Journal of the College of Physicians and Surgeons--Pakistan : JCPSP最新文献

{"title":"Downregulation of F11R in Colorectal Cancer and Tumour Progression.","authors":"Fengjiao Wang, Xiumin Bao, Qingchun Lei, Xiao Yuan, Xiaodan Tang, Pengli Zhang","doi":"10.29271/jcpsp.2025.10.1269","DOIUrl":"10.29271/jcpsp.2025.10.1269","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the prognostic value and expression profile of F11R (junctional adhesion molecule-A, JAM-A) in colorectal cancer (CRC) and to elucidate its functional role, particularly in epithelial-mesenchymal transition (EMT) and Rap1 signalling.</p><p><strong>Study design: </strong>Integrated bioinformatic and experimental study. Place and Duration of the Study: Department of Gastroenterology, Affiliated Hospital of Kunming University of Science and Technology, the First People's Hospital of Yunnan Province, Kunming, China, from 1st August 2021 to 30th June 2023.</p><p><strong>Methodology: </strong>F11R-associated genes were analysed using The Cancer Genome Atlas (TCGA) and the Human Protein Atlas (HPA). Protein expression was assessed by immunohistochemistry, and cell-type localisation was determined by single-cell RNA-seq. Functional enrichment was performed to explore related pathways. CRC cell proliferation, migration, invasion, and apoptosis were examined with CCK-8, Transwell, scratch, and flow cytometry assays, while EMT-related proteins were evaluated by western blotting.</p><p><strong>Results: </strong>F11R expression was significantly reduced in CRC compared with normal tissues. IHC revealed cytoplasmic and membranous localisation, and single-cell data showed enrichment in endothelial and epithelial cells. Enrichment analysis implicated F11R in T-cell receptor signalling, cadherin binding, and tight-junction pathways. Expression correlated with CD4⁺ Th1-like cells, effector and resting Tregs, and effector-memory T cells. Silencing F11R enhanced proliferation, migration, and invasion; reduced apoptosis; and promoted EMT, evidenced by decreased ZO-1 and E-cadherin, increased N-cadherin and vimentin, and Rap1 activation.</p><p><strong>Conclusion: </strong>F11R regulates EMT and Rap1 signalling, thereby influencing CRC metastasis. Its reduced expression is associated with unfavourable outcomes and tumour progression. Cell type-specific enrichment in endothelial and epithelial cells, along with links to immune subsets, highlights F11R as a potential prognostic biomarker in CRC.</p><p><strong>Key words: </strong>Colorectal cancer, F11R, Tumour progression, Prognostic potential, Immune infiltration.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 10","pages":"1269-1278"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245923","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":"Risk Assessment of Cardiovascular Atherogenicity in Growth Hormone-Deficient Children.","authors":"Fatimah Javaid Qureshi, Muhammad Anwar, Muhammad Asif Nawaz, Mehnaz Omer, Sanober Hameed, Saqibah Rehman","doi":"10.29271/jcpsp.2025.10.1284","DOIUrl":"https://doi.org/10.29271/jcpsp.2025.10.1284","url":null,"abstract":"<p><strong>Objective: </strong>To assess cardiovascular atherogenic risk in children with growth hormone deficiency (GHD) by comparing lipid profiles and plasma atherogenic indices (PAI) with those of healthy controls.</p><p><strong>Study design: </strong>A comparative cross-sectional study. Place and Duration of the Study: Department of Chemical Pathology, the Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from February to July 2024.</p><p><strong>Methodology: </strong>Ninety children with short stature, aged 3-12 years were evaluated. They were categorised into the growth hormone-deficient group (GHD group) and the healthy control group (Control group) based on the insulin tolerance test, IGF-1, and IGFBP-3 levels. Fasting lipid profiles were assessed, including total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and non-HDL cholesterol. The PAI was calculated as log (TG/HDL). Data were analysed using SPSS version 23. The independent t-test and Mann-Whitney U test were used to compare continuous variables between the two groups, whilst the Chi-square test was applied for categorical variables. Statistical significance was set at p ≤0.05.</p><p><strong>Results: </strong>Among the 90 participants, 48 exhibited GHD and 42 were healthy. Children with GHD showed markedly increased TC, TG, LDL, non-HDL cholesterol, and PAI values (p <0.001). Their HDL levels were also reduced compared with those of the healthy controls. A substantial proportion of GHD children (77.8%) were classified as high-risk based on PAI, whilst 100% of those with elevated non-HDL cholesterol were GHD. Atherogenic lipid parameters demonstrated a negative correlation with IGF-1 levels (p <0.001). IGF-1 concentrations correlated favourably with GH and HDL basal concentrations.</p><p><strong>Conclusion: </strong>Children with GHD exhibited dyslipidaemia and elevated atherogenic risk markers, indicating a predisposition to premature atherosclerosis.</p><p><strong>Key words: </strong>Cardiovascular disease, Growth hormone, Dyslipidaemia, Plasma atherogenic indices.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 10","pages":"1284-1288"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245955","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":"Predictive Significance of Changes in Haemoglobin Level Following Imatinib Treatment in Patients with Advanced Gastrointestinal Stromal Tumour.","authors":"Burhan Safakoglu, Tulay Kus, Gokmen Aktas","doi":"10.29271/jcpsp.2025.10.1255","DOIUrl":"https://doi.org/10.29271/jcpsp.2025.10.1255","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the predictive value of haemoglobin decrease following imatinib treatment in patients with advanced gastro- intestinal stromal tumours (GIST).</p><p><strong>Study design: </strong>An retrospective observational study. Place and Duration of the Study: Department of Medical Oncology, Gaziantep Medical Point Private Hospital, Gaziantep, Turkiye, between July 2021 and February 2024.</p><p><strong>Methodology: </strong>The study included 79 patients diagnosed with advanced GIST following imatinib therapy. Comprehensive clinical information, such as age, gender, tumour location, sites of metastasis, number of metastatic sites, and initial staging before treatment, was collected, and haematological parameters were measured both prior to and 1-3 months after starting imatinib. Changes in haematological parameters were analysed, and the relationship between clinical variables and both disease-free survival (DFS) and overall survival (OS) was assessed using the Kaplan-Meier method.</p><p><strong>Results: </strong>Post-imatinib treatment, 35 patients (44.3%) experienced a decrease in haemoglobin levels. Those with reduced haemoglobin levels exhibited better progression-free survival (PFS) compared to those without a decline [43.0 months (31.5-54.5) vs. 22.0 months (14.9-29.1); p <0.001]. No significant predictive associations for PFS were identified with changes in other haematological parameters. Multivariate analysis revealed that only a decrease in haemoglobin values remained an independent predictive factor, even after adjusting for tumour localisation [2.5 (1.3-4.7); p = 0.004]. Conversely, concerning the overall survival (OS), neither the decrease in haemoglobin levels nor other haematological and clinical parameters demonstrated statistical significance following imatinib treatment.</p><p><strong>Conclusion: </strong>Decreased haemoglobin levels following imatinib treatment is a predictive on-target toxicity in patients with advanced GIST.</p><p><strong>Key words: </strong>GIST, Imatinib treatment, On-target toxicity, Predictive marker, Anaemia.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 10","pages":"1255-1260"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245976","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":"Efficacy of Stapled Haemorrhoidopexy vs. Ferguson Haemorrhoidectomy in the Treatment of Haemorrhoidal Disease: A Prospective, Randomised, Single-Blind Comparison.","authors":"Mehmet Sait Berhuni, Huseyin Yonder","doi":"10.29271/jcpsp.2025.10.1234","DOIUrl":"10.29271/jcpsp.2025.10.1234","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of stapled (sutured) haemorrhoidopexy (SH) in the treatment of haemorrhoidal disease (HD) symptoms, and to compare it with the Ferguson haemorrhoidectomy (FH) technique.</p><p><strong>Study design: </strong>Randomised, single-blind, experimental study. Place and Duration of the Study: Department of General Surgery, Faculty of Medicine, Harran University, Sanliurfa, Turkiye, from April 2024 to February 2025.</p><p><strong>Methodology: </strong>Patients over 18 years of age who were diagnosed with haemorrhoidal disease, accepted surgical treatment, agreed to participate in the study, and did not meet any of the exclusion criteria were included in the study. Postoperative symptom management efficacy was assessed using the haemorrhoidal disease symptom score (HDSS). For data obtained from repeated measurements, the Mann-Whitney U test was performed to evaluate comparisons among groups at multiple time points.</p><p><strong>Results: </strong>A total of 42 patients who completed the six-month follow-up period were included in the study, with 18 patients in the FH group and 24 patients in the SH group. Of the total patients, 29 were male (69.0%), and 13 were female (31%). The median age was 39 (IQR:23) years. Both groups showed significant differences in the HDSS when comparing preoperative scores with postoperative scores at months 1, 3, and 6 (p <0.001 for each comparison). However, no statistically significant difference in the HDSS was observed between the groups at any time point (0.573, <0.123, <0.679, <0.393).</p><p><strong>Conclusion: </strong>SH was equally effective as FH in controlling symptoms associated with HD in the postoperative period and may be recommended as a minimally invasive treatment option for patients.</p><p><strong>Key words: </strong>Ferguson haemorrhoidectomy, Haemorrhoidal disease symptom score, Sutured haemorrhoidopexy.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 10","pages":"1234-1240"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245853","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":"Predictive Factors for Metastatic Castration-Resistant Prostate Cancer (mCRPC) Patients Undergoing ¹⁷⁷Lu-PSMA-617 Radioligand Treatment.","authors":"Seray Saray, Hasan Bozkurt, Eyyup Cavdar, Yakup Iriagac, Huseyin Kanmaz","doi":"10.29271/jcpsp.2025.10.1261","DOIUrl":"https://doi.org/10.29271/jcpsp.2025.10.1261","url":null,"abstract":"<p><strong>Objective: </strong>To determine prognostic factors in patients with metastatic castration-resistant prostate cancer (mCRPC) undergoing 177Lutetium-Prostate-specific membrane Antigen-617 radioligand therapy (177Lu-PSMA RLT).</p><p><strong>Study design: </strong>Descriptive, analytical study. Place and Duration of the Study: Department of Medical Oncology and Nuclear Medicine, Balikesir Ataturk City Hospital, Balikesir, Turkiye, from 2021 to 2024.</p><p><strong>Methodology: </strong>The study retrospectively examined patients diagnosed with metastatic castration-resistant prostate cancer (mCRPC) and received 177Lu-PSMA RLT. Data were collected from electronic health records of the hospital, including patient characteristics, clinical and pathological details, and blood test outcomes. Pre-treatment blood markers were documented, including platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), albumin-to-alkaline phosphatase ratio (AAPR), prognostic nutritional index (PNI), haemoglobin, albumin, lymphocyte and platelet (HALP) scores, and the systemic ımmune-ınflammation index (SII). Treatment-related adverse events were recorded, and their associations with other factors were assessed using Spearman's correlation analysis. Survival analysis was conducted using the Kaplan-Meier method, and group comparisons were performed using the log-rank test. Univariate and multivariate Cox regression analyses were conducted to identify factors affecting survival.</p><p><strong>Results: </strong>This study included 31 patients with median age of 69 (57-80) years. Twenty-three (74.2%) patients undergoing 177Lu-PSMA RLT experienced at least one adverse event, while seven (22.6%) experienced serious adverse events. The presence of visceral metastasis (p = 0.023), fatigue (p = 0.032), anorexia (p = 0.048), and nephropathy (p = 0.001) were significantly associated with poor overall survival (OS). In a multivariate model, visceral metastasis (HR = 24.10; 95% CI: 1.26-461.47; p = 0.035), fatigue (HR = 6.17; 95% CI: 1.65-23.02; p = 0.007), and nephropathy (HR = 10.14; 95% CI: 2.52-40.87; p = 0.001) remained significant prognostic factors. Patients with visceral metastases (OS 20.79 months; 95% CI: 16.77-24.81; p = 0.001), anorexia (OS 15.57 months; 95% CI: 7.17-23.97; p = 0.036), fatigue (OS of 13.32 months; 95% CI: 5.39-21.25; p = 0.023), and nephropathy (OS of 14.96 months; 95% CI: 6.22-15.13; p <0.001), showed significant association with survival.</p><p><strong>Conclusion: </strong>Adverse events during 177Lu-PSMA RLT had independent prognostic factors for survival.</p><p><strong>Key words: </strong>Metastatic castration-resistant prostate cancer, Lutetium, Radioligand therapy.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 10","pages":"1261-1268"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246015","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":"Five Cases of Hip Fracture in Elderly Patients Complicated by New Silent Cerebral Infarction: Clinical Alert and Analysis.","authors":"Jing Wang, Xianfa Zhang","doi":"10.29271/jcpsp.2025.10.1357","DOIUrl":"https://doi.org/10.29271/jcpsp.2025.10.1357","url":null,"abstract":"<p><p>Null.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 10","pages":"1357-1358"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245936","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":"Impact of Face-Down and Book-Reading Positions on the Success of Macular Hole Surgery.","authors":"Suleyman Gokhan Kerci, Berna Sahan","doi":"10.29271/jcpsp.2025.10.1279","DOIUrl":"https://doi.org/10.29271/jcpsp.2025.10.1279","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of face-down positioning (FDP) and book reading position (BRP) on the success of full-thickness macular hole (FTMH) surgery and their influence on patients' quality of life.</p><p><strong>Study design: </strong>Descriptive, analytical study. Place and Duration of the Study: Department of Ophthalmology, Medicana International Izmir Hospital, Izmir, Turkiye, from January 2018 to June 2024.</p><p><strong>Methodology: </strong>Thirty-six patients adopted the FDP after surgery (Group 1), and another 36 adopted the BRP (Group 2) following FTMH surgery. The two groups were compared in terms of preoperative patient data, postoperative parameters, success rates, and complications. Additionally, patients filled the short form-36 (SF-36) quality of life questionnaire preoperatively and at the first 1-month postoperative check-up. Continuous variables were compared using the independent Student's t-test or the Mann-Whitney U test, as appropriate. Categorical variables were analysed using the Chi-square test.</p><p><strong>Results: </strong>Functional success was achieved in 26 (72.2%) patients in Group 1 and 29 (80.6%) patients in Group 2 (p = 0.405). Anatomical success was obtained in 34 (94.4%) patients in both Group 1 and Group 2 (p >0.99). Complications occurred in 5 (13.8%) patients in Group 1, and 4 (11.1%) in Group 2 (p = 0.443). Three subdomains of SF-36, including physical functioning, bodily pain, and general health, significantly improved in Group 2 compared with Group 1 (p <0.05 for all three parameters).</p><p><strong>Conclusion: </strong>The results of this study indicated that FDP and BRP had similar effects on the anatomical and functional success and complications of FTMH surgery. However, patients in the BRP group had significantly better quality of life following surgery, according to the SF-36 questionnaire.</p><p><strong>Key words: </strong>Book reading position, Face-down positioning, Macular hole surgery, Short form-36.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 10","pages":"1279-1283"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245991","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":"Limitations of Using Tumour Grade for Preoperative Lymph Node Metastasis Prediction in GEP-NENs: A Letter to the Editor.","authors":"Mesut Tez","doi":"10.29271/jcpsp.2025.10.1359","DOIUrl":"https://doi.org/10.29271/jcpsp.2025.10.1359","url":null,"abstract":"<p><p>Null.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 10","pages":"1359-1360"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245996","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":"Glomerular Filtration Rate by Gamma Camera-Based Method: Interobserver Agreement at a Single Centre.","authors":"Rebecca Sharoon, Zaigham Salim Dar, Muhammad Atif, Zeeshan Sikandar, Raana Fatima","doi":"10.29271/jcpsp.2025.09.1207","DOIUrl":"10.29271/jcpsp.2025.09.1207","url":null,"abstract":"<p><p>The objective of this study was to determine interobserver agreement (IOA) in the calculation of glomerular filtration rate (GFR) by the gamma camera-based method. It was a cross-sectional prospective study carried out at the Nuclear Medical Centre, the Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from December 2021 to August 2022. A total of 52 patients with a median age of 47.20 years (range = 2-77 years) were included. All the patients underwent technetium-99m diethylene triamine pentaacetate (Tc-99m DTPA) renal scan following a standard protocol, and the scans were processed by the same group of three different observers. The patients were divided into four groups. The intraclass correlation coefficients (ICCs) for interobserver agreement in GFR estimation were as follows: Group 1 = 0.988 (95% CI: 0.971- 0.996), Group 2 = 0.997 (95% CI: 0.990 - 0.999), Group 3 = 0.985 (95% CI: 0.960 - 0.995), and Group 4 = 0.991 (95% CI, 0.976 - 0.996). The present study found excellent agreement among observers in estimating GFR using the gamma camera-based method. Key Words: Glomerular filtration rate, Interobserver variability, Intraclass correlation coefficient, Gamma camera imaging 99mTc-DTPA.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 9","pages":"1207-1209"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066377","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":"Mixed-Phenotype Acute Leukaemia: Bridging the Gap Between Myeloid and Lymphoid Lineages.","authors":"Muhammad Zain Arshad, Muhammad Hussain, Muhammad Omair Riaz, Mustajab Alam, Muhammad Aftab Hassan, Maymoona Sohail","doi":"10.29271/jcpsp.2025.09.1190","DOIUrl":"10.29271/jcpsp.2025.09.1190","url":null,"abstract":"<p><strong>Objective: </strong>To characterise mixed-phenotype acute leukaemia (MPAL) using flowcytometric immunophenotyping in a flow cytometric local population of Pakistan.</p><p><strong>Study design: </strong>A descriptive, cross-sectional study. Place and Duration of the Study: Department of Immunology, Armed Forces Institute of Pathology, National University of Medical Sciences, Rawalpindi, Pakistan, from November 2021 to October 2023.</p><p><strong>Methodology: </strong>A total of 1,115 patients (728 males and 387 females) with peripheral blood, bone marrow, or cerebrospinal fluid samples referred for immunophenotyping due to suspected acute leukaemia were included in the study. Cells were stained with lineage-specific fluorochrome-labelled monoclonal antibodies. Acquisition of cell suspension was done on the BD FACS Canto II multi-parameter (flow cytometer), and analysis was done on the BD FACS Diva software. Qualitative variables (gender, diagnosis, or positivity of CD markers) were expressed as frequency and percentages, and quantitative variables (age) were expressed as mean ± SD. The Chi-square test was used to compare positivity in both male and female patients.</p><p><strong>Results: </strong>Among 875 patients with acute leukaemia, 11 cases (1.25%) were diagnosed as MPAL, with a mean age 32 ± 28 years. Of the MPAL cases 9 (81.8%) were males, and 2 (18.2%) were females (p = 0.25). The most common MPAL subtype was B-myeloid, found in 7 out of 11 cases (63.6%), followed by T-myeloid in 3 cases (27.3%) and B-T MPAL in 1 case (9.1%). The aberrant expression of a third lineage was present in 2 out of 11 cases, (18.2%), while 9 cases (81.8%) were biphenotypic, and 2 cases (18.2%) were bilineage. A fatal outcome occurred in 3 out of 11 cases (27.3%) and the average diagnostic delay was 5.5 weeks.</p><p><strong>Conclusion: </strong>In a local Pakistani population, B/Myeloid MPAL is the most prevalent immunophenotype, followed by T/Myeloid MPAL, with an average diagnostic delay of about five weeks. It is more common in males and can occur at any age, from infancy to old age.</p><p><strong>Key words: </strong>Acute leukaemia of ambiguous lineage, Bilineage acute leukaemia, Biphenotypic acute leukaemia, Mixed-phenotype acute leukaemia.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 9","pages":"1190-1195"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066875","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}