Exploration of bronchoalveolar lavage fluid GM test standardized by internal reference in the diagnosis of invasive pulmonary aspergillosis

Abstract

Abstract:

Objective To to choose and standardizeinternal reference of bronchoalveolar lavage fluid galactomannan detection(BALF GM test), and to investigatewhether the BALF GM test after standardizing could improve the clinical diagnostic efficiency for invasive pulmonary aspergillosis(IPA). Methods A total of 156 BALF specimens were collected from The First Affiliated Hospital of Chongqing Medical University from May 2018 to January 2019. All samples were performed GM test and the levels of potassium, urea and albumin were measured. According to histopathology, microbiological results, clinical symptoms and characteristics, host factors and other data, all patients were divided into two groups:IPA group(39 cases) and non-IPA group(117 cases).The clinical diagnostic efficiencies of standardized and non-standardized BALF GM tests for IPAwere compared. Results The I values of the standardized and non-standardized BALF GM tests were both significantly different between two groups(P<0.001).The ROC curves showed that the cut-off value of the non-standardized BALF GM test was 0.69, the area under the curve was 0.731(P<0.001), the sensitivity was 71.8%, and the specificity was 70.1%. After standardizing by K⁺, UREA, and ALB, the cut-off values were 0.605, 1.905, 0.69, and the areas under the curve were 0.71, 0.653,0.701, respectively(P<0.001, 0.004, 0.002, respectively).The sensitivities were 74.4%, 66.7%, 69.2%,and the specificities were 70.9%, 63.2%, 69.8%, respectively. Conclusion With the cut-off value of 0.69,the non-standardized BALF GM test hadthe best diagnostic efficiency for IPA. The diagnostic efficiency of the BALF GM test after standardizing by K⁺ for IPA wasbetter than the non-standardized BALF GM test(P<0.001).

Key words: invasive pulmonary aspergillosis, GM test, bronchoalveolar lavage fluid, cut-off value, internal reference

CLC Number:

R519.8

QIU Ju, CHEN Qian, HUANG Lin, XIA Ji-rong. Exploration of bronchoalveolar lavage fluid GM test standardized by internal reference in the diagnosis of invasive pulmonary aspergillosis[J]. Chinese Journal of Mycology, 2019, 14(5): 280-283.

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