Early diagnostic value of galactomannan test to invasive pulmonary aspergillosis in patients with non- neutropenia / 中华检验医学杂志

ABSTRACT

Objective To evaluate the early diagnostic value of galactomannan ( GM ) test in bronchoalveolar lavage fluid ( BALF ) to invasive pulmonary aspergillosis ( IPA ) in patients with non-neutropenia.Methods A total of 199 patients with suspected IPA were enrolled in the Department of Critical Care Medicine and Respiration of the Union Hospital of Fujian Medical University from January 2016 to October 2017, these patients excluded neutropenia .The patients were divided into IPA group and non-IPA group according to the European Organization for Research and Treatment of Cancer /Infectious Diseases Mycoses Study Group ( EORTC/MSG ) consensus.BALF and serum GM tests were performed in both groups.SPSS 20.0 statistical software was used to analyze the results of both IPA group and non-IPA group.Results The GM index in BALF and serum of IPA group was 2.41 ±2.19 and 0.65 ±1.08 respectively.The former is higher than the latter , the difference was statistically significant ( u=8.27,P<0.0005 ) . The GM index in BALF and serum of non-IPA group was 0.37 ±0.33 and 0.2 ±0.15 respectively, compared with the IPA group, the difference were statistically significant (u=11.18 and 7.07, P<0.0005).When the cut-off of GM was equal or greater than 0.5, the sensitivity, positive predictive value and negative predictive value of GM test in BALF was 86.36％, 74.02％and 92.62％ respectively , were significantly higher than those in serum (31.8％, 67.74％and 73.21％respectively).The specificity of GM test in BALF was 84.96％, which was lower than that in serum (92.48％).When the cut-off of GM was equal or greater than 1.0, the sensitivity, positive predictive value and negative predictive value of GM test in BALF was 66.66％, 84.61％and 85.03％ respectively, significantly higher than those in serum ( 24.24％, 76.19％and 71.9％ respectively ) . The specificity was similar ( 95.98％vs 96.24％) . Conclusions GM test in BALF has a highly sensitivity and specificity in patients with non-neutropenia, better than that in serum.It has high value for early diagnosis of IPA.