In June 2023, Premier Integrated Labs, formerly known as Pantai Premier Pathology, celebrated a momentous occasion with its official launch, marking a significant milestone. We take great pride in being the quadruple-crowned clinical laboratory in Malaysia, having attained the distinguished accreditations of the College of American Pathology (CAP), MS ISO 15189, Malaysian Society for Quality in Health (MSQH) and Joint Commission International (JCI).

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Molecular Oncology services provided by Pantai Premier Pathology

Molecular Oncology services provided by Pantai Premier Pathology

Premier Integrated Labs has distinguished itself as a leader in molecular oncology by the breadth and depth of service to support pathologists and oncologists in making diagnoses, assessing prognoses, and discovering opportunities for targeted therapy & other treatment option as per suggested in NCCN Guidelines and other reputable oncology organizations.

 

Molecular oncology service in PPP comprises of single gene assays, multi-gene panels and comprehensive genomic profiling. With testing methods like FISH, IHC, PCR, and NGS are available in-house. With this comprehensive range of tests, accompanied with the clarity and personalization of the consultations, it allows an integrated approach to the case, maximizes yield from small specimens, and minimizes turnaround time.

 

Our single genes molecular testing is to help physician in deciding fast and actionable treatment options, like BRCA 1 & 2 for Olaparib chemotherapy on breast, ovarian and prostate cancer. Same goes to PDL-1 sp142 testing for breast cancer immunotherapy treatment.

 

Besides single genes testing, PPP have come-up with our own actionable panel testing, which comprises of biomarkers that have treatment suggestion which is most commonly requested by physicians. For example, Lung Cancer Panel which consist of EGFR, ALK, ROS1, KRAS, BRAF, and PDL1.

 

Besides solid tumour molecular testing, PPP also offers a broad collection of comprehensive, targeted and single gene liquid biopsy assays for solid tumor cancer like T790M for Lung Cancer and hematologic malignancies. Our goal is to provide all patients access to testing in a timely manner to ensure efficient diagnosis and disease progression monitoring.

 

Next-Generation Sequencing (NGS) & Advancing Precision Oncology in PPP

While it began as a revolutionary research tool a decade ago, NGS is now the method of choice for simultaneous genomic profiling of multiple cancer markers.  For hospitals, the advantages of NGS over traditional methods are indisputable in terms of time savings, tissue perservation, and a precision oncology approach to patient care.

 

Comprehensive Genomic Profiling (CGP)

Our pan-cancer analysis using next-generation sequencing assay includes 523 genes involved in solid tumor development and progression. This panel provides broad coverage of actionable markers supported by clinical guidelines and on-going clinical trials.

Biomarkers detected are implicated in a variety of tumor types including bladder, brain/CNS, breast, cervical, colorectal, endometrial, esophageal, gastric, head and neck, kidney, liver, lung, melanoma, ovarian, pancreatic, prostate, stomach, and thyroid.

Clinical applications of our CGP NGS:

  • Identifying targetable alterations to guide treatment decision
  • Monitoring disease status
  • Detecting potential resistance to therapy and its cause

Types of Diabetes | Causes, Risk Factors and Symptoms

Types of Diabetes | Causes, Risk Factors and Symptoms

Diabetes is a chronic disease which affects how your body converts food into energy.1 It is a condition when your blood sugar level is higher than normal.2 The three main types of diabetes are diabetes type 1, type 2 and gestational diabetes.1, 2, 3

 

The global prevalence of diabetes in 2014 is 8.5% among adults above 18 years old with an increase in the premature mortality rate by 5% between 2000 and 2016.3 In Malaysia, a survey has indicated that more than 3 million Malaysians suffer from diabetes.2

 

Most of the food you eat will be broken down into glucose and released into your bloodstream which will then be taken up by your cells to be used as fuel.3, 4 Insulin is a hormone produced in the pancreas to regulate your blood sugar level.3 It acts like a key which allows blood glucose to enter into your cells for use as energy.4 Diabetes occurs when the pancreas does not produce enough insulin or when the body is not able to use the insulin produced effectively, hence, unable to transport the glucose to the cells, leaving the amount of glucose in the blood raised.2, 3, 4

 

Hyperglycemia or raised blood glucose is a common result of uncontrolled diabetes where too much blood glucose stays in the bloodstream which overtime will lead to serious damage to many body systems, especially the nerves and blood vessels.3, 4  

 

Diabetes Type 1

Type 1 diabetes is caused by an immune response (body attacks itself by mistake). This causes a deficiency in insulin production, hence, requires daily administration of insulin. The risk factors of type 1 diabetes includes having family history and age. You can get type 1 diabetes at any age, but more likely to develop it during childhood.2, 3, 5

 

Symptoms of type 1 diabetes may occur suddenly which includes excessive urination (polyuria), excessive thirst (polydipsia), constant hunger, weight loss, vision changes and fatigue.3 There is currently no known cure or prevention for type 1 diabetes.3, 5

 

Diabetes Type 2

Type 2 diabetes occurs when your cells do not respond to the insulin produced by your body effectively. This condition is called insulin resistance.3, 6 The risk factors of type 2 diabetes includes having prediabetes, being overweight, 45 years old or older, having family history, physically inactive, have had gestational diabetes and have non-alcoholic fatty liver disease.5

 

Symptoms of type 2 diabetes may be similar to type 1 diabetes which often develop over several years and sometimes can be asymptomatic. Therefore, it is important to know the risk factors and to consult your doctor to get your blood glucose level tested early before the onset of diabetes.2, 3, 6

 

Type 2 diabetes can be prevented or delayed by having a healthy lifestyle such as losing weight, eating healthy food and being active.4

 

Gestational Diabetes

Gestational diabetes develops during pregnancy in women who do not already have diabetes when the body cannot produce enough insulin.3, 7 A pregnant woman’s body goes through changes such as weight gain. These changes will cause the cells in the body to use insulin less efficiently (insulin resistance). Insulin resistance is common in pregnant women during late pregnancy, however, some women who develop insulin resistance even before getting pregnant will have an increased need for insulin during pregnancy, resulting in them to more likely have gestational diabetes.7 The risk factors of gestational diabetes are being overweight, have a family history of type 2 diabetes, have a hormone disorder called polycystic ovary syndrome (PCOS), had gestational diabetes during previous pregnancy and have given birth to a baby who weighed more than 9 pounds.5

 

The risk of complications during pregnancy and at delivery is high for women with gestational diabetes. These women and their children are more likely to have an increased risk of type 2 diabetes later in life.3, 5, 7 Hence, it is important to manage gestational diabetes to make sure you have a healthy pregnancy and a healthy baby.7

 

Gestational diabetes is commonly diagnosed through prenatal screening than through reported symptoms.3

 

What are the common screening tests for Diabetes?

  1. Glucose
  2. Glycated Haemoglobin (HbA1c)

 

For more information on the tests provided, please contact us at +603-42809115 (Customer Service) or email us at info@premierpathology.com.my

 

 

References:

  1. Diabetes Basics. (n.d.). Centers for Disease Control and Prevention. Retrieved October 28, 2020, from https://www.cdc.gov/diabetes/basics/index.html
  2. Ismail, D. F. (n.d.). Diabetes Mellitus. MyHealth Kementerian Kesihatan Malaysian. Retrieved October 28, 2020, from http://www.myhealth.gov.my/en/diabetes-mellitus-4-2/
  3. Diabetes. (n.d.). World Health Organization. Retrieved October 29, 2020, from https://www.who.int/news-room/fact-sheets/detail/diabetes
  4. What is Diabetes? (n.d.). Centers for Disease Control and Prevention. Retrieved October 28, 2020, from https://www.cdc.gov/diabetes/basics/diabetes.html
  5. Diabetes Risk Factors. (n.d.). Centers for Disease Control and Prevention. Retrieved November 4, 2020, from https://www.cdc.gov/diabetes/basics/risk-factors.html
  6. Type 2 Diabetes. (n.d.). Centers for Disease Control and Prevention. Retrieved November 4, 2020, from https://www.cdc.gov/diabetes/basics/type2.html
  7. Gestational Diabetes. (n.d.). Centers for Disease Control and Prevention. Retrieved November 5, 2020, from https://www.cdc.gov/diabetes/basics/gestational.html

Pantai Premier Pathology | Forward in the Fight Against Covid-19

Pantai Premier Pathology | Forward in the Fight Against Covid-19

  • Pantai Premier Pathology (PPP) was among the first four private labs in Malaysia approved by MOH to perform Covid-19 testing.
  • Since February 2020:
    • PPP performed 183,000 COVID-19 samples (As at 19th October 2020).
    • Samples from PPP contributed 7.6% from total Malaysia’s COVID-19 tests conducted.
    • PPP runs average of 800 COVID-19 samples per day (As at 19th October 2020).
  • Result LTAT: 12 – 24 hours
  • Samples received from Pantai Gleneagles hospitals,  Non Pantai Gleneagles Private hospitals, MOH, and Corporate Clients.
  • Drive-Thru testing facilities in collaboration with Pantai Gleneagles hospitals.
  • Coordinating and hosting the COVID preparedness / sample collection training for medical practitioners. This was in collaboration with MOH/BPKK.
  • Setting up a hotline call center to address the public concerns after the 2nd wave.
  • Contributing to communities by sharing the Covid-19 information and updates in Pantai Premier Pathology’s website and social media platforms.
  • Types of Covid-19 tests offered by Pantai Premier Pathology:
    • COVID RT-PCR Test
    • COVID Rapid PCR Test
    • COVID Antigen Test
    • COVID Antibody Test

Breast Cancer | Symptoms and Risk Factors

Breast Cancer | Symptoms and Risk Factors

Cancer is the second leading cause of death worldwide which is responsible for an estimated 9.6 million deaths in 2018.1

Breast cancer ranks as the second most common cancer and the fifth most common cause of deaths due to cancer globally.2, 3, 4, 5 In Malaysia, this disease has accounted for 34.1% of all cancer among the females.6        

Breast cancer can occur at different parts of the breast like the lobules, ducts and connective tissue. The lobules are the milk producing gland, the ducts are tubes that allow milk to reach the nipple and the connective tissue which consists of fibrous and fatty tissues surrounds and keeps everything together. Breast cancers most commonly occur in the ducts or lobules.4, 7    

Different people experience different symptoms of breast cancer and some does not experience any signs and symptoms at all.8 Some of the warning symptoms are changes in the shape or size of breasts, presence of lump in the breasts or underarm areas, changes in nipples (appearance of nipples, pointing direction or presence of any clear or blood discharge), swelling of part of the breast, dimpling or irritation on the breasts skin area, redness, rash or eczema on breasts skin and nipples area, continuous pain in any area of breast, nipples or axilas.4, 8, 9, 10, 11

Breast cancer risk increases with age and a majority of those diagnosed are post-menopausal. Other factors that increases the risk of breast cancer include being a female, inherited genetic mutation, first pregnancy at a later age, low parity, early menarche, late menopause, having dense breast, being overweight or obese in post-menopausal women, physically inactive, previous history of radiotherapy to the breasts and drinking alcohol.9, 12

Breast cancer screening examines a vast number of asymptomatic individuals to identify positive cancer cases and to prevent deaths due to breast cancer by detecting the cancer at an early stage when treatment will be more effective. The cancer can be controlled by early detection through routine self-breast exams, mammographic screening, reducing prevalence of known risk factors and improved treatment.4, 5, 9

 

At Pantai Premier Pathology, we provide screening tests for Breast Cancer. Here are some tests related to breast cancer offered by Pantai Premier Pathology:

Breast CA Screening Test Prognosis
1.      BRCA Heredity Germline Testing 1.      Immunohistochemistry Testing

2.      HER2 Fish Testing

3.      BRCA1 & 2 Testing (Somatic & Germline)

4.      PIK3CA Testing for hormonal positive, HER2 negative

 

For more information on the tests provided, please contact us at +603-42809115 (Customer Service) or email us at info@premierpathology.com.my.

 

 

References:

  1. Cancer. (2018, September 12). World Health Organization. https://www.who.int/news-room/fact-sheets/detail/cancer
  2. Liu, F. C., Lin, H. T., Kuo, C. F., See, L. C., Chiou, M. J., & Yu, H. P. (2017). Epidemiology and survival outcome of breast cancer in a nationwide study. Oncotarget, 8(10), 16939–16950. https://doi.org/10.18632/oncotarget.15207
  3. Moodley, J., Cairncross, L., Naiker, T., & Constant, D. (2018). From symptom discovery to treatment-women’s pathways to breast cancer care: a cross-sectional study. BMC cancer, 18(1), 312.
  4. Winters, S., Martin, C., Murphy, D., & Shokar, N. K. (2017). Breast cancer epidemiology, prevention, and screening. In Progress in molecular biology and translational science (Vol. 151, pp. 1-32). Academic Press.
  5. Torre, L. A., Siegel, R. L., Ward, E. M., & Jemal, A. (2016). Global cancer incidence and mortality rates and trends—an update. Cancer Epidemiology and Prevention Biomarkers, 25(1), 16-27.
  6. National Cancer Registry Department. (2019). MALAYSIA NATIONAL CANCER REGISTRY REPORT (MNCR) 2012-2016. Retrieved from https://drive.google.com/file/d/1BuPWrb05N2Jez6sEP8VM5r6JtJtlPN5W/view
  7. What is Breast Cancer? (n.d.). Centers for Disease Control and Prevention. Retrieved September 25, 2020, from https://www.cdc.gov/cancer/breast/basic_info/what-is-breast-cancer.htm
  8. What are the Symptoms of Breast Cancer? (n.d.). Centers for Disease Control and Prevention. Retrieved September 25, 2020, from https://www.cdc.gov/cancer/breast/basic_info/symptoms.htm
  9. Harmer, V. (2016). Signs and symptoms of breast cancer: The practice nurse role. Practice Nursing, 27(8), 377-382.
  10. Waks, A. G., & Winer, E. P. (2019). Breast cancer treatment: a review. Jama, 321(3), 288-300.
  11. Morrow, M. (2004). Physical examination of the breast. Diseases of the Breast, 3rd ed. Philadelphia: Lippincott Williams & Wilkins, 29-32.
  12. What Are the Risk Factors for Breast Cancer? (n.d.). Centers for Disease Control and Prevention. Retrieved September 25, 2020, from https://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm

What is Atherosclerosis and how it can contribute to heart disease?

What is Atherosclerosis and how it can contribute to heart disease?

Atherosclerosis is a chronic inflammatory disease caused by build-up of plaque inside the arteries.1, 2, 3  This disease is a major contributor of cardiovascular diseases (CVDs) and has an increasing prevalence globally each year.2, 3, 4 

The chronic build-up of plaque (fatty deposits) in the artery wall causes blood vessel thickening and arterial stenosis (narrowing of artery wall). The narrowing within the artery channel will result in blood flow restriction, thereby, leading to tissue hypoxia.5, 6, 7, 8

Immune activation was identified in the atherosclerotic plaque where inflammatory cells are attracted within the arterial wall and into the atherosclerotic plaque, hence, promoting the progression of atherosclerotic lesions.2, 6, 7, 8

 

Signs & Symptoms

Atherosclerosis usually does not manifest any signs and symptoms until an artery is severely narrowed or blocked. Many people will only get to know they have the disease when a medical emergency such as a heart attack, unstable angina pectoris or stroke occurs.9, 10

Some individuals may have signs and symptoms of the disease which depends on which arteries are affected.11

 

Risk Factors

Atherosclerosis is a slow and complex disease which may develop in childhood and progress as a person ages.5, 11

Some common factors that cause damage to the inner lining of the arteries which will lead to atherosclerosis to take place are smoking, high blood pressure, being overweight or obese, oxidative stress (reactive oxygen species), high blood cholesterol, high blood glucose levels, family history and lack of physical activities.5, 11, 12, 13

 

Diagnosis

A medical practitioner will diagnose atherosclerosis based on the patient’s medical and family histories, physical examination and test results.5, 14

 

Blood Tests

A blood test is done to measure the levels of certain fats, cholesterol, glucose and proteins (biomarkers) in the blood. Abnormal levels of these parameters may be a sign that a person is at an increased risk of developing atherosclerosis.5, 14

 

Electrocardiogram (ECG)

An ECG is a simple and painless test that detects and records the electrical activity of the heart. The test can detect signs of a previous or current heart attack.5, 14

 

Echocardiography

An echocardiography test shows the size and shape of the heart and how well the heart chambers and valves are functioning. The test can also identify poor blood flow areas of the heart, areas of heart muscles that are not contracting normally and previous injury to heart muscle due to poor blood flow.5, 14

 

Exercise Stress Testing

During a stress test, the patient is required to exercise and make the heart work hard and beat fast while the heart tests are performed. Arteries that are narrowed due to plaque build up do not supply adequate amounts of oxygen-rich blood to the heart, hence, a stress test indicates possible symptoms of a coronary artery disease.5, 14

 

Angiography

An angiography test is done to observe the inside of the arteries by using dye and special x-rays. This test can show whether the arteries are blocked by a plaque and how severe is the blockage.5, 14

 

Computer Tomography (CT) Scan

A CT scan can show if an artery is hardening or narrowing.  The test can also indicate when there is calcium build up in the walls of the coronary arteries which is an early sign of a coronary artery disease.5

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Screening for asymptomatic atherosclerosis is important for an early diagnosis as an efficient strategy to control risk factors and prevent or delay atherosclerosis and its related diseases. It is also crucial to identify patients that require long-term surveillance, medication or surgery.5, 15, 16

At Pantai Premier Pathology, we provide screening tests for Heart Disease. For more information on the tests provided, please contact us at +603-42809115 (Customer Service) or email us at info@premierpathology.com.my.

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References:

  1. Wolf, D., & Ley, K. (2019). Immunity and inflammation in atherosclerosis. Circulation research, 124(2), 315-327.
  2. Gregersen, I., & Halvorsen, B. (2018). Inflammatory Mechanisms in Atherosclerosis [E-book]. In Atherosclerosis. Licensee IntechOpen. https://doi.org/10.5772/intechopen.72222
  3. Taleb, S. (2016). Inflammation in atherosclerosis. Archives of cardiovascular diseases, 109(12), 708-715.
  4. Cardiovascular Diseases (CVDs). (2017, May 17). World Health Organization. https://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
  5. Atherosclerosis. (2017, April 30). American Heart Association. https://www.heart.org/en/health-topics/cholesterol/about-cholesterol/atherosclerosis
  6. Wolf, D., & Ley, K. (2019). Immunity and inflammation in atherosclerosis. Circulation research, 124(2), 315-327.
  7.  Libby, P., Ridker, P. M., & Maseri, A. (2002). Inflammation and atherosclerosis. Circulation, 105(9), 1135-1143.
  8. Tuttolomondo, A., Di Raimondo, D., Pecoraro, R., Arnao, V., Pinto, A., & Licata, G. (2012). Atherosclerosis as an inflammatory disease. Current pharmaceutical design, 18(28), 4266-4288.
  9. Boamponsem, A. G., & Boamponsem, L. K. (2011). The role of inflammation in atherosclerosis. AASRFC. ISSN, 978610, 194-207.
  10. McCurdy, L. E., Winterbottom, K. E., Mehta, S. S., & Roberts, J. R. (2010). Using nature and outdoor activity to improve children’s health. Current problems in pediatric and adolescent health care, 40(5), 102-117.
  11. Atherosclerosis. (n.d.). National Heart, Lung and Blood Institute. Retrieved August 26, 2020, from https://www.nhlbi.nih.gov/health-topics/atherosclerosis
  12. Wang, L., Ai, D., & Zhang, N. (2017). Exercise Benefits Coronary Heart Disease. Advances in experimental medicine and biology, 1000, 3–7. https://doi.org/10.1007/978-981-10-4304-8_1
  13. Crowther, M. A. (2005). Pathogenesis of atherosclerosis. ASH Education Program Book, 2005(1), 436-441.
  14. Seong, A. C., & John, C. K. M. (2016). A review of coronary artery disease research in Malaysia. Med J Malaysia, 71(Supplement 1), 46.
  15. Woo, S. Y., Joh, J. H., Han, S. A., & Park, H. C. (2017). Prevalence and risk factors for atherosclerotic carotid stenosis and plaque: A population-based screening study. Medicine, 96(4), e5999. https://doi.org/10.1097/MD.0000000000005999
  16. Macedo, L. E. T. D. (2017). Cholesterol and prevention of atherosclerotic events: limits of a new frontier. Revista de saude publica, 51, 2.
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