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        Comparison of Direct and Extraction Immunoassay Methods With Liquid Chromatography-Tandem Mass Spectrometry Measurement of Urinary Free Cortisol for the Diagnosis of Cushing’s Syndrome

        Mu Danni,Fang Jiadan,Yu Songlin,Ma Yichen,Cheng Jin,Hu Yingying,Song Ailing,Zhao Fang,Zhang Qi,Qi Zhihong,Zhang Kui,Xia Liangyu,Qiu Ling,Zhu Huijuan,Cheng Xinqi 대한진단검사의학회 2024 Annals of Laboratory Medicine Vol.44 No.1

        Background: Twenty-four-hour urinary free cortisol (UFC) measurement is the initial diagnostic test for Cushing’s syndrome (CS). We compared UFC determination by both direct and extraction immunoassays using Abbott Architect, Siemens Atellica Solution, and Beckman DxI800 with liquid chromatography-tandem mass spectrometry (LC-MS/MS). In addition, we evaluated the value of 24-hr UFC measured by six methods for diagnosing CS. Methods: Residual 24-hr urine samples of 94 CS and 246 non-CS patients were collected. A laboratory-developed LC-MS/MS method was used as reference. UFC was measured by direct assays (D) using Abbott, Siemens, and Beckman platforms and by extraction assays (E) using Siemens and Beckman platforms. Method was compared using Passing–Bablok regression and Bland–Altman plot analyses. Cut-off values for the six assays and corresponding sensitivities and specificities were calculated by ROC analysis. Results: Abbott-D, Beckman-E, Siemens-E, and Siemens-D showed strong correlations with LC-MS/MS (Spearman coefficient r=0.965, 0.922, 0.922, and 0.897, respectively), while Beckman-D showed weaker correlation (r=0.755). All immunoassays showed proportionally positive bias. The areas under the curve were 0.975 for Abbott-D, 0.972 for LC-MS/MS, 0.966 for Siemens-E, 0.948 for Siemens-D, 0.955 for Beckman-E, and 0.877 for Beckman-D. The cut-off values varied significantly (154.8–1,321.5 nmol/24 hrs). Assay sensitivity and specificity ranged from 76.1% to 93.2% and from 93.0% to 97.1%, respectively. Conclusions: Commercially available immunoassays for measuring UFC show different levels of analytical consistency compared to LC-MS/MS. Abbott-D, Siemens-E, and Beckman-E have high diagnostic accuracy for CS.

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        Survival of Cancer Patients in Northeast China: Analysis of Sampled Cancers from Population-Based Cancer Registries

        Yanxia Li,Liya Yu,Jun Na,Shuang Li,Li Liu,Huijuan Mu,Xuanjuan Bi,Xiaoxia An,Xun Li,Wen Dong,Guowei Pan 대한암학회 2017 Cancer Research and Treatment Vol.49 No.4

        Purpose The cancer survival was characterized by following up sampled subgroups of cancer cases from three population-based cancer registries in Northeast China. Materials and Methods Survival analysis was used to analyze 6,871 patients, who had one of the 21 most common cancers based on sampling from the population-based cancer registries of three cities in Liaoning Province. All patients were diagnosed between 2000 and 2002 and were followed up to the end of 2007 by active and passive methods. The 5-year age standardized relative survival rates (ASRS) were estimated for all cancers combined and each of the 21 individual cancers. Results The survival status was traced for 80.8% of 8,506 sampled cancer cases. The 5-year ASRS for all 21 cancers combined was 41.5% (95% confidence interval, 40.3 to 42.7), the highest ASRS was observed for thyroid cancer (85.2%), breast cancer (78.9%), uterine corpus cancer (75.9%), and urinary bladder cancer (70.2%); the lowest 5-year ASRS was noted in pancreatic cancer (8.8%), liver cancer (11.0%), esophageal cancer (18.8), and lung cancer (19.6%). The cancer survival rates in Liaoning cities were similar to those of urban areas in mainland China, but significantly lower than those in Hong Kong, Korea, and Japan. Conclusion The strikingly poor cancer survival rates in three cities of Liaoning Province and in other places in China highlight the need for urgent investment in cancer prevention, early detection, and standardized and centralized treatment.

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