Evaluating the performance characteristics of five lateral flow assays for the detection of the SARS-CoV-2 nucleocapsid antigen.

In response to the COVID-19 pandemic, lateral flow assays (LFAs) for the detection of SARS-CoV-2 antigen have been proposed as a complementary option to the more costly and time consuming reverse-transcriptase polymerase chain reaction (RT-PCR). We assessed five commercially available SARS-CoV-2 antigen detecting LFAs (ASSUT EUROPE (Rome, Italy), Besthree (Taizhou, China), Encode (Zhuhai, China), Fortress (Antrim UK), and Hughes Medical (Buckinghamshire, UK), using samples collected from hospitalised individuals with COVID-19 and compared these results against established RT-PCR assays with the aim of estimating test performance characteristics. We performed a diagnostic accuracy study of the five LFAs on 110 inpatients with confirmed COVID-19 and 75 COVID-19 negative control participants. Assay evaluation was performed using a modified version of each manufacturer's protocol allowing for parallel testing of a single sample on multiple assays. Additional variables were studied including infection acquisition, oxygenation requirements at time of swabbing, and patient outcomes. The 110 patients were 48% (53) female, with mean age 67 years (range 26-100 years), and 77% (85) cases were community onset SARS-CoV-2. Across the five assays, sensitivity ranged from 64 (95% CI 53-73) to 76% (95% CI 65-85); Fortress performed best with sensitivity of 76% (95% CI 65-85). Specificity was high across all assays with 4/5 LFAs achieving 100%. LFA sensitivity was not dependant on RT-PCR cycle thresholds. SARS-CoV-2 antigen detecting LFAs may complement RT-PCR testing to facilitate early diagnosis and provide community testing strategies for identification of patients with COVID-19, however we find suboptimal test performance characteristics across a range of commercially available manufacturers, below WHO and MHRA pre-set sensitivity performance thresholds. With such variation in sensitivity between LFAs and PCR testing and between assay brands, we advise caution in the deployment of LFAs outside of environments with clinical oversight.

Implication of miRNA-153 on PTEN expression in prostatic adenocarcinoma.

OBJECTIVE: A little is known about the role of miRNA-153 expression in prostate cancer (PCa), in this study we aimed to determine the prognostic value of miRNA-153 and PTEN expression in PCa, by correlating their expression with Gleason patterns, Gleason scores, and Grade groups. PATIENTS AND METHODS:  In situ hybridization for miRNA-153 and immunohistochemical staining for PTEN were applied on microarray sections of 80 PCa, with different Gleason grades, and 20 benign prostate hyperplasia (BPH) cases. RESULTS: We found that miRNA-153 expression was significantly higher and PTEN was significantly lower in PCa compared to BPH. In PCa, high miRNA-153 expression and loss of PTEN expression were associated significantly with higher Gleason patterns, higher Gleason scores, and higher Grade groups. The expression of miRNA-153 showed a significant inverse correlation with PTEN expression. CONCLUSIONS: Increased miRNA-153 expression and lost PTEN expression in PCa may provide information on their role in the progression of this cancer, suggesting that miRNA-153 could affect PTEN directly in prostatic neoplastic and hyperplastic lesions, and therefore miRNA-153 can be considered a new tool to improve the treatment efficacy and prognosis of PCa patients.

Survey of 1725 bone scans in patients with malignant disease with particular emphasis on carcinoma of the breast.

1725 bone scans, done for evaluation of metastatic involvement from malignant neoplasms, were reviewed. The fraction of positive scans (multiple lesions in the bone scan) was 34% of the patients with different malignancies. In 251 patients (12%) a single bone lesion was detected and 114 of these patients were followed-up and re-scanned once or twice within 1 to 4 years. 39 of the 93 patients with solitary bone lesion who on follow-up developed multiple lesions had carcinoma of the breast as the primary.

Clinical utility of a simple physical technique in thyroid scintigraphy.

Fifty two patients with visualization of one lobe or one lobe with faint active thyroid tissue in the region of the other lobe on thyroid scintigraphy, were studied using shielding of the active thyroid tissue in order to visualize the rest of the gland. This technique is useful in the differential diagnosis of autonomous nodules without need for the time consuming, costly, and sometimes hazardous TSH stimulation and T3 suppression tests. Furthermore, this technique could be used to verify total lobectomy in patients following thyroid surgery. Further work to differentiate congenital thyroid hemiagenesis from non toxic sutonomous nodules is suggested.

Measurement of thyroid hormone in experimental thyroid tumours in rats.

Rats treated with 131I and propylthiouracil were shown to develop thyroid tumours 7--9 months after treatment. In this group, the levels of total thyroxine and tri-iodothyronine, and free thyroxine and tri-iodothyronine in the serum were low, and that of TSH was raised. In a group of rats treated with 131I and then propylthiouracil and thyroxine, thyroid tumours were found despite normal concentrations of total and free thyroxine and tri-iodothyronine in the serum. The level of TSH in the serum was significantly raised in this group. Thyroid tumours were not found in the various control groups of rats.