{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T01:35:14Z","timestamp":1784856914227,"version":"3.55.0"},"reference-count":47,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T00:00:00Z","timestamp":1644192000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Lipid alterations may serve as potential tumour biomarkers. The ratio of triglycerides to HDL cholesterol (TG\/HDL ratio) is associated with various cancers. Pseudocholinesterase (PChE) activity, involved in TG hydrolysis, plays an important role in the metabolism of lipoprotein. There is scarce data assessing the reliability of both the TG\/HDL ratio and PChE levels in correctly classifying patients suffering from bladder cancer. Methods: Three hundred and ninety-six patients undergoing cystoscopy or transurethral resection of the bladder (TURB), broken into two major groups, i.e., patients with histologically confirmed, non-metastatic bladder cancer (n = 208) and without bladder cancer (no bladder cancer, n = 188), formed the study population. The last group was split into two subgroups consisting of a cohort of patients never suffering from bladder cancer but with other bladder diseases (no CaBD, n = 100) and another cohort formed by patients characterised by eradicated bladder cancer after TURB with no recurrence during a three-month follow-up (previous bladder cancer, n = 88). Pieces of information by both metabolic derangement (the presence of type 2 diabetes mellitus), hypertension and lipid profile were retrieved from patient records upon entry to the study. Sensitivity, specificity, areas under the ROC (AUROC) of the TG\/HDL ratio, and PChE levels were used in diagnostic decision making. Results: The TG\/HDL ratio as well as PChE concentrations of bladder cancer patients were significantly different when compared to those with previous bladder cancer and the no CaBD patients (p = 0.023 and 0.0004, respectively). There was an independent role of both the TG\/HDL ratio and PChE levels in predicting the presence of bladder cancer (OR: 1.22 and 0.99, respectively), but the reliability of the TG\/HDL ratio (AUROC: 0.587) was superior to that of PChE levels (AUROC: 0.374). The AUROC of a new parameter resulting from the combination of the TG\/HDL ratio with PChE levels showed a further increment in the discriminant power of the bladder cancer presence (0.6298), interestingly with a negative predictive value (89%) according to the Bayesian approach. The cut-off of the TG\/HDL ratio, the main marker of the present study that better distinguishes bladder cancer from no bladder cancer patients, was 2.147. Discussion and Conclusions: The reliability of the TG\/HDL ratio is based on the fact that this parameter likely mirrors the insulin resistance (IR) underlying bladder cancer patients. Furthermore, PChE levels evidence both IR and the associated non-alcoholic fatty liver disease. The TG\/HDL ratio and PChE levels as well as their combined use could help physicians to assess\/confirm the presence of this very common cancer, where early detection is important to ensure the best therapeutical approach.<\/jats:p>","DOI":"10.3390\/diagnostics12020431","type":"journal-article","created":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T20:36:42Z","timestamp":1644266202000},"page":"431","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["A Comparative Study of the Triglycerides\/HDL Ratio and Pseudocholinesterase Levels in Patients with Bladder Cancer"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4315-7660","authenticated-orcid":false,"given":"Felice","family":"Crocetto","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9621-3059","authenticated-orcid":false,"given":"Savio Domenico","family":"Pandolfo","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, 80131 Naples, Italy"},{"name":"Division of Urology, VCU Health, Richmond, VA 23219, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8470-1995","authenticated-orcid":false,"given":"Achille","family":"Aveta","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Martino","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9291-2426","authenticated-orcid":false,"given":"Francesco","family":"Trama","sequence":"additional","affiliation":[{"name":"Andrology and UroGynecology Clinic, AOSP Santa Maria di Terni, 05100 Terni, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo Francesco","family":"Caputo","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4884-132X","authenticated-orcid":false,"given":"Biagio","family":"Barone","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Abate","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2725-8530","authenticated-orcid":false,"given":"Enrico","family":"Sicignano","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8431-9830","authenticated-orcid":false,"given":"Simone","family":"Cilio","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2698-9470","authenticated-orcid":false,"given":"Gianluca","family":"Russo","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Naples Federico II, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Massanova","sequence":"additional","affiliation":[{"name":"Department of Urology, Queen Elizabeth, University Hospital, Glasgow G51 4TF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Concetta","family":"Di Vito","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciro","family":"Imbimbo","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7751-2715","authenticated-orcid":false,"given":"Giovanni","family":"Tarantino","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery, Federico II Medical School of Naples, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1159\/000447229","article-title":"The Association between Metabolic Syndrome and High-Stage Primary Urothelial Carcinoma of the Bladder","volume":"12","author":"Nagase","year":"2018","journal-title":"Curr. Urol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12967-021-02865-8","article-title":"Metabolic classification of bladder cancer based on multi-omics integrated analysis to predict patient prognosis and treatment response","volume":"19","author":"Tang","year":"2021","journal-title":"J. Transl. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.cmet.2019.11.010","article-title":"Greasing the Wheels of the Cancer Machine: The Role of Lipid Metabolism in Cancer","volume":"31","author":"Snaebjornsson","year":"2020","journal-title":"Cell Metab."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.cbi.2015.09.005","article-title":"Lipidomics: Novel insight into the biochemical mechanism of lipid metabolism and dysregulation-associated disease","volume":"240","author":"Zhao","year":"2015","journal-title":"Chem. Interact."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"577420","DOI":"10.3389\/fonc.2020.577420","article-title":"Alterations of Lipid Metabolism in Cancer: Implications in Prognosis and Treatment","volume":"10","year":"2020","journal-title":"Front. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.ctrv.2016.03.005","article-title":"Metabolic phenotype of bladder cancer","volume":"45","author":"Massari","year":"2016","journal-title":"Cancer Treat. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2520","DOI":"10.1161\/01.CIR.96.8.2520","article-title":"Fasting Triglycerides, High-Density Lipoprotein, and Risk of Myocardial Infarction","volume":"96","author":"Gaziano","year":"1997","journal-title":"Circulation"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.7150\/jca.15776","article-title":"Pretreatment TG\/HDL-C Ratio Is Superior to Triacylglycerol Level as an Independent Prognostic Factor for the Survival of Triple Negative Breast Cancer Patients","volume":"7","author":"Dai","year":"2016","journal-title":"J. Cancer"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1002\/kjm2.12033","article-title":"Pretreatment triglycerides-to-high density lipoprotein cholesterol ratio in postmenopausal women with endometrial cancer","volume":"35","author":"Luo","year":"2019","journal-title":"Kaohsiung J. Med. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"6829","DOI":"10.7150\/jca.35939","article-title":"Triglyceride-to-high density lipoprotein cholesterol ratio predicts clinical outcomes in patients with gastric cancer","volume":"10","author":"Sun","year":"2019","journal-title":"J. Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1055\/s-2007-978852","article-title":"The relation between plasma lipid levels and pseudo-cholinesterase activity in hypothyroidism","volume":"30","year":"1998","journal-title":"Horm. Metab. Res."},{"key":"ref_12","first-page":"31","article-title":"A comparative study of LDH and PCHE in sera of cancer patients\u2014Preliminary report","volume":"17","author":"Ghooi","year":"1980","journal-title":"Indian J. Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"21","DOI":"10.4103\/0973-1482.39601","article-title":"Prognostic and diagnostic value of serum pseudocholinesterase, serum aspartate transaminase, and serum alinine transaminase in malignancies treated by radiotherapy","volume":"4","author":"Chougule","year":"2008","journal-title":"J. Cancer Res. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1993","DOI":"10.1007\/s11255-016-1401-1","article-title":"Pretreatment serum pseudocholinesterase level as a novel prognostic biomarker for upper tract urothelial carcinoma","volume":"48","author":"Zhang","year":"2016","journal-title":"Int. Urol. Nephrol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1097\/MPA.0b013e31815b6b2b","article-title":"Low serum level of cho-linesterase at recurrence of pancreatic cancer is a poor prognostic factor and relates to systemic disorder and nerve plexus invasion","volume":"36","author":"Mitsunaga","year":"2008","journal-title":"Pancreas"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"580800","DOI":"10.3389\/pore.2021.580800","article-title":"Cholinesterase is Associated with Prognosis and Response to Chem-otherapy in Advanced Gastric Cancer","volume":"27","author":"Bi","year":"2021","journal-title":"Pathol. Oncol. Res."},{"key":"ref_17","first-page":"775","article-title":"Muscarinic cholinergic signaling and overactive bladderlike symptoms associated with invasive bladder cancer","volume":"16","author":"Wei","year":"2018","journal-title":"Oncol. Lett."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"265","DOI":"10.3892\/br.2013.60","article-title":"Assessment of the value of serum cholinesterase as a liver function test for cirrhotic patients","volume":"1","author":"Meng","year":"2013","journal-title":"Biomed. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s10147-016-1068-8","article-title":"Biomarkers for precision medicine in bladder cancer","volume":"22","author":"Kojima","year":"2016","journal-title":"Int. J. Clin. Oncol."},{"key":"ref_20","unstructured":"European Association of Urology (2017). Guidelines, European Association of Urology. [2017 ed.]. Available online: https:\/\/uroweb.org\/wp-content\/uploads\/Guidelines_WebVersion_Complete-1.pdf."},{"key":"ref_21","unstructured":"American Cancer Society (2021, October 15). Available online: https:\/\/www.cancer.org\/latest-news.html."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.5551\/jat.35634","article-title":"Reference Values for The Triglyceride to High-Density Lipoprotein Cholesterol Ratio and Non-High-Density Lipoprotein Cholesterol in Korean Children and Adolescents: The Korean National Health and Nutrition Examination Surveys 2007-2013","volume":"23","author":"Shim","year":"2016","journal-title":"J. Atheroscler. Thromb."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1002\/bimj.200410135","article-title":"Estimation of the Youden Index and its associated cut-off point","volume":"47","author":"Fluss","year":"2005","journal-title":"Biom. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"Bray","year":"2018","journal-title":"CA Cancer J. Clin."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.numecd.2015.01.012","article-title":"CARdiometabolic risk factors in overweight and obese children in ITALY (CARITALY) Study Group: Com-parison of non-HDL-cholesterol versus triglycerides-to-HDL-cholesterol ratio in relation to cardiometabolic risk factors and preclinical organ damage in overweight\/obese children: The CARITALY study","volume":"25","author":"Valerio","year":"2015","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1869","DOI":"10.2337\/dc10-2234","article-title":"The triglyceride-to-HDL cholesterol ratio: Association with insulin resistance in obese youths of different ethnic backgrounds","volume":"34","author":"Giannini","year":"2011","journal-title":"Diabetes Care"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.numecd.2014.01.010","article-title":"Association of serum triglyceride-to-HDL cholesterol ratio with carotid artery intima-media thickness, insulin resistance and nonalcoholic fatty liver disease in children and adolescents","volume":"24","author":"Pacifico","year":"2014","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1186\/s12944-016-0270-z","article-title":"The triglyceride to high-density lipoprotein cholesterol (TG\/HDL-C) ratio as a predictor of insulin resistance but not of \u03b2 cell function in a Chinese population with different glucose tolerance status","volume":"15","author":"Zhou","year":"2016","journal-title":"Lipids Health Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"411","DOI":"10.2337\/diab.43.3.411","article-title":"Isolated low HDL cholesterol. An insulin-resistant state","volume":"43","author":"Malkki","year":"1994","journal-title":"Diabetes"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Tarantino, G., Crocetto, F., Di Vito, C., Creta, M., Martino, R., Pandolfo, S.D., Pesce, S., Napolitano, L., Capone, D., and Imbimbo, C. (2021). Association of NAFLD and Insulin Resistance with Non-Metastatic Bladder Cancer Patients: A Cross-Sectional Retrospective Study. J. Clin. Med., 10.","DOI":"10.3390\/jcm10020346"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1089\/dia.2013.0131","article-title":"Diabetes Mellitus Increases the Risk of Bladder Cancer: An Updated Meta-Analysis of Observational Studies","volume":"15","author":"Fang","year":"2013","journal-title":"Diabetes Technol. Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1177\/1358863X12450094","article-title":"Link between the renin-angiotensin system and insulin resistance: Implications for cardi-ovascular disease","volume":"17","author":"Zhou","year":"2012","journal-title":"Vasc. Med."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Teleka, S., Hindy, G., Drake, I., Poveda, A., Melander, O., Liedberg, F., Orho-Melander, M., and Stocks, T. (2020). Blood pressure and bladder cancer risk in men by use of survival analysis and in interaction with NAT2 genotype, and by Mendelian randomization analysis. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0241711"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e1123","DOI":"10.1016\/j.clgc.2018.07.002","article-title":"Prognostic Value of Serum Cholinesterase in Non\u2013muscle-invasive Bladder Cancer","volume":"16","author":"Kimura","year":"2018","journal-title":"Clin. Genitourin. Cancer"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1177\/0300060513517485","article-title":"Fatty liver and serum cholinesterase are independently correlated with HbA1c levels: Cross-sectional analysis of 5384 people","volume":"42","author":"Katoh","year":"2014","journal-title":"J. Int. Med. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"168","DOI":"10.3109\/00365513.2010.547947","article-title":"The relationship between glycosylated haemoglobin (HbA1c) and measures of insulin resistance across a range of glucose to3erance","volume":"71","author":"Borai","year":"2011","journal-title":"Scand. J. Clin. Lab. Investig."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"20193996","DOI":"10.1042\/BSR20193996","article-title":"HbA1c may contribute to the development of non-alcoholic fatty liver disease even at normal-range levels","volume":"40","author":"Chen","year":"2020","journal-title":"Biosci. Rep."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/S0895-7061(98)00178-2","article-title":"Abnormalities of membrane function and lipid metabolism in hypertension A review","volume":"12","author":"Zicha","year":"1999","journal-title":"Am. J. Hypertens."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1200\/JCO.2001.19.1.89","article-title":"Transurethral Resection of Muscle-Invasive Bladder Cancer: 10-Year Outcome","volume":"19","author":"Herr","year":"2001","journal-title":"J. Clin. Oncol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"641","DOI":"10.23736\/S0393-2249.20.03850-3","article-title":"Laparoscopic radical cystectomy with extra-corporeal urinary diversion: An Italian single-center experience with 10-year outcomes","volume":"72","author":"Bada","year":"2020","journal-title":"Minerva Urol. Nefrol."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Ferro, M., La Civita, E., Liotti, A., Cennamo, M., Tortora, F., Buonerba, C., Crocetto, F., Lucarelli, G., Busetto, G., and Del Giudice, F. (2021). Liquid Biopsy Biomarkers in Urine: A Route towards Molecular Diagnosis and Personalized Medicine of Bladder Cancer. J. Pers. Med., 11.","DOI":"10.3390\/jpm11030237"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"FSO709","DOI":"10.2144\/fsoa-2021-0008","article-title":"Neutrophil percentage-to-albumin ratio predicts mortality in bladder cancer patients treated with neoadjuvant chemotherapy followed by radical cystectomy","volume":"7","author":"Ferro","year":"2021","journal-title":"Future Sci. OA"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/S0009-9120(01)00263-6","article-title":"The plasma parameter log (TG\/HDL-C) as an atherogenic index: Correlation with lipoprotein particle size and esterification rate in apoB-lipoprotein-depleted plasma (FER(HDL))","volume":"34","author":"Frohlich","year":"2001","journal-title":"Clin. Biochem."},{"key":"ref_44","first-page":"160","article-title":"Non-HDL cholesterol as a metric of good quality of care: Opportunities and challenges","volume":"38","author":"Virani","year":"2011","journal-title":"Tex. Heart Inst. J."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2011\/549137","article-title":"LDL-C\/HDL-C Ratio Predicts Carotid Intima-Media Thickness Progression Better Than HDL-C or LDL-C Alone","volume":"2011","author":"Enomoto","year":"2011","journal-title":"J. Lipids"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e8058","DOI":"10.1097\/MD.0000000000008058","article-title":"The atherogenic index of plasma is a strong and independent predictor for coronary artery disease in the Chinese Han population","volume":"96","author":"Cai","year":"2017","journal-title":"Medicine"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12944-018-0828-z","article-title":"Atherogenic index of plasma (AIP): A novel predictive indicator for the coronary artery disease in postmenopausal women","volume":"17","author":"Wu","year":"2018","journal-title":"Lipids Health Dis."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/2\/431\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:15:44Z","timestamp":1760134544000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/2\/431"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,7]]},"references-count":47,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["diagnostics12020431"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics12020431","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,7]]}}}