Laboratory medicine最新文献_第9页

Successful diagnosis and monitoring of giant prolactinomas: the role of sample dilutions. 巨大泌乳素瘤的成功诊断和监测：样品稀释的作用。

Laboratory medicine Pub Date : 2025-06-10 DOI: 10.1093/labmed/lmaf021

Amnon Schlegel, Joely A Straseski

{"title":"Successful diagnosis and monitoring of giant prolactinomas: the role of sample dilutions.","authors":"Amnon Schlegel, Joely A Straseski","doi":"10.1093/labmed/lmaf021","DOIUrl":"https://doi.org/10.1093/labmed/lmaf021","url":null,"abstract":"Introduction: Giant prolactinoma, a prolactin-secreting pituitary adenoma greater than 4 cm in largest dimension, poses unique diagnostic and therapeutic challenges, setting it apart from smaller prolactin-secreting tumors.Methods: A 48-year-old man reported decreased ability to maintain penile erection. His genital examination was normal. Massively elevated prolactin (17 164.5 µg/L, confirmed by dilution), low testosterone, and low luteinizing hormone were found. A giant prolactinoma encasing the internal carotid arteries and invading the surrounding bones was found. Carotid flow voids were not narrowed. Formal visual field testing revealed no deficits.Results: The insulinlike growth factor 1 was normal, and the growth hormone suppressed appropriately 120 minutes after a 75-g oral glucose load. Over 8 months of cabergoline, the prolactin level normalized and the testosterone level increased. Striking regression of the tumor was observed after 1 year of therapy, although prolonged therapy was planned given that the mass was still encasing the carotid arteries. The patient's sexual symptoms improved. All prolactinomas should be treated with dopamine agonists to lower prolactin levels, shrink the tumor, preserve vision (if compromised), and restore gonadal function.Discussion: This case of giant macroprolactinoma highlights the need for confirming markedly elevated prolactin measurements with dilution of the sample; assessing for concurrent growth hormone excess; and initiating dopamine agonist therapy as a first line, long- term therapy.","PeriodicalId":94124,"journal":{"name":"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":"144268275","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}

引用次数: 0

Association of thyroid disorders and breast cancer: a retrospective case-control study. 甲状腺疾病与乳腺癌的关联：一项回顾性病例对照研究。

Laboratory medicine Pub Date : 2025-06-07 DOI: 10.1093/labmed/lmaf024

Nadine Noubani, Muneeza Esani, Daniel F M Gonzalez, Carol A Carman, Niti Vyas

{"title":"Association of thyroid disorders and breast cancer: a retrospective case-control study.","authors":"Nadine Noubani, Muneeza Esani, Daniel F M Gonzalez, Carol A Carman, Niti Vyas","doi":"10.1093/labmed/lmaf024","DOIUrl":"https://doi.org/10.1093/labmed/lmaf024","url":null,"abstract":"Introduction: This study investigated the association between thyroid disorders and breast cancer.Methods: A retrospective case-control study was conducted using electronic health record data from an academic health care system. This study included 300 female patients 18 years of age and older with a diagnosis of breast cancer and 300 control individuals with no cancer history. Statistical analysis included calculation of prevalence and odds ratios for association, ꭓ2 for categorical variables, and mean (SD) and median for age.Results: Patients with breast cancer were, on average, 58 years old, statistically significantly older than patients without cancer (P < .001). Patients were 6 times more likely to have thyroid disorders (P < .001), including hypothyroidism (P < .001), than women who did not have cancer. Patients with triple-negative breast cancer had 4 times higher odds of being diagnosed with thyroid disorders overall (P < .001) and hypothyroidism (P < .001) compared with control individuals. Moreover, patients with estrogen receptor-positive/progesterone receptor-positive breast cancer were 15 times more likely to develop the autoimmune disorder Hashimoto thyroiditis compared with controls, which was statistically significant (P = .026).Discussion: This study highlighted a strong association between breast cancer and thyroid disorders, particularly indicating a higher prevalence of hypothyroidism among individuals with breast cancer.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251659","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}

引用次数: 0

Correction to: Interference of hemoglobin variants with HbA1c measurements by six commonly used HbA1c methods. 更正：血红蛋白变异体对六种常用 HbA1c 测量方法的干扰。

Laboratory medicine Pub Date : 2025-05-09 DOI: 10.1093/labmed/lmae073

引用次数: 0

Associations between glycemic status and the ratio of γ-glutamyl transferase to HDL-C in middle-aged women. 中年女性血糖状况与γ-谷氨酰转移酶与高密度脂蛋白胆固醇比率之间的关系。

Laboratory medicine Pub Date : 2025-05-09 DOI: 10.1093/labmed/lmae084

Ichiro Wakabayashi

{"title":"Associations between glycemic status and the ratio of γ-glutamyl transferase to HDL-C in middle-aged women.","authors":"Ichiro Wakabayashi","doi":"10.1093/labmed/lmae084","DOIUrl":"10.1093/labmed/lmae084","url":null,"abstract":"Objective: The ratio of γ-glutamyl transferase to HDL-C (GGT/HDL-C) has been proposed as a discriminator of metabolic syndrome. The purpose of this study was to elucidate the relationship between GGT/HDL-C and glycemic status in women.Methods: The subjects were 18,218 middle-aged women who had received annual health checkups in their workplaces. They were divided by habitual alcohol intake into nondrinkers, occasional drinkers, regular light drinkers, and regular heavy drinkers.Results: In overall subjects, hemoglobin A1c level and prevalence of diabetes tended to be higher in subjects with higher GGT/HDL-C, and GGT/HDL-C tended to be higher with an increase of alcohol intake. The odds ratio for hyperglycemia in subjects with vs. subjects without high GGT/HDL-C tended to be lower with an increase of alcohol intake, and the association between high GGT/HDL-C and hyperglycemia was significantly weaker in regular heavy drinkers than in nondrinkers.Conclusion: In middle-aged women, there were positive associations of GGT/HDL-C with alcohol intake and glycemic status, and the association between GGT/HDL-C and glycemic status tended to be weaker with an increase of alcohol intake. Thus, alcohol use should be taken into account when GGT/HDL-C is used as a discriminator of diabetes.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"230-237"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564440","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}

引用次数: 0

Is the repeat worth it? Optimizing syndromic panel pathogen detection protocols. 这样的重复值得吗？优化综合征组病原体检测方案。

Laboratory medicine Pub Date : 2025-05-09 DOI: 10.1093/labmed/lmae100

Filipe M Cerqueira, Linh Do, Janet Enderle, Ping Ren

{"title":"Is the repeat worth it? Optimizing syndromic panel pathogen detection protocols.","authors":"Filipe M Cerqueira, Linh Do, Janet Enderle, Ping Ren","doi":"10.1093/labmed/lmae100","DOIUrl":"10.1093/labmed/lmae100","url":null,"abstract":"Objective: The aim of the study was to compare the cost and clinical impact of repeating BioFire FilmArray gastrointestinal (GI) and respiratory (RP) panel assays with 3 vs 4 pathogen targets positive.Method: We analyzed 12,027 GI and RP panels to evaluate our retesting policy, which retested panels with 3 or more detected pathogens (3-pathogen protocol) compared with the manufacturer's 4-pathogen (4-pathogen protocol) recommendation. We compared the retesting results, calculated the cost implications, and reviewed the clinical impact on antibiotic prescriptions and patient outcomes.Results: Retesting with our 3-pathogen protocol revealed that 81% (39/48) of GI and 76% (26/34) of RP panels had identical results, whereas 19% (9/48) of GI and 24% (8/34) of RP panels showed discrepancies on retesting. The additional cost incurred by our protocol compared with the manufacturer's protocol was $9820.32. There was no evidence that our more stringent policy affected antibiotic prescription or clinical outcomes.Conclusion: Our more stringent 3-pathogen protocol for retesting panels did not improve patient management compared with the manufacturer's 4-pathogen protocol but resulted in unnecessary costs and increased the risk of depleting testing kits during supply shortages. Consequently, we adopted the manufacturer's suggestions, highlighting the need to balance clinical rigor with cost-effectiveness in laboratory testing protocols.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"285-290"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840713","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}

引用次数: 0

SNAP25 as a prognostic marker in transcriptome analysis of meningioma. 脑膜瘤转录组分析中的预后标志物 SNAP25

Laboratory medicine Pub Date : 2025-05-09 DOI: 10.1093/labmed/lmae085

Yu Ge, Tao Zhang

{"title":"SNAP25 as a prognostic marker in transcriptome analysis of meningioma.","authors":"Yu Ge, Tao Zhang","doi":"10.1093/labmed/lmae085","DOIUrl":"10.1093/labmed/lmae085","url":null,"abstract":"Background: Meningiomas are the most common intracranial tumors and their diagnosis relies mostly on neuroimaging and histology. However, the histology grades cannot predict the outcome exactly and some meningiomas tend to recur after resection of even benign tumors. Therefore, it is necessary to explore prognostic and diagnostic molecular targets.Methods: Differential expression analysis between meningiomas and meninges was performed based on the merged data of GSE43290 and GSE84263. Next, we performed gene set enrichment analysis (GSEA), immune cell infiltration analysis, protein-protein interaction analysis, and survival analysis using public data. The expression level of Synaptosome-associated-protein-25kDa (SNAP25) was verified by reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) and Western blotting in meningioma tissues.Results: There were 263 upregulated and 592 downregulated genes identified in meningiomas by differential expression analysis. GSEA results revealed that meningiomas were negatively related to the pathway of soluble N-ethylmaleimide sensitive factor attachment protein receptor interactions in vascular transport and chemokine signaling. SNAP25 was characterized as a hub gene and downregulated in meningiomas. The Kaplan-Meier plot indicated that high expression of SNAP25 is a favorable factor.Conclusion: SNAP25 was downregulated and identified as a potential prognostic marker in meningioma.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"238-248"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607444","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}

引用次数: 0

The utility of an algorithm based on procalcitonin monitoring in patients with sepsis. 基于脓毒症患者降钙素原监测的算法的实用性。

Laboratory medicine Pub Date : 2025-05-09 DOI: 10.1093/labmed/lmae074

Alicia de Lózar de la Viña, Gloria Andrade Vivero, Eduardo Palencia Herrejón, Eva Márquez Liétor, Tamar Talaván Zanón, Elia Pérez-Fernández, Fernando Cava Valenciano, Eduardo Tamayo Gómez

{"title":"The utility of an algorithm based on procalcitonin monitoring in patients with sepsis.","authors":"Alicia de Lózar de la Viña, Gloria Andrade Vivero, Eduardo Palencia Herrejón, Eva Márquez Liétor, Tamar Talaván Zanón, Elia Pérez-Fernández, Fernando Cava Valenciano, Eduardo Tamayo Gómez","doi":"10.1093/labmed/lmae074","DOIUrl":"10.1093/labmed/lmae074","url":null,"abstract":"Objective: The aim of the study was to develop and validate an algorithm based on procalcitonin (PCT) monitoring to predict the prognosis of patients with sepsis.Design: The design was a retrospective and observational prospective study.Setting: The study was set in intensive care units (ICUs) in 2 different hospitals in Spain.Patients: Patients in the study included 101 patients with sepsis aged ≥18 years.Interventions: In the retrospective study, PCT results from patients admitted to the ICU in 2011-2012 were collected. In the prospective study, PCT was determined at specific time points as indicated by the algorithm from March 2018 to April 2019. The primary outcome measure, 28-day mortality, was the main variable of interest.Results: The study developed an algorithm based on early PCT monitoring for predicting the prognosis of patients with sepsis. The algorithm was initially developed retrospectively in 1 cohort and subsequently validated prospectively in another cohort.Conclusions: The developed algorithm provides information on the prognosis of patients with sepsis, distinguishing between those with a good prognosis and those with a poor prognosis (defined as mortality).","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"220-229"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515513","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}

引用次数: 0

Evidence-based approach for the generation of a multivariate logistic regression model that predicts instrument failure. 基于证据的方法，生成可预测仪器故障的多元逻辑回归模型。

Laboratory medicine Pub Date : 2025-05-09 DOI: 10.1093/labmed/lmae092

Stephan L Cleveland, Carol A Carman, Niti Vyas, Jose H Salazar, Juan U Rojo

{"title":"Evidence-based approach for the generation of a multivariate logistic regression model that predicts instrument failure.","authors":"Stephan L Cleveland, Carol A Carman, Niti Vyas, Jose H Salazar, Juan U Rojo","doi":"10.1093/labmed/lmae092","DOIUrl":"10.1093/labmed/lmae092","url":null,"abstract":"Objective: Identification of instrument failure (IF) represents a point to improve the quality of services provided by medical laboratories. Here, a logistic regression model was created to define the relationship between instrument downtime and laboratory quality management systems.Methods: Interval-level quality control (QC) and categorical quality assurance data from 3 identical chemistry analyzers was utilized to generate a logistic regression model able to predict IF. A case-control approach and the forward stepwise likelihood-ratio method was used to develop the logistic regression model. The model was tested using a case-control dataset and again using the complete sample.Results: A total of 650 downtime events were identified. A total of 22,880 QC data points, 187 calibrations, 24 proficiency testing events, and 107 maintenance records were analyzed. The regression model was able to correctly predict 59.2% of no instrument downtime events and 69.2% of instrument downtime events using the case-control data. Using the entire data set, the sensitivity of the model was 69.2% and the specificity was 58.2%.Conclusion: A logistic regression model can predict instrument downtime nearly 70% of the time. This study acts as a proof of concept using a limited data set collected by the chemistry laboratory.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"279-284"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684017","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}

引用次数: 0

Diagnostic value of TAP, PIVKA-II, and AFP in hepatocellular carcinoma and their prognostic value for patients treated with transarterial chemoembolization. TAP、PIVKA-II、AFP对肝细胞癌的诊断价值及其对经动脉化疗栓塞患者的预后价值。

Laboratory medicine Pub Date : 2025-05-09 DOI: 10.1093/labmed/lmae104

Delu Gan, Yali Wang, Xin Yang, Juan Huang, Lijun Zhang, Bianqin Guo, Pu Li, Dan Gou

{"title":"Diagnostic value of TAP, PIVKA-II, and AFP in hepatocellular carcinoma and their prognostic value for patients treated with transarterial chemoembolization.","authors":"Delu Gan, Yali Wang, Xin Yang, Juan Huang, Lijun Zhang, Bianqin Guo, Pu Li, Dan Gou","doi":"10.1093/labmed/lmae104","DOIUrl":"10.1093/labmed/lmae104","url":null,"abstract":"Objective: The diagnosis and prognosis of hepatocellular carcinoma (HCC) present significant challenges in clinical practice. This study aimed to evaluate the clinical utility of tumor abnormal protein (TAP), Prothrombin induced by vitamin K absence-II (PIVKA-II), and alpha-fetoprotein (AFP) in diagnosing HCC as well as to investigate their prognostic significance in patients with HCC undergoing transarterial chemoembolization.Methods: A total of 93 HCC patients were enrolled and 101 healthy individuals served as controls. Fresh venous blood samples were collected, and TAP, PIVKA-II, and AFP levels were measured by chemiluminescence immunoassay.Results: Significant differences in TAP, PIVKA-II, and AFP levels were found between HCC patients and healthy individuals. The combined assay of TAP, AFP, and PIVKA-II showed better diagnostic performance for HCC. Patients who underwent transarterial chemoembolization and achieved complete response (CR) had lower levels of prechemotherapy serum TAP, AFP, and PIVKA-II. There are significant differences in levels of TAP, AFP, and PIVKA-II between CR and partial response (PR), CR and stable disease (SD), and CR and progressive disease (PD).Conclusion: Combined detection of TAP, PIVKA-II, and AFP has better diagnostic performance for HCC. Higher levels of prechemotherapy serum TAP, AFP, and PIVKA-II are significantly associated with poor clinical chemoresponse.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"297-304"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924363","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}

引用次数: 0

Serologic and molecular identification of the variation on ABO*B.01 gene in ABO glycosyltransferases associated with Bw phenotype: a case report. ABO*B变异的血清学和分子鉴定。ABO糖基转移酶01基因与Bw表型相关1例报告

Laboratory medicine Pub Date : 2025-05-09 DOI: 10.1093/labmed/lmae086

Xiaoshuai Li, Qiushi Wang

{"title":"Serologic and molecular identification of the variation on ABO*B.01 gene in ABO glycosyltransferases associated with Bw phenotype: a case report.","authors":"Xiaoshuai Li, Qiushi Wang","doi":"10.1093/labmed/lmae086","DOIUrl":"10.1093/labmed/lmae086","url":null,"abstract":"AB antigen is formed by glycosyltransferase enzyme, which catalyzes the corresponding substrates to be connected to the galactose of the precursor substance H antigen. To study the effect of the α-1,3-D galactosyltransferase (GTB) gene mutation on B antigen expression, we explored its molecular mechanism by combining molecular biological methods with bioinformatics. The ABO blood type of the patients was identified using conventional serologic methods, and the polymerase chain reaction (PCR) products of exons 1-7 of the ABO gene were directly sequenced using gene-specific primers and direct sequencing. Proteins in the secretory supernatant of transfected cells were collected in vitro, and GTB content was quantitatively analyzed using western blotting. Bioinformatics software was used to simulate the 3-dimensional structure of the mutant protein. In this case, the patient's serologic test results revealed subtype B. Gene sequencing results confirmed a mutation at base 278 of exon 6. The mutation (c.278C>T) changed the 93rd amino acid of the protein polypeptide chain from proline to leucine (p.P93L). The variant p.P93L did not affect the expression and secretion of GTB, but affected enzyme activity and stability, ultimately manifesting as weakened expression of the B antigen and reduced affinity.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"312-317"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824637","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}

引用次数: 0