Outside organised colorectal cancer (CRC) screening programmes, faecal occult blood testing helps general practitioners decide whether to refer symptomatic patients for a colonoscopy. In France, practices vary widely, have not been evaluated, and are based on several qualitative and quantitative faecal immunochemical tests (FITs) with very different performance characteristics that clinicians do not appreciate. In the United Kingdom, this practice is generally based on two recommended automated quantitative FITs and usually follows very specific recommendations. Quantitative FITs have been extensively evaluated and have demonstrated their superiority, both in organised CRC screening programmes and in the investigation of symptomatic patients, albeit with different decision thresholds. In a symptomatic patient, the threshold of 10μg haemoglobin/gram of faeces (μg/g) from the English guidelines is not applicable in France. We suggest a threshold of 2μg/g, offering a sensitivity of 94.7% for the diagnosis of CRC, which must be confirmed by further studies in the French symptomatic population. The advantages of quantitative faecal immunochemical tests (FIT) are such that they will gradually replace qualitative FITs: self-collection, a single sample, at most two, lower cost, control of the pre-analytical phase, automation, a significant reduction in equivocal and uninterpretable results, control of the positivity threshold, information on the degree of urgency of colonoscopy, better analytical and clinical performance, and better cost-effectiveness ratio. It is urgent that the French National Authority for Health (HAS) draw up recommendations and a framework for use in symptomatic patients and update the nomenclature of medical biology procedures.

Streptococcus pneumoniae is an encapsulated bacterium responsible for invasive infections, particularly in the very young and very old, where morbidity and mortality rates are high. Its polysaccharide capsule, which defines the serotype and is the main virulence factor, also serves as an antigenic target for pneumococcal vaccines. There are two main categories of vaccines: the non-conjugated polysaccharide vaccine PPV-23, covering 23 serotypes but with limited and short-lived efficacy in children, and the more recent conjugate vaccines (PCV), offering longer protection, even in the pediatric population. Their serotype coverage has gradually expanded to include the latest generation PCV-21. According to the WHO, the evaluation of the vaccine response must be based both on the quantification of specific IgG to a given serotype by ELISA and on the qualitative study of antibody functionality via the opsonophagocytosis (OPA) test. ELISA thresholds have been defined to assess protection: 1μg/mL in adults and 0.35μg/mL in children. A patient is considered to have protective vaccine immunity if these levels are achieved for at least 70% of the serotypes tested (50% in children). For OPA, each laboratory defines limits of quantification (LOQ) for every serotype tested, and the response is considered protective if the opsonization index exceeds the LOQ in at least 70% of cases. Introduction of new vaccines is changing the epidemiology of these invasive infections, making it necessary to regularly update vaccination recommendations and expand the evaluation of vaccine response in order to include these new serotypes.

Superficial fungal infections, mainly caused by dermatophytes but also by yeasts or molds, exhibit wide clinical variability and are a common reason for medical consultation. Recent epidemiological trends, particularly the emergence of extensive cutaneous dermatophytoses, -highlight the need for rigorous mycological diagnosis. The development of nucleic acid amplification techniques (NAAT) and advances in proteomics (MALDI-TOF) have prompted a reassessment of the role of conventional methods, without replacing them. These recommendations aim to guide biologists and COFRAC auditors in selecting and implementing the various available techniques, in order to harmonize practices and improve the overall quality of mycological diagnosis.

We report a case of pseudohyperphosphatemia in a patient with multiple myeloma that progressed to plasma cell leukaemia. This pseudohyperphosphatemia was caused by an analytical interference between monoclonal immunoglobulin and ammonium molybdate, a reagent used for measuring inorganic phosphate. Accurate measurement of blood inorganic phosphate levels requires prior protein precipitation to eliminate assay interference. Extrarenal purification treatments helped reduce the monoclonal immunoglobulin concentration and eliminated the interference during phosphate measurement. Pseudohyperphosphatemia is a rare event that can lead to inappropriate and harmful medical management for affected patients; thus, prompt recognition by clinical biologists is crucial to avoid misdiagnosis and inappropriate interventions. This case report also provides an opportunity to do a brief review of the literature and to remind some recommendations and actions to take into consideration in the presence of discrepancies between the clinic and the biology.

Current guidelines recommend using at least two different assays for lupus anticoagulant (LA) detection. One such assay is the dilute Russell's viper venom time (dRVVT). This study aimed to evaluate the analytical performance of the Lupus Screen and Lupus Confirm dRVVT reagents (Roche Diagnostics) on the cobas t711 analyzer and to compare their diagnostic performance against an established reagent pair (LA1/LA2, Siemens) using the Sysmex CN-6000 analyzer (Sysmex Corporation) for LA detection. Repeatability was assessed by testing lyophilized quality control plasmas 20 times in a single run. Reproducibility was evaluated over at least five days with duplicate testing. A total of 101 anonymized patient samples were analyzed with both Roche and Siemens reagents on their respective platforms. Statistical analysis was performed using GraphPad Prism software version 9.5.0 (GraphPad Software, San Diego, CA, USA). Diagnostic performance was assessed via positive percentage agreement (PPA), negative percentage agreement (NPA), and overall rate of agreement (ORA). The within-run and between-run CVs were < 2%. Results obtained with the Roche and Siemens reagents were strongly correlated (r = 0.950, 0.923, and 0.877 for screen, confirm, and normalized screen/confirm ratios, respectively; all p < 0.001) and bias were acceptable. Assuming Siemens reagents as reference, PPA, NPA, and ORA were 92.42%, 100%, and 95.05%, respectively. The Lupus Screen and Lupus Confirm reagents demonstrated excellent analytical and diagnostic performance and are well-suited for LA detection in non-anticoagulated patient samples.

Pre-analytical management of samples in hemostasis is essential for the correct assessment of parameters. Although there is extensive literature on this subject, the Working Group of the French Society of Thrombosis and Hemostasis deemed it necessary to conduct a review of the literature and propose recommendations for the stability of samples before hemostasis assays. These recommendations are based on a literature review of publications from 1997 to 2024, initially analyzed by a working group of 6 experts and then reviewed by 13 other biologists. The various conditions are summarized in tables that will assist hemostasis laboratories in managing samples and -transporting specimens. Furthermore, since some conditions clearly have not been the subject of evaluation, this review opens new fields of investigation.

Monocytes, circulating mononuclear phagocytes, play a fundamental role in innate immunity and the maintenance of tissue homeostasis. Using advanced technologies like flow cytometry, the characterization of monocytes has evolved from a simplistic view of a homogeneous population to a more complex understanding of a heterogeneous system comprising three main subtypes: classical monocytes (CD14++CD16-), intermediate monocytes (CD14++CD16+), and non-classical monocytes (CD14+CD16++). The identification of these subpopulations has enabled precise characterization of their functional profiles, enhancing the understanding of their roles in various pathological contexts, particularly in oncology. While anti-tumoral functions of monocytes have been clearly established in certain categories of cancers through tumor antigen presentation, induction of cytotoxic responses, and inhibition of metastatic progression, their role in promoting the development and progression of other cancers has also been highlighted during recent years. The utilization of monocytes in cancer immunotherapy presents promising opportunities, particularly by reprogramming their activity to enhance anti-tumoral responses or suppress their pro-tumoral functions. This review provides a comprehensive analysis of recent advances in the phenotypic and functional diversity of monocytes and their role in tumor progression, while highlighting emerging therapeutic strategies targeting these cells to optimize cancer treatment.

The diagnosis of B- and T-cell lymphomas relies on a multidisciplinary approach that combines morphological, immunological (via flow cytometry - FCM), and genetic analyses. The integration of cytological evaluation from tissue biopsy imprints with FCM enables rapid diagnostic orientation, which is valuable for guiding further complementary investigations. This atlas illustrates the main types of B- and T-cell lymphomas using cytology images, FCM data, and histological analyses derived from lymph node and splenic samples. The FCM profiles were established using routinely employed antibody panels. While results may show slight variations depending on the cytometer settings and fluorochromes used, they remain generally comparable across different instruments. An orientation panel consisting of 16 antibodies is used for the initial classification of lymphomas, with specific markers allowing for subsequent assessment of antigen expression according to cell type and pathological context. The combined study of cytological and histological features provides an integrated perspective of lymphoid pathology.