Table of Content

30 June 2025, Volume 40 Issue 6

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Combined determination of Septin9 gene methylation and SDC2 gene methylation in auxiliary diagnosis of colorectal cancer

HUANG Ren, SHI Weizhong, LU Renquan, GUO Lin, WANG Yanchun

2025, 40(6):  519-524.  DOI: 10.3969/j.issn.1673-8640.2025.06.001

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Objective To investigate the clinical application value of combined determination of plasma Septin9 gene methylation and fecal SDC2 gene methylation in the diagnosis of colorectal cancer（CRC）. Methods A total of 110 CRC patients from Fudan University Shanghai Cancer Center from November 2023 to January 2024 were enrolled as CRC group，which included 48 patients in the early stage（TNM stage Ⅰ-Ⅱ）（early CRC group），62 patients in the advanced stage（TNM stage Ⅲ-Ⅳ）（advanced CRC group）. Totally，21 patients with benign colorectal tumors（disease control group） and 37 healthy subjects（healthy control group） were enrolled as well. The levels of serum carcinoembryonic antigen（CEA） and carbohydrate antigen（CA19-9），as well as the methylation levels of fecal SDC2 gene and plasma Septin9 gene were determined. The consistency of plasma Septin9 gene methylation and fecal SDC2 gene methylation determination results was evaluated. The efficacy of combined determination of various indicators in the diagnosis of CRC was evaluated by receiver operating characteristic（ROC） curve. Results Compared with healthy control group，the positive rates of SDC2 gene methylation in both disease control group and CRC group were increased（P<0.01）. The positive rate of Septin9 gene methylation in CRC group was increased（P<0.001）. The positive rates of SDC2 gene methylation and Septin9 gene methylation in both early CRC group and advanced CRC group were increased（P<0.001）. There was no statistical significance in the positive rate of Septin9 gene methylation between disease control group and healthy control group（P>0.05）. Except for healthy control group（Kappa=0.358，P=0.026），there was no consistency in the methylation of SDC2 gene and Septin9 gene in the other groups（P>0.05）. The area under curve（AUC） of the combined determination of SDC2 gene+Septin9 gene+CA19-9 in diagnosing CRC was 0.958，the optimal cut-off value was 0.571，the sensitivity was 95.5%，and the specificity was 90.3%. The AUC for diagnosing early CRC was 0.940，the optimal cut-off value was 0.700，the sensitivity was 91.7%，and the specificity was 90.3%. Conclusions The combined determination of Septin9 gene methylation，SDC2 gene methylation and the traditional tumor marker CA19-9 is helpful to improve the diagnostic efficacy of CRC.

Roles of LDH，MO# and LMR in differential diagnosis of RA-ILD

WANG Li, TANG Ling, JIN Yaxiong, ZHANG Junlong, GAO Xuedan, NIU Qian

2025, 40(6):  525-533.  DOI: 10.3969/j.issn.1673-8640.2025.06.002

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Objective To assess the roles of routine laboratory indicators for the differential diagnosis of rheumatoid arthritis（RA）associated with interstitial lung disease（ILD）. Methods Totally，80 patients with RA-ILD diagnosed at West China Hospital of Sichuan University from January 2014 to October 2021 were enrolled as RA-ILD group，and 89 patients with RA were enrolled as RA group. The general data and clinical laboratory routine determination results [complete blood count，anti-cyclic citrullinated peptide（CCP）antibody，rheumatoid factor（RF），C-reactive protein（CRP），erythrocyte sedimentation rate（ESR），lactate dehydrogenase（LDH）] were collected. Lymphocyte/monocyte ratio（LMR），neutrophil/lymphocyte ratio（NLR）and neutrophil/monocyte ratio（NMR）were calculated. They were classified according to genders，ages，anti-CCP antibodies and RF levels. The influencing factors of RA-ILD were evaluated by Logistic regression analysis. Receiver operating characteristic（ROC）curve was used to evaluate the differential diagnosis efficiency of RA-ILD. Results Compared with RA group，the level of LDH and the absolute value of monocytes （MO#） were increased in RA-ILD group，while LMR was decreased（P<0.05）. There was no statistical significance for the other indicators（P>0.05）. The changes in LDH and LMR were obvious in female subgroup and <60 years old subgroup. Elevated LDH，MO# and reduced LMR were risk factors for RA-ILD [odds ratios（OR） were 1.010，8.317 and 0.805，95% confidence intervals（CI）were 1.003-1.017，1.555-44.498 and 0.671-0.966，P<0.05]. The areas under curves（AUC）of LDH，MO# and LMR single and combined determinations for the differential diagnosis of RA-ILD were 0.697，0.611，0.633 and 0.744，respectively. LDH was more effective in the differential diagnosis of RA-ILD in female，<60 years old，or anti-CCP antibody <170 U·mL^-1 patients. Conclusions Elevated LDH and MO#，as well as reduced LMR，are associated with an increased risk of RA-ILD，particularly in female patients or patients <60 years old. LDH，MO# and LMR may be used as the important and rapid tool for the differential diagnosis and risk prediction of RA-ILD.

Construction of a machine learning-based model for predicting the risk of neuroblastoma bone metastasis

WANG Xumei, XU Dongqing, GAO Limei, ZHANG Lihua, JIANG Wenli, WANG Weiwei, MA Juan, SHEN Lisong

2025, 40(6):  534-539.  DOI: 10.3969/j.issn.1673-8640.2025.06.003

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Objective To construct a risk prediction model for bone metastasis in neuroblastoma（NB） through machine learning algorithms，aimed at assisting clinical diagnosis and treatment. Methods Totally，138 patients with NB who were first diagnosed in Xinhua Hospital of Shanghai Jiao Tong University School of Medicine from January 2019 to May 2024 were enrolled and randomly divided into training set（97 cases） and validation set（41 cases） in a 7∶3 ratio. The clinical data and laboratory determination results of all the NB patients at the first hospital admission were collected. LASSO regression analysis was used to screen variables. Nine machine learning algorithms were used to establish models for predicting the risk of NB bone metastasis. Receiver operating characteristic（ROC） curve was used to evaluate the diagnostic efficacy of each model. The optimal model was screened out based on the area under curve（AUC），and its efficacy was evaluated in the validation set. Results The variables screened by LASSO regression analysis included tumor bone marrow metastasis status，pretreatment risk classification of NB，Myc gene amplification status，bone marrow blast cell ratio，bone marrow megakaryocyte count，hemoglobin，lactate dehydrogenase（LDH），CD8⁺ T cell percentage and CD8⁺ T cell absolute value. The screened variables were included in 9 machine learning algorithms for training. The ExtraTrees model had optimal performance in predicting the bone metastasis risk of NB，with AUC of 1.000 and 0.927 in the training set and validation set. The ExtraTrees model achieved a 100% accuracy in prediction results in the training set，and a 90.2% accuracy in the validation set. Conclusions The construction of an ExtraTrees model based on machine learning algorithms has demonstrated significant potential for assessing the risk of bone metastasis in NB.

Distribution and drug resistance of clinical rapidly growing Mycobacterium in a Grade 3 Class A hospital

BAO Rong, SHEN Jiajin, YAO Yumeng, MIAO Qing, WANG Beili, PAN Baishen, GUO Wei, HU Bijie

2025, 40(6):  540-544.  DOI: 10.3969/j.issn.1673-8640.2025.06.004

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Objective To analyze the distribution and drug resistance of clinical rapidly growing Mycobacterium（RGM）. Methods The clinical isolates of the patients infected with nontuberculous Mycobacterium（NTM） from January 2019 to December 2022 were collected. All the isolates were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry，and the antimicrobial susceptibility was determined using a broth microdilution method. The related clinical data of patients were analyzed retrospectively. Results A total of 103 RGM isolates were isolated，including Mycobacterium abscessus（89 isolates，86.4%），Mycobacterium fortuitum（13 isolates，12.6%） and Mycobacterium chelonae（1 isolate，1.0%）. The average age of patients was（54.0±16.2） years old，with 66.0%（68/103） females. Cough and expectoration（69.9%，72/103） were the most common clinical symptoms，followed by fever and hemoptysis. RGM isolates were all sensitive to amikacin（100.0%） and highly resistant to doxycycline（82.5%）. Mycobacterium abscessus was highly resistant to a variety of antibiotics. The resistance rate of induced clarithromycin was 49.4%. Mycobacterium fortuitum showed high sensitive rates to trimethoprim/sulfamethoxazole，linezolid，moxifloxacin and ciprofloxacin（90.0%-100.0%），but resistant to doxycycline（53.8%），clarithromycin（53.8%） and imipenem（30.8%）. Conclusions The susceptibility of RGM to antibiotics varies. Species identification and drug susceptibility testing are necessary to ensure appropriate treatment regimens for patients.

A retrospective analysis of serum 25（OH）D levels and related factors in a physical examination population in a Grade 3 Class A hospital in Beijing

GUO Jingjing, LI Haixia, MA Qian, HUANG Haiming, ZENG Ziyi, AN Chongwen, PANG Lu

2025, 40(6):  545-550.  DOI: 10.3969/j.issn.1673-8640.2025.06.005

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Objective To analyze the relationship between serum 25-hydroxyvitamin D [25（OH）D] level and gender，age，season，and to study the nutritional status of vitamin D in a physical examination population，so as to provide a reference for clinical rational vitamin D supplementation. Methods General data and laboratory determination results were collected from 23 438 patients who underwent physical examination in Peking University First Hospital from April 2019 to December 2023. The proportions of vitamin D sufficiency，insufficiency and deficiency and the relationship between serum 25（OH）D level and gender，age and season were compared under different evaluation criteria. Results The overall serum 25（OH）D level in the 23 438 patients was 48.89（38.43，63.07）nmol·L^-1. The proportions of vitamin D deficiency and insufficiency were high，and the proportion of vitamin D sufficiency was low. According to evaluation criterion A，the proportions of vitamin D deficiency，insufficiency and sufficiency were 7.80%，44.54% and 47.66%，respectively. According to evaluation criterion B，the proportions of vitamin D deficiency，insufficiency and sufficiency were 52.34%，34.42% and 13.24%，respectively. The serum 25（OH）D level in males was 53.57（42.92，67.30）nmol·L^-1，and the serum 25（OH）D level in females was 43.83（34.92，56.79）nmol·L^-1，and the difference in 25（OH）D level between different genders was statistically significant（P<0.001）. The serum 25（OH）D levels of the age groups from low to high were <31 years old group（41.23 nmol·L^-1），31-40 years old group（47.25 nmol·L^-1），41-50 years old group（48.37 nmol·L^-1），51-60 years old group（53.72 nmol·L^-1），>80 years old group（54.76 nmol·L^-1），71-80 years old group（58.83 nmol·L^-1） and 61-70 years old group（59.45 nmol·L^-1）. There was statistical significance in serum 25（OH）D level between males and females aged above 80 years（P<0.05）. There was statistical significance in vitamin D nutritional ststus levels between different seasons（P<0.001）. Conclusions The levels of 25（OH）D are generally insufficient or deficient in the physical examination population. The level of 25（OH）D is related to genders，ages and seasons. Personalized vitamin D supplementation should be provided based on genders，ages and seasons.

Drug resistance and molecular epidemiology of OS-MRSA in Hulunbuir，Inner Mongolia

SUN Gang, SUN Hui, BAO Lina, LIU Xianwei, LU Mingyang, LIU Jing, TIAN Yuan

2025, 40(6):  551-554.  DOI: 10.3969/j.issn.1673-8640.2025.06.006

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Objective To analyze the drug resistance and molecular epidemiological characteristics of oxacillin-sensitive methicillin-resistant Staphylococcus aureus（OS-MRSA） in Hulunbuir，Inner Mongolia. Methods Staphylococcus aureus isolated clinically from 5 medical institutions in Hulunbuir from 2015 to 2021 were collected. Methicillin-resistant Staphylococcus aureus（MRSA） and methicillin-sensitive Staphylococcus aureus（MSSA） were screened based on the results of in vitro drug susceptibility test. The mecA and mecC of MSSA were determined by polymerase chain reaction（PCR），and the OS-MRSA isolates were screened out. Multilocus sequence typing（MLST） and Staphylococcus protein A typing（Spa） were performed. Results The determination rate of OS-MRSA in Hulunbuir was 1.20%. The sensitivities of OS-MRSA to tigecycline，moxifloxacin，linezolid，oxacillin，cefoxitin，rifampicin and vancomycin were 100.00%，the penicillin resistance rate was 100.00%，and OS-MRSA was resistant to erythromycin，sulfamethoxazole，gentamicin，clindamycin，tetracycline，ciprofloxacin and levofloxacin to varying degrees. Spa determined 10 types，and MLST determined 8 types. Conclusions No dominant type of OS-MRSA has been found in Hulunbuir，and it is sporadic overall. The conventional drug resistance phenotypic determination methods are prone to wrongly identify OS-MRSA as MSSA. The determination of mecA and mecC genes and drug resistance phenotypic determination should be combined to reduce the missed determination rate of OS-MRSA.

Clinical roles of γδT cell and NK cell determinations in pregnant patients through IVF

LIU Xiaoxue, YANG Huiyun, ZHU Wenxiu, LIU Shenghuan, SHI Ming

2025, 40(6):  555-559.  DOI: 10.3969/j.issn.1673-8640.2025.06.007

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Objective To investigate the clinical significance of the changes of γδT cells and natural killer（NK） cells in the peripheral blood of pregnant patients with a previous history of spontaneous abortion and assisted pregnancy through in vitro fertilization（IVF）. Methods Totally，45 patients with a history of spontaneous abortion in Dalian Women and Children Medical Group from March 2022 to March 2023 who successfully became pregnant after undergoing IVF were enrolled. They were classified into normal pregnancy group and missed abortion group according to whether early abortion occurred at the present stage. Totally，27 females in the early pregnancy who were pregnant naturally during the same period were enrolled as control group. The clinical data of all the research subjects were collected，and the percentages of γδT cells and NK cells in peripheral blood were determined by flow cytometry. Results Compared with control group，the percentages of γδT cells in both normal pregnancy group and missed abortion group were increased（P<0.05）. There was no statistical significance between normal pregnancy group and missed abortion group（P>0.05）. The percentage of NK cells in missed abortion group was higher than that in normal pregnancy group（P<0.05），and there was no statistical significance compared with control group（P>0.05）. There was no statistical significance in the percentages of γδT cells and NK cells between elderly（≥35 years old） and non-elderly（<35 years old） in control group，normal pregnancy group and missed abortion group（P>0.05）. There was no statistical significance in the percentages of γδT cells and NK cells between those with the first abortion（number of abortion=1） and those with recurrent abortion（number of abortion≥2） in normal pregnancy group and missed abortion group（P>0.05）. Conclusions γδT cells and NK cells may serve as monitoring indicators for the immune status of patients with a history of spontaneous abortion and assisted pregnancy through IVF.

Changes of coagulation function in elderly patients with severe pneumonia infected by different Gram-negative bacteria

YANG Qi, LIN Ying, GUO Nan, LI Xiaobin, SHANG E, LI Hongmin, YAO Xingwei

2025, 40(6):  560-564.  DOI: 10.3969/j.issn.1673-8640.2025.06.008

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Objective To observe the changes of coagulation function in elderly patients with severe pneumonia infected by different Gram-negative bacteria，and to provide a reference for clinical diagnosis and treatment. Methods A total of 197 elderly patients with severe pneumonia in Dongzhimen Hospital of Beijing University of Chinese Medicine from September 2019 to September 2022 were enrolled. Before the treatment with antibacterial drugs，the sputum samples were taken for pathogen culture. The coagulation function was determined. The differences in coagulation function indicators [activated partial thromboplastin time（APTT），prothrombin time（PT），thrombin time（TT），D-dimer（DD），plasma fibrinogen（Fib）] were compared between patients infected with Gram-negative bacteria and those infected with Gram-positive bacteria. Based on the disease outcome，patients infected with Gram-negative bacteria were classified into poor and good prognosis groups. The differences in coagulation function among patients infected with different Gram-negative bacteria were compared. The differences in coagulation function among patients with severe pneumonia infected by Gram-negative bacteria with different prognoses were evaluated. Results Among the 197 patients，110（55.84%）cases were infected with Gram-negative bacteria. The APTT of patients infected with Gram-positive bacteria was shorter than that with negative sputum culture，and the DD level was higher（P<0.05）. The APTT and PT of patients infected with Gram-negative bacteria were shorter than those with negative sputum culture and Gram-positive bacteria，while the DD and Fib levels were higher than those with negative sputum culture and Gram-positive bacteria（P<0.05）. The APTT and PT of patients infected with Acinetobacter baumannii were shorter than those of patients infected with other types of Gram-negative bacteria，while the levels of DD and Fib were higher than those of patients infected with other types of Gram-negative bacteria（P<0.05）. The APTT and PT in poor prognosis group were shorter than those in good prognosis group，and the levels of DD and Fib were higher than those in good prognosis group（P<0.05）. Conclusions Elderly patients with severe pneumonia infected by Gram-negative bacteria have coagulation dysfunction，and the coagulation dysfunction is more obvious in patients infected with Acinetobacter baumannii. There is a certain relationship between poor coagulation function and poor prognosis of patients.

Correlation and clinical significance of serum lncRNA THRIL and miR-495-3p expressions with common intestinal bacterial species in children with inflammatory bowel disease

YAN Hua, GAO Dahan, LIU Dongfeng

2025, 40(6):  565-570.  DOI: 10.3969/j.issn.1673-8640.2025.06.009

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Objective To investigate serum long non-coding RNA（lncRNA） tumor necrosis factor-related heterogeneous ribonucleoprotein particle（THRIL） and miR-495-3p expressions in children with inflammatory bowel disease（IBD） and their correlation with common intestinal bacterial species，and to provide a reference for the clinical diagnosis of IBD. Methods From June 2021 to May 2023，109 children with IBD admitted to Zhengzhou Yihe Hospital were enrolled as study group，and another 109 healthy children were enrolled as control group. The common intestinal bacterial species in the fecal samples of enrolled children were identified by culture methods. The expression levels of serum lncRNA THRIL and miR-495-3p were determined by reverse transcription polymerase chain reaction（PCR）. Using ENCORI database，the binding site between lncRNA THRIL and miR-495-3p was predicted. The relevant clinical data of study group and control group were collected，and the differences between the 2 groups were compared. Spearman method was used to analyze the correlation between the expression levels of serum lncRNA THRIL and miR-495-3p and the number of common intestinal bacterial species. Logistic regression analysis was used to analyze the related factors for the occurrence of IBD. The diagnostic value of serum lncRNA THRIL and miR-495-3p for IBD was analyzed by receiver operating characteristic（ROC） curve. Results The proportion of patients with a history of intestinal diseases and unhealthy dietary habits in study group was higher than that in control group（P<0.01）. There was statistical significance in the colony numbers of Escherichia coli，Bifidobacterium，Lactobacillus，Enterococcus and yeast between the 2 groups（P<0.001）. The relative expression level of serum lncRNA THRIL in study group was higher than that in control group（P<0.001），while the relative expression level of miR-495-3p was lower than that in control group（P<0.001），and there were complementary sites in the nucleic acid sequences of the 2 indicators. Serum lncRNA THRIL relative expression level was positively correlated with the colony numbers of Escherichia coli，Enterococcus and yeast（r=0.543，0.551 and 0.703，P<0.001），and it was negatively correlated with the colony numbers of Bifidobacterium and Lactobacillus（r=-0.561 and -0.627，P<0.001）. The miR-495-3p was on the contrary. History of gastrointestinal diseases [odds ratio（OR）=1.772，P=0.029]，unhealthy dietary habits（OR=2.048，P=0.010），increased lncRNA THRIL（OR=12.117，P=0.001） and decreased miR-495-3p（OR=0.665，P=0.043） were risk factors for the occurrence of IBD. The combined determination of serum lncRNA THRIL and miR-495-3p was superior to the single determinations（P<0.001）. Conclusions The relative expression levels of serum lncRNA THRIL and miR-495-3p are related to the common intestinal bacterial species of patients with IBD. The combined determination has a high diagnostic value for IBD.

Role of neutrophil CD64 absolute value determined by cell solid-phase chip method in bacterial infectious disease diagnosis

YIN Liangping, YUAN Yongming, QU Bin, LI Wenna, ZHANG Shu

2025, 40(6):  571-575.  DOI: 10.3969/j.issn.1673-8640.2025.06.010

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Objective To investigate the role of absolute value of neutrophil CD64（nCD64） determined by cell solid-phase chip method in the diagnosis of bacterial infectious diseases. Methods Totally，120 bacterial infection patients（bacterial infection group），60 viral infection patients（viral infection group） and 92 healthy subjects（healthy control group） were enrolled from Ruijin Hospital，Shanghai Jiao Tong University School of Medicine from January 2024 to September 2024. The absolute value of nCD64 was determined using cell solid-phase chip method. White blood cell（WBC）count，procalcitonin（PCT） and C-reactive protein（CRP） were determined as well. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of the 4 indicators in diagnosing bacterial infectious diseases. Results The levels of absolute value of nCD64，WBC count，PCT and CRP in bacterial infection group were higher than those in viral infection group and healthy control group（P<0.05）. WBC count in viral infection group was lower than that in healthy control group（P<0.05）. There was no statistical significance in the absolute value of nCD64，PCT and CRP between viral infection group and healthy control group（P>0.05）. The areas under curves（AUC） of the absolute value of nCD64，WBC count，PCT，CRP were 0.934，0.868，0.868 and 0.856 for the differential diagnosis of bacterial infection and non-bacterial infection，respectively. The optimal cut-off value，sensitivity and specificity of the absolute value of nCD64 for diagnosing bacterial infectious diseases were >892 μL^-1，88.3% and 92.8%，respectively. The diagnostic efficacy of the absolute value of nCD64 for bacterial infectious diseases was better than WBC count，PCT and CRP（P<0.05）. Conclusions The absolute value of nCD64 can be used as one of the auxiliary diagnostic indicators for bacterial infection. Using cell solid-phase chip method to determine the absolute value of nCD64 in peripheral blood is easy to operate and cost-effective，which can be promoted and applied in primary hospitals.

Roles of serum miR-524-5p and miR-708-5p expression levels in prognostic assessment of laryngeal cancer

QU Li, CAO Hualin, ZHANG Rui, YANG Xike, YIN Xin

2025, 40(6):  576-582.  DOI: 10.3969/j.issn.1673-8640.2025.06.011

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Objective To investigate the relationship between the levels of serum miR-524-5p and miR-708-5p and the clinicopathological characteristics and prognosis of patients with laryngeal cancer. Methods A total of 93 patients with laryngeal cancer（laryngeal cancer group） and 93 healthy subjects（healthy control group） in Nanyang Central Hospital from January 2018 to January 2021 were enrolled. The clinical data of all patients were collected，and the relative expression levels of miR-524-5p and miR-708-5p were determined. All the patients were followed up for 3 years. Pearson correlation analysis was used to analyze the correlation between miR-524-5p and miR-708-5p. The efficacy of serum miR-524-5p and miR-708-5p in the diagnosis of laryngeal cancer was evaluated by receiver operating characteristic（ROC） curve. The survival conditions of laryngeal cancer patients with different expressions of miR-524-5p and miR-708-5p were analyzed using Kaplan-Meier survival curve. Cox regression analysis was used to evaluate the influencing factors of death in patients with laryngeal cancer. Results The relative expression levels of serum miR-524-5p and miR-708-5p in laryngeal cancer group were lower than those in healthy control group（P<0.001）. The expression of serum miR-524-5p in patients with laryngeal cancer was positively correlated with that of miR-708-5p（r=0.714，P<0.05）. The areas under curves（AUC） of serum miR-524-5p and miR-708-5p in the diagnosis of laryngeal cancer were 0.801 and 0.753，respectively，and the optimal cut-off values were 0.788 and 0.813，respectively. There was statistical significance in the relative expression levels of serum miR-524-5p and miR-708-5p among laryngeal cancer patients with lymphatic metastasis，different tumor diameters，TNM stages and degrees of differentiation（P<0.05）. There was no statistical significance in the relative expression levels of serum miR-524-5p and miR-708-5p among laryngeal cancer patients of different genders，ages，tumor locations，tumor invasion depths and pathological types（P>0.05）. The optimal cut-off values of miR-524-5p and miR-708-5p were used to classify the subjects into high-expression group and low-expression group. The survival rates of both miR-524-5p high-expression group and miR-708-5p high-expression group were higher than those of their low-expression groups（P<0.05）. Lymphatic metastasis，tumor diameter>3.0 cm，low differentiation，TNM stage Ⅲ-Ⅳ，low expression of miR-524-5p and low expression of miR-708-5p were risk factors for death in patients with laryngeal cancer（P<0.05）. Conclusions The relative expression levels of serum miR-524-5p and miR-708-5p in laryngeal cancer patients are decreased，and both of them are related to clinicopathological characteristics and prognosis，which may be used as markers for prognostic assessment of laryngeal cancer.

Retrospective analysis of anti-nuclear antibody determination results in 167 202 clinical specimens

WANG Xiaobo

2025, 40(6):  583-591.  DOI: 10.3969/j.issn.1673-8640.2025.06.012

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Objective To conduct a large-scale analysis of the distribution of anti-nuclear antibody（ANA） fluorescence patterns，antibody titers and specific ANA profiles，and to provide a reference for health management and disease diagnosis and treatment of potential autoimmune disease（AID）. Methods A retrospective analysis was performed on 167 202 individuals for ANA determination，71 723 individuals for 15 specific ANA profiles（referred to as ANA-15）and 65 493 individuals for 7 specific ANA profiles（referred to as ANA-7）at Hangzhou Adicon Clinical Laboratories Inc. from January 2022 to May 2023. Indirect immunofluorescence assay（IFA）was used to determine ANA，and line immunoassay（LIA）was used to determine specific ANA profiles. Statistics was performed on ANA fluorescence pattern，antibody titer，positive rate，gender，age characteristics and the difference between different quarters. Results The overall positive rates for ANA，ANA-15 and ANA-7 were 30.6%，12.9% and 8.2%，respectively. The ANA positive rate showed an increasing trend with age（P<0.01），while there was no statistical significance in the positive rates of ANA-15 and ANA-7 among different age groups（P>0.05）. The highest ANA positive rate was found in females ≥81 years old（47.3%），and the highest positive rates for both ANA-15 and ANA-7 were found in females with 41-50 years old （18.5% and 12.6%，respectively）. The common fluorescence patterns for ANA positive results were speckled（AC-4，AC-5）（56.9%），cytoplasmic speckled（AC-19，AC-20）（14.1%）and dense fine speckled（AC-2）（10.7%）. ANA positivity was mainly low titer（74.3%），with medium and high titers accounting for 8.6% and 17.1%，respectively. The common specific antibodies for ANA-15 and ANA-7 positivities were anti-Ro52 antibodies，anti-Sjögren's syndrome A（SS-A）antibodies and anti-Smith（Sm）antibodies. There was no statistical significance in the positive rates of ANA，ANA-15 and ANA-7 between different seasons（P>0.05）. Conclusions ANA，ANA-15 and ANA-7 have certain positive rates in individuals of different genders and ages，with slightly higher positive rates in females than males. Middle-aged and elderly populations，especially middle-aged and elderly females，should pay attention to the risk of developing AID.

Expression of programmed death-1/programmed death-ligand 1 in chronic lymphocytic leukemia patients and its correlation with T lymphocyte subsets

SHI Fangjing, HU Shanshan, LUO Xinguo, ZHU Yan, YU Fangquan, YE Hongwei

2025, 40(6):  592-595.  DOI: 10.3969/j.issn.1673-8640.2025.06.013

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Objective To investigate the expression of programmed death-1（PD-1）/programmed death-ligand 1（PD-L1） in chronic lymphocytic leukemia（CLL） patients and its correlation with T lymphocyte subsets，and to provide a reference for targeted intervention of CLL. Methods Totally，70 patients with CLL in Jinhua People's Hospital from April 2020 to June 2023 were enrolled as CLL group，and the patients were classified into Group A（24 cases），Group B（30 cases） and Group C（16 cases） according to Binet classification. Another 49 patients with chronic myelogenous leukemia in Jinhua People's Hospital were enrolled as control group. The PD-1 mRNA，PD-L1 mRNA and T lymphocyte subsets were determined. Multivariate Logistic regression analysis was used to investigate the relationship between CLL and PD-1 mRNA，PD-L1 mRNA. Pearson correlation analysis was used to evaluate the correlation between PD-1 mRNA，PD-L1 mRNA and T lymphocyte subsets. Results Compared with control group，the expressions of PD-1 mRNA，PD-L1 mRNA，T helper cell（Th）9 and Th17 in CLL group were increased（P<0.05），while the expression of Treg was decreased（P<0.05）. The levels of PD-1 mRNA，PD-L1 mRNA，Th9 and Th17 in Group A，B and C were increased，and Treg was decreased gradually（P<0.05）. PD-1 mRNA，PD-L1 mRNA，Th9 and Th17 increasing and Treg decreasing were independent influencing factors for CLL（P<0.05）. PD-1 mRNA，PD-L1 mRNA were negatively correlated with Treg, and PD-1 mRNA，PD-L1 mRNA were positively correlated with Th9 and Th17（P<0.05）. Conclusions The expressions of PD-1 mRNA，PD-L1 mRNA are increased in CCL，which can be used to predict CCL，providing a reference for clinical diagnosis.

Research progress in phenotypic characteristics and treatment efficacy evaluation of acute promyelocytic leukemia variants

MA Jingyun, WANG Mengmeng, XIONG Boyu, DAI Zhuowen, PAN Yueyue, WANG Qiong

2025, 40(6):  606-614.  DOI: 10.3969/j.issn.1673-8640.2025.06.016

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Acute promyelocytic leukemia（APL） is a unique subtype of acute myeloid leukemia（AML），more than 98% of patients belong to typical APL，expressing PML::RARα，sensitive to all-trans retinoic acid（ATRA） and arsenic trioxide（ATO） induced differentiation，and its clinical effect is good. Variant APL exhibits different clinical and morphologic characteristics and responds differently to ATRA compared with classic APL. This review summarizes and analyzes the clinical characteristics，incidence rate，laboratory determinations，sensitivities to ATRA，ATO and chemotherapy，as well as the prognosis of patients with variant APL. It also draws the 3D gene fusion profile of variant APL to investigate its role in the occurrence of APL and its mechanism of ATRA.

Research progress of lipid peroxidation in dysregulation of glucose and lipid metabolism

CAO Shuxian, GAO Yinan, SONG Yufan, LU Sumei

2025, 40(6):  615-620.  DOI: 10.3969/j.issn.1673-8640.2025.06.017

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Lipid peroxidation means the generation process of a series of peroxidation products from polyunsaturated fatty acids（PUFA） within cells under enzymatic or non-enzymatic processes. This process disrupts the structure and function of biological membranes，consequently leading to various diseases，particularly those associated with disrupted glucose and lipid metabolism such as type 2 diabetes mellitus，non-alcoholic fatty liver disease and cardiovascular diseases. The present study provides comprehensive summary of the 3 pathways of lipid peroxidation，elucidating the primary reactions occurring within each pathway and identifying key oxidative metabolites. Furthermore，it examines the connections between these lipid peroxidation pathways and disease development，with a specific focus on the effects of multiple oxidative metabolites on the progression of diseases. This review aims to offer theoretical guidance for future treatments of disorders related to lipid metabolism and the exploration of novel biomarkers.