Detecting galactomannan in bronchoalveolar lavage fluid for diagnosing invasive pulmonary aspergillosis: a meta-analysis

Abstract

Abstract:

Objective To evaluate the diagnostic accuracy of bronchoalveolar lavage fluid (BALF) galactomannan (GM) for invasive pulmonary aspergillosis (IPA) and determine the optimal cut-off value by meta-analysis. Methods The Pubmed, EMBASE, OVID, Cochrane Library, CNKI(China National Knowledge Infrastructure),WANFANG,CBM(China Biology Medicine) databases were searched for relevant studies published in all languages up until October 31, 2018. Twenty-six studies (71 sets of data) meeting the criteria were included in this meta-analysis, conducted quality evaluation and heterogeneity analysis. Then, the pooled indicators of each diagnostic cut-off value, drew the receiver operating characteristic (ROC) curve were analyzed and calculated, and finally the optimal diagnostic cut-off was determined. Results The summary estimates of pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of the BALF-GM (cut-off value 0.5) for the diagnosis of IPA (proven and probable IPA) were 0.87 (95% CI 0.84-0.89), 0.79 (95% CI 0.77-0.81), 4.60 (95% CI 3.49-6.05), 0.19 (95% CI 0.14-0.25), 38.84 (95% CI 22.99-52.81).The area under the curve (AUC) of the summary receiver operating characteristics (SROC) was 0.92 (95% CI 0.90-0.95). When the BALF-GM diagnostic cutoff value in 1.0, the area under curve(AUC) of the summary receiver operating characteristic (SROC) was a maximum of 0.94 (95% CI 0.93-0.97). Conclusions BALF GM was easy to detect and had high diagnostic accuracy for IPA. It could be used for diagnosis of IPA early, so as to implement early treatment and reduce mortality. At present, the recommended diagnostic cut-off was 1.0.

Key words: bronchoalveolar lavage fluid, galactomannan, invasive pulmonary aspergillosis, cut-off value

CLC Number:

R379.6

CAI Kai-xia, ZHOU Jing, CAO Wei, WANG Sheng-yu. Detecting galactomannan in bronchoalveolar lavage fluid for diagnosing invasive pulmonary aspergillosis: a meta-analysis[J]. Chinese Journal of Mycology, 2019, 14(5): 284-291.

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