• Title/Summary/Keyword: laboratory diagnosis

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Proactive Consultation by a Clinical Pathologist Prevents Diagnostic Delay in Hematological Malignancies

  • Chang, Chih-Chun;Su, Ming-Jang;Ho, Jung-Li;Sun, Jen-Tang;Tsai, Huang-Wen;Tang, Hui-Fei;Chu, Fang-Yeh
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1019-1022
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    • 2016
  • Background: Diagnostic difficulties in hematological malignancies may lead to unacceptably prolonged help-seeking to diagnostic interval as well as increased complications and poor outcomes. Proactive consultation by a clinical pathologist (PCCP) may help clinical diagnosis and therapeutic strategy. Hence, the aim of this investigation was to evaluate the effect of PCCP on the help-seeking to diagnostic interval in hematological cancer cases. Materials and Methods: From January to November, 2015, abnormal results of hematological laboratory testing with added laboratory comment were selectively screened out, and patients with such abnormalities in hematological laboratory testing and accompanied laboratory comment with PCCP were enrolled. Results: A total of 125 aberrant results of hematological laboratory testing were given with accompanied laboratory comments with PCCP and 40.8% (n=51) of these patient-oriented comments had an effect on clinical diagnosis and therapeutic strategy. Twelve of the subjects belonged to newly diagnosed hematological malignancies with the assistance of PCCP, and the help-seeking to diagnostic interval was also shortened from 42 days to 26 days in chronic lymphoid leukemia (CLL), from 83 days to 11 days in multiple myeloma (MM), and from 128 days to 15 days in myelodysplastic syndrome/myeloproliferative neoplasm (MDS/MPN). During the monitoring interval, neither complication events nor deaths were reported in the study group. Conclusions: It was seemingly that PCCP prevented diagnostic delay in hematological malignancies via shortening the help-seeking to diagnostic interval, particularly in CLL, MM and MDS/MPN cases. PCCP can be considered to play an essential role in prompt establishment of diagnosis in hematological malignancies for those who newly present.

Direct Costs of Cervical Cancer Management in Morocco

  • Berraho, Mohamed;Najdi, Adil;Mathoulin-Pelissier, Simone;Salamon, Roger;Nejjari, Chakib
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3159-3163
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    • 2012
  • Background: For cervical cancer the epidemiological profile is poorly known in Morocco and no data is available concerning the direct medical costs. The purpose of this work is to estimate the direct cost of medical management of invasive cervical cancer during the first year after diagnosis in Morocco. Methods: The estimation of direct costs of medical management of invasive cervical cancer during the first year after diagnosis in Morocco is based on the estimation of individual cost in each stage which covers diagnosis, treatment and follow-up during first year. The cost was estimated per patient and whole cycle-set using the costs for each drug and procedure as indicated by the Moroccan National Agency for Health Insurance. Extrapolation of the results to the whole country was used to calculate the total annual cost of cervical cancer treatments in Morocco. Results: Overall approximately 1,978 new cases of cervical cancer occur each year in Morocco. The majority (82.96%) of these cases were diagnosed at a late stage (stageII or more). The cost of one case of cervical cancer depends on stage of diagnosis, the lowest cost is $382 for stageCis followed by the cost of stageIA1 for young women (< 40 years) which is $2,952. The highest cost is for stageIV, which is $7,827. The total cost of cervical cancer care for one year after diagnosis is estimated at $13,589,360. The share allocated to treatment is the most important part of the global care budget with an annual sum of $13,027,609 whereas other cost components are represented as follows: $435,694 for annual follow-up activity and $126,057 for diagnosis and preclinical staging. Conclusion: This study provides health decision-makers with a first estimate of costs and the opportunity to achieve the optimal use of available data to estimate the needs of health facilities in Morocco.

Overview of Utilization of Tumor Markers for Cancer Diagnosis

  • Hong Sung Kim
    • Biomedical Science Letters
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    • v.28 no.4
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    • pp.223-228
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    • 2022
  • It has well reported that tumor markers have many advantages like minimally invasive, convenient use, low cost but also has many limitations like low sensitivity and specificity, relevance of prognosis, low organ specificity. Although no tumor markers are ideal, many tumor markers are used for cancer diagnosis, treatment monitoring, and surveillance monitoring after treatment. We review the classification and characteristics of tumor markers according cancer types and clinical roles in current times.

Canine Multicentric Large B Cell Lymphoma with Increased Mott Cells Diagnosed by Flow Cytometry

  • Yang, Yeseul;Jung, Jae-Ha;Hwang, Sung-Hyun;Kim, Yongbaek
    • Journal of Veterinary Clinics
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    • v.38 no.1
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    • pp.36-40
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    • 2021
  • A 12-year-old dog was referred due to multiple superficial lymphadenopathy. On cytology, each lymph node showed different cell populations where some of them consisted of intermediate to large lymphocytes with frequent Mott cells. Presence of Mott cells along with immature lymphocytes made the cytological diagnosis challenging, and therefore, supplementary diagnostic tests including PCR for Antigen Receptor Rearrangement (PARR) assay and flow cytometry were performed. This case report illustrates the value of flow cytometry in the diagnosis of lymphadenopathy with ambiguous cytologic findings.

Diagnosis and Management of Post-Partum Hemorrhage Caused by Acquired Hemophilia A: A Case Report

  • Rashid, Nawshirwan G.;Amin, Shaema Salih;Abdulqader, Aveen M. Raouf
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.2
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    • pp.163-166
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    • 2022
  • Acquired hemophilia A (AHA) is an uncommon autoimmune bleeding disorder in which autoantibodies that affect the functions of factor VIII (FVIII) are present in the blood. The initial diagnosis of AHA is difficult as the presentations of AHA differ from those of congenital hemophilia A. Moreover, the treatment of AHA is more complex due to the presence of autoantibodies against FVIII. Here, we present a case report of postpartum AHA, to increase the perception and knowledge regarding the recognition and management of such cases. We present a young female with the chief complaint of vaginal bleeding and upper arm ecchymosis. Laboratory results exhibited isolated prolonged activated partial thromboplastin time (APTT) and FVIII inhibitors. The patient was treated with corticosteroids, FVIII concentrates, and a bypassing agent. In conclusion, unexplained postpartum bleeding, unmanageable with basic hemostatic measures, should lead to clinical suspicion of an acquired bleeding disease.

Genotype Analysis of Human Papilloma Virus Infection in Accordance with Cytological Diagnoses

  • Park, Mi-Suk;Cho, Hyun-Wook;Kim, Jin-Gak;Bae, Nan-Young;Oh, Dong-Sun;Park, Ho-Hyun
    • Korean Journal of Clinical Laboratory Science
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    • v.47 no.1
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    • pp.39-45
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    • 2015
  • We investigated whether multiple infections can be used as predictors of progression to carcinogenesis in accordance with the cytological diagnosis in women receiving abnormal cytologic diagnosis as analysis genotype and compared to single infection. HPV prevalence is highest in the age of under 30 years old woman, HPV prevalence is started to lower after 30 years old and started to increase over 60 years old as like a U-shape. The specific HPV genotypes is an important factor because increased single infection and reduced multiple infections and appeared single infection with AC in progressing carcinogenesis. HPV 16 revealed the statistical significance at the single infection in squamous cell lesions, and HPV 18 revealed the statistical significance at the single infection in adenocarcinoma with showed HPV 16, 58, 18, 52-type distribution.

Molecular Genetic Testing and Diagnosis of Wilson Disease (윌슨병의 진단과 분자유전학적 검사)

  • Seo, Jeong Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.sup1
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    • pp.72-82
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    • 2008
  • Wilson disease (WD) is an autosomal recessive disorder of copper metabolism that results in accumulation of copper primarily in the liver, the brain and the cornea. Mutations in the WD gene, ATP7B cause failure of copper excretion from hepatocyte into bile and a defective synthesis of ceruloplasmin. More than 370 mutations are now recognized, scattering throughout the ATP7B gene. Since WD has protean clinical presentations, awareness of WD in clinical practice is important for the early diagnosis and prevention of accumulated copper toxicity. None of the laboratory parameters alone allows a definite diagnosis of WD. There are numerous pitfalls in the diagnosis of WD. Low serum ceruloplasmin concentrations, increased 24 hour urinary copper excretion, increased hepatic copper concentrations and the presence of Kayser-Fleischer rings in the cornea are major diagnostic points. A combination of any two of these 4 laboratory findings is strong support for a diagnosis of WD. Molecular methods are now being used to aid diagnosis. Molecular genetic testing has confirmed the diagnosis in individuals in whom the diagnosis is not clearly established biochemically and clinically. Siblings should be screened for WD once an index case has been diagnosed. Discrimination of heterozygotes from asymptomatic patients is essential to avoid inappropriate lifelong therapy for heterozygotes. Genetic testing, either by haplotype analysis or by mutation analysis, is the only reliable tool for differentiating heterozygote carriers from affected asymptomatic patients. Currently, genetic testing is of limited value in the primary diagnosis. However, genetic testing will soon play an essential role in diagnosing WD as rapid advancement of biomedical technology will allow more rapid, easier and less expensive mutation detection.

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Serum Peroxiredoxin3 is a Useful Biomarker for Early Diagnosis and Assessemnt of Prognosis of Hepatocellular Carcinoma in Chinese Patients

  • Shi, Liang;Wu, Li-Li;Yang, Jian-Rong;Chen, Xiao-Fei;Zhang, Yi;Chen, Zeng-Qiang;Liu, Cun-Li;Chi, Sheng-Ying;Zheng, Jia-Ying;Huang, Hai-Xia;Yu, Fu-Jun;Lin, Xiang-Yang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.2979-2986
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    • 2014
  • Background: Recently, peroxiredoxin3 (PRDX3) was identified as a novel molecular marker for the progression of hepatocellular carcinoma (HCC). However, its potential clinical application as a serum marker for the early diagnosis and prognosis of HCC has not been investigated. Methods: PRDX3, alpha-fetaprotein (AFP), and other biochemical parameters were measured in serum samples from 297 Chinese patients, including 96 with HCC, 98 with liver cirrhosis (LC), and 103 healthy controls (HCs). Correlations between serum PRDX3 expression and clinicopathological variables and the relationship between serum PRDX3 expression and prognosis were analyzed. Results: Serum PRDX3 was significantly higher in HCC patients than in the LC and HC groups. The sensitivity and specificity of serum PRDX3 for the diagnosis of HCC were 85.9% and 75.3%, respectively, at a cutoff of 153.26 ng/mL, and the area under the curve was 0.865. Moreover, serum PRDX3 expression was strongly associated with AFP level, tumor diameter, TNM stage, and portal vein invasion. Kaplan-Meier curve analysis revealed that HCC patients with high serum PRDX3 expression had a shorter median survival time than those with low PRDX3 expression. Moreover, serum PRDX3 expression was an independent risk factor for overall survival. The inverse correlation between serum PRDX3 and patient survival remained significant in patients with early-stage HCC and in those with normal serum AFP levels. Conclusions: Serum PRDX3 can be used as a noninvasive biomarker for the diagnosis and/or prognosis of HCC.

Comparison of the Usefulness of Diagnostic Tests for Rheumatoid Arthritis (류마티스 관절염 진단을 위한 검사의 유용성 비교)

  • Park, Chang-Eun
    • Korean Journal of Clinical Laboratory Science
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    • v.47 no.4
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    • pp.168-174
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    • 2015
  • Rheumatoid arthritis (RA) is a chronic inflammatory disease, which is mainly characterized by disease of joints affected with synovial hyperplasia, pathological immune response, and progressive destruction; all of which represent an important social health problem. These provide new insights in its pathogenesis of rheumatoid arthritis diagnosis and disease progression in molecular changes. This review focuses on new serological and immunological markers which seem to be useful in early diagnosis and prognosis of rheumatoid arthritis. Therefore, such tests are widely conducted for serological biomarkers and the developments with such immunological factors to identify patients who are at risk for disease progression. This evidence of the disease based on laboratory medicine could provide the best outcome for patients. Finally, data from recent studies will help to refine the ultimate usefulness of this novel approach for early diagnosis, treatment, and helping clinicians to optimize therapy by using this approach.

Limited Diagnostic Value of microRNAs for Detecting Colorectal Cancer: A Meta-analysis

  • Zhou, Xuan-Jun;Dong, Zhao-Gang;Yang, Yong-Mei;Du, Lu-Tao;Zhang, Xin;Wang, Chuan-Xin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4699-4704
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    • 2013
  • Background: MicroRNAs have been demonstrated to play important roles in the development and progression of colorectal cancer. Several studies utilizing microRNAs as diagnostic biomarkers for colorectal cancer (CRC) have been reported. The aim of this meta-analysis was to comprehensively and quantitatively summarize the diagnostic value of microRNAs for detecting colorectal cancer. Methods: We searched PubMed, Embase and Cochrane Library for published studies that used microRNAs as biomarkers for the diagnosis of colorectal cancer. Summary estimates for sensitivity, specificity and other measures of accuracy of microRNAs in the diagnosis of colorectal cancer were calculated using the bivariate random effects model. A summary receiver operating characteristic (SROC) curve was also generated to summarize the overall effectiveness of the test. Result: Thirteen studies from twelve published articles met the inclusion criteria and were included. The overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odd ratio of microRNAs for the diagnosis of colorectal cancer were 0.81 (95%CI: 0.79-0.84), 0.78 (95%CI: 0.75-0.82), 4.14 (95%CI: 2.90-5.92), 0.24 (95%CI: 0.19-0.30), and 19.2 (95%CI: 11.7-31.5), respectively. The area under the SROC curve was 0.89. Conclusions: The current evidence suggests that the microRNAs test might not be used alone as a screening tool for CRC. Combining microRNAs testing with other conventional tests such as FOBT may improve the diagnostic accuracy for detecting CRC.