rates of autoantibody detections, using the new cutoffs, compared to the manufacturer's defined cutoff of 10 units for each autoantibody.</p><p><strong>Conclusions.—: </strong>We have used a novel approach to redefining anti-ENA LIA cutoffs by using clinical diagnoses across a range of pathologic conditions. This ensures that results are clinically relevant to a general laboratory cohort and, when used as a characterizing assay after an initial anti-ENA screen, maximizes diagnostic specificity. Longitudinal evaluation of the new cutoffs is required after implementation to examine clinical impact.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Rapidly Evolving Landscape of Human Epidermal Growth Factor Receptor 2 (HER2) Testing in Endometrial Carcinoma and Other Gynecologic Malignancies.","authors":"Natalia Buza","doi":"10.5858/arpa.2025-0046-RA","DOIUrl":"https://doi.org/10.5858/arpa.2025-0046-RA","url":null,"abstract":"<p><strong>Context.—: </strong>Trastuzumab in combination with standard chemotherapy has been included in the guideline recommendations for human epidermal growth factor receptor 2 (HER2)-positive advanced-stage and recurrent endometrial carcinomas since 2019. A novel antibody drug conjugate, trastuzumab deruxtecan, gained tumor agnostic approval for HER2-positive metastatic solid tumors, including endometrial, ovarian, and cervical cancer in 2024.</p><p><strong>Objective.—: </strong>To provide a detailed overview of HER2 protein expression, gene amplification, and mutation in gynecologic malignancies in light of the newly available anti-HER2 therapies. Tumor-specific HER2 testing and scoring algorithms are discussed, including the implications of the DESTINY-PanTumor02 trial results and the significance of the HER2-low tumor category.</p><p><strong>Data sources.—: </strong>Review of the literature and personal experience of the author.</p><p><strong>Conclusions.—: </strong>The clinical indications and demand for HER2 testing in gynecologic malignancies beyond endometrial cancer are expanding. It is essential for practicing pathologists to stay up-to date on the latest clinical developments and use evidence-based HER2 testing and scoring criteria.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning Assessment of Gestational Age in Accelerated Maturation, Delayed Maturation, Villous Edema, Chorangiosis, and Intrauterine Fetal Demise.","authors":"Jeffery A Goldstein, Ramin Nateghi, Lee A D Cooper","doi":"10.5858/arpa.2024-0274-OA","DOIUrl":"10.5858/arpa.2024-0274-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Assessment of placental villous maturation is among the most common tasks in perinatal pathology. However, the significance of abnormalities in morphology is unclear and interobserver variability is significant.</p><p><strong>Objective.—: </strong>To develop a machine learning model of placental maturation across the second and third trimesters and quantify the impact of different pathologist-diagnosed abnormalities of villous morphology.</p><p><strong>Design.—: </strong>Digitize placental villous slides from more than 2500 placentas at 12.0 to 42.6 weeks. Build whole slide learning models to estimate obstetrician-determined gestational age for cases with appropriate maturation and normal morphology. Define the model output as \"placental age\" and compare it to the chronologic gestational age.</p><p><strong>Results.—: </strong>Our model showed an r2 of 0.864 and mean absolute error of 1.62 weeks for placentas with appropriate maturation in the test set. Pathologist diagnosis of accelerated maturation was associated with a 2.56-week increase in placental age (±2.91 weeks, P < .001), while delayed maturation was associated with a 0.92-week decrease in placental age (±1.82 weeks, P < .001). Intrauterine fetal demise causes diverse changes to placental age, driven by the nature of the demise. We tested the impact of training a model, using all live births. The resulting r2 was 0.874 and mean absolute error was 1.73 weeks. Furthermore, by including cases with abnormal maturation in the training data, the effect size of accelerated maturation was blunted to only 0.56 ± 2.35 weeks (P < .001).</p><p><strong>Conclusions.—: </strong>We show that various abnormalities of villous maturation and morphology correlate with abnormalities in placental age. This \"no pathologist\" model could be useful in situations where pathologists are unavailable or the need for consistency outweighs the utility of expertise.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"503-510"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long COVID in Immunocompromised and Immunocompetent Patients: A Clinical, Morphologic, and Virologic Portrait.","authors":"Fátima Ramalhosa, Francesca Lunardi, Nicol Bernardinello, Silvia Gori, Federica Pezzuto, Veronica Tauro, Claudia Del Vecchio, Chiara Giraudo, Elisabetta Balestro, Fiorella Calabrese","doi":"10.5858/arpa.2024-0043-OA","DOIUrl":"10.5858/arpa.2024-0043-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Coronavirus disease 2019 (COVID) primarily affects the lung and can lead to chronic/post-COVID syndrome. Some insights about late pulmonary changes occurring in patients recovering from COVID have been published, but the evidence of detailed pathologic changes coming from follow-up care patients with long COVID is limited.</p><p><strong>Objective.—: </strong>To evaluate tissue morphologic and viral features in transbronchial biopsies of long COVID patients (immunocompetent and immunocompromised).</p><p><strong>Design.—: </strong>This retrospective observational study included 18 patients (9 immunocompetent and 9 immunocompromised) who were consecutively referred to our outpatient clinic for post-COVID pneumonia, undergoing transbronchial biopsy. Several histologic changes were analyzed by computer-assisted morphometric analysis. As organizing pneumonia (OP) was consistently detected, fibrosis and inflammation were also evaluated in transbronchial biopsies from 28 control patients with histologic confirmation of OP. Tissue SARS-CoV-2 and the subgenomic transcripts were investigated. Morphologic findings were correlated with clinical and radiologic data.</p><p><strong>Results.—: </strong>Long COVID patients showed lower inflammation than controls (P < .001) despite a similar fibrotic extension. When considering separately the 2 long COVID groups, the same inflammatory infiltrate extension was found, whereas a higher fibrotic remodeling characterized the immunocompetent subgroup (P = .05). Molecular investigation showed that SARS-CoV-2 was present in tissue samples obtained from 3 long COVID patients.</p><p><strong>Conclusions.—: </strong>Long COVID patients showed a peculiar OP pattern, with more vascular and fibrotic changes. SARS-CoV-2 RNA, even in replicative status, can be detected in lung biopsies of both immunocompetent and immunocompromised patients. This pilot study is a forerunner of more in-depth lung tissue investigations to gain a better understanding of long COVID pathobiology.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"535-541"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human Papillomavirus Testing in Head and Neck Carcinomas: Guideline Update.","authors":"James S Lewis, Beth Beadle, Justin A Bishop, Rebecca D Chernock, Carol Colasacco, Tanja Kalicanin, Jeffrey F Krane, Christina Lacchetti, Joel T Moncur, James W Rocco, Mary R Schwartz, Raja R Seethala, William C Faquin","doi":"10.5858/arpa.2024-0388-CP","DOIUrl":"10.5858/arpa.2024-0388-CP","url":null,"abstract":"<p><strong>Context.—: </strong>In 2018, an evidence-based guideline was published by the College of American Pathologists to develop recommendations for the testing, application, interpretation, and reporting of high-risk human papillomavirus and surrogate marker tests in head and neck carcinomas. Substantial new evidence has prompted a review, including data on human papillomavirus (HPV) in nonoropharyngeal anatomic sites, HPV global rates, p16 immunohistochemistry, and HPV testing performance in cytology specimens, and performance of p16 immunohistochemistry as a surrogate marker.</p><p><strong>Objective.—: </strong>To assess research published since the release of the original 2018 guideline and to update evidence-based recommendations for HPV testing in head and neck carcinomas.</p><p><strong>Design.—: </strong>The College of American Pathologists convened a panel of experts to update the guideline following the standards established by the National Academy of Medicine for developing trustworthy clinical practice guidelines. The expert panel defined the key questions and performed a systematic review of the literature. Using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, recommendations were updated on the basis of available evidence, certainty of that evidence, and key judgments.</p><p><strong>Results.—: </strong>Seven strong recommendations, 4 conditional recommendations, and 5 good practice statements are offered in the guideline update.</p><p><strong>Conclusions.—: </strong>The updated guideline statements provide direction on the nature of HPV testing in various head and neck specimens (including key updates based on new research on sinonasal squamous cell carcinoma) and expanded guidance on specific scenarios and practice settings. The goal is to improve and standardize, where possible, HPV testing across diverse pathology practice settings and different countries.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"e115-e150"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polypoid Kaposi Sarcoma Involving the Lower Gastrointestinal Tract: Clinicopathologic Study of 15 Cases.","authors":"David I Suster, Shima Rastegar, Tiziana Salviato, Weizheng Wang, Katrina Collins, Iván A González, Won-Tak Choi, Hannah H Chen, Raul S Gonzalez, Kelsey McHugh, Marcela Salomao, Gregory W Charville","doi":"10.5858/arpa.2024-0196-OA","DOIUrl":"10.5858/arpa.2024-0196-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Gastrointestinal manifestations of Kaposi sarcoma are rare but may cause morbidity. Lower gastrointestinal involvement is particularly rare, and lesions may resemble conventional bowel polyps.</p><p><strong>Objective.—: </strong>To study 15 patients who presented with lower gastrointestinal tract Kaposi sarcoma with polypoid architecture.</p><p><strong>Design.—: </strong>The surgical pathology files of the departments of pathology at multiple institutions were searched for cases of Kaposi sarcoma forming polyps in the lower gastrointestinal tract (jejunum, colon, rectum); 15 cases with such features were identified. Clinicopathologic information was extracted from the medical record and documented by reviewing individual hematoxylin-eosin-stained slides.</p><p><strong>Results.—: </strong>The patients were 13 men and 2 women aged 26-80 years (median = 44 years). Gastrointestinal tract involvement was multifocal in 11 cases and unifocal in 4. The tumors involved the rectum, rectosigmoid junction, cecum, ascending colon, transverse colon, and descending colon and presented as polypoid lesions measuring 0.2-2.1 cm. Six patients had upper gastrointestinal tract involvement in addition to lower gastrointestinal lesions. Histologically, the tumors were characterized in 6 cases by a dense spindle cell proliferation in the lamina propria; however, the remaining cases showed only a subtle fascicular spindle cell proliferation in the lamina propria that did not form an expansile mass.</p><p><strong>Conclusions.—: </strong>Biopsies of gastrointestinal polyps showing absence of the common features of hyperplastic or adenomatous polyps, particularly in immunocompromised patients, should be carefully examined for the presence of a stromal spindle cell proliferation. Use of immunohistochemical stains, particularly human herpesvirus-8, can help in establishing the correct diagnosis.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"519-526"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Well-Differentiated Pancreatic Neuroendocrine Tumor: Does Morphologic Variant Matter?","authors":"Yue Xue, Michelle D Reid","doi":"10.5858/arpa.2025-0034-RA","DOIUrl":"https://doi.org/10.5858/arpa.2025-0034-RA","url":null,"abstract":"<p><strong>Context.—: </strong>Pancreatic neuroendocrine tumors (PanNETs) are the second most common primary pancreatic neoplasms. Tumors in their classical state are characterized by monotonous plasmacytoid epithelial cells featuring moderate amounts of eosinophilic cytoplasm and eccentrically placed round to oval nuclei with stippled \"salt-and-pepper\" chromatin. Tumors may exhibit diverse architectural patterns such as nests, pseudorosettes, and trabeculae. Nontraditional morphologic patterns have been described, but their prognostic and clinical relevance and molecular correlations have not been explored.</p><p><strong>Objective.—: </strong>To elucidate the morphologic spectrum of PanNETs, emphasizing the various subtypes that may mimic other neoplasms, highlighting their unique diagnostic challenges, and exploring the clinical significance of these variants.</p><p><strong>Data sources.—: </strong>The review synthesizes findings from a thorough literature review of published studies and incorporates the authors' own research.</p><p><strong>Conclusions.—: </strong>PanNETs represent a group of neoplasms with significant histologic and cytologic variability that may complicate and confound diagnosis. Accurate recognition of these variants is crucial for effective diagnosis and in some cases carries important prognostic implications, particularly for more aggressive tumor forms (oncocytic, hepatoid, lipid rich, rhabdoid/plasmacytoid, and papillary). Additionally, certain morphologic variants or adjacent precursors may be linked to syndromic diseases or specific hormone expressions. Integrating detailed morphologic analysis with advanced molecular techniques is essential for diagnosis, predicting patient outcome, and improving patient management.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral Blood Plasminogen Activator Inhibitor 1 and Tissue-Type Plasminogen Activator-Inhibitor Complex Levels for the Diagnosis and Prediction Value of Venous Thromboembolism in Malignant Tumors.","authors":"Na Yu, Minghao Shi, Honghong Li, Zhongjun Shen, Ying Sun, Yao Li, Xiaoyi Liu, Liyan Zhao","doi":"10.5858/arpa.2024-0276-OA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0276-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Patients with malignant tumors complicated by venous thromboembolism (VTE) face high mortality rates because of a lack of effective diagnostic and predictive markers. Plasminogen activator inhibitor 1 (PAI-1) and tissue-type plasminogen activator-inhibitor complex (t-PAIC) may contribute to VTE formation in these patients.</p><p><strong>Objective.—: </strong>To evaluate the diagnostic and predictive value of peripheral blood PAI-1 and t-PAIC levels in patients with malignant tumors complicated by VTE and to develop a new thrombosis risk score model (NRS) based on PAI-1 levels.</p><p><strong>Design.—: </strong>This study included 216 patients with malignant tumors (lung, colorectal, ovarian, breast, and gastric cancers). The correlation between PAI-1 and t-PAIC levels was explored. The predictive value of PAI-1 and t-PAIC, combined with the COMPASS-CAT risk score, Khorana risk score, and Padua risk score, was assessed for postoperative VTE risk. Differences in PAI-1 and t-PAIC levels across tumor types were also analyzed.</p><p><strong>Results.—: </strong>The PAI-1 and t-PAIC levels were positively correlated. Preintervention PAI-1 levels independently predicted VTE risk, and the new thrombosis risk score model could effectively predict the occurrence of concurrent VTE in patients with malignancy. PAI-1 and t-PAIC have better diagnostic value for VTE than D-dimers. Combining these markers with the COMPASS-CAT risk score, Khorana risk score, and Padua risk score improves the risk prediction of VTE. PAI-1 levels were significantly associated with VTE risk in colorectal cancer, whereas t-PAIC levels were significantly associated with VTE risk in breast cancer.</p><p><strong>Conclusions.—: </strong>Peripheral blood PAI-1 and t-PAIC levels have excellent predictive and diagnostic value for VTE in patients with malignancy.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}