The objective of this study was to explore the diagnostic value of the bronchoalveolar lavage fluid galactomannan (BALF GM) test for chronic respiratory disease with pulmonary aspergillosis and to establish the optimal cutoff value. Samples from a total of 309 chronic respiratory disease patients seen at the respiratory medicine department of Peking University Shenzhen Hospital from September 2016 to September 2019 were analyzed. According to the diagnostic criteria, we divided the patients into a case group (n = 79, comprising 25 proven cases and 54 probable cases) and a control group (n = 230). Bronchoalveolar lavage fluid was collected, and the BALF GM test results were analyzed. A nonparametric rank sum test showed that the mean rank of the case group was 255.30, which was higher than that of the control group (120.55). The Z-value was −11.567 (P = 0.000), indicating that the general distributions of BALF GM differed between the two groups. A BALF GM cutoff value of 0.88 showed the highest diagnostic efficacy for pulmonary aspergillosis. The sensitivity, specificity, positive predictive value, and negative predictive value were 77.2%, 93%, 79.2%, and 92.2%, respectively. As the cutoff value increased, the specificity and sensitivity of the BALF GM test increased and decreased, respectively. The BALF GM test can be used confirm the diagnosis of patients with pulmonary aspergillosis and chronic respiratory disease. The optimum BALF GM cutoff value is 0.88.
12Objective To explore the diagnostic value of the bronchoalveolar lavage fluid galactomannan (BALF GM) test for 13 chronic respiratory disease with pulmonary aspergillosis, and establish the optimal cut-off value. 14 Methods A total of 180 chronic respiratory disease patients seen at the Respiratory Medicine Department of Peking 15 University Shenzhen Hospital from September 2017 to September 2018 were analyzed. According to the diagnostic 16 criteria, we divided the patients into the case group (n = 70, comprising 5, 20, and 45 proven, probable, and 17 possible cases, respectively) and the control group (n = 110). Bronchoalveolar lavage fluid was collected, and the 18BALF GM test results were analyzed. Results A non-parametric rank-sum test showed that the mean rank of the 19 case group was 140.80, which was higher than that of the control group (58.49). The Z-value was 10.335 20 (P = 0.000), indicating that the general distribution of BALF GM differed between the two groups. A BALF GM 21 cut-off value of 0.485 showed the highest diagnostic efficacy for pulmonary aspergillosis. The sensitivity, 22 specificity, positive predictive value, and negative predictive value were 92.9%, 100%, 92.8%, and 100%, 23 respectively. As the cut-off value increased, the specificity and sensitivity of the BALF GM test increased and 24 decreased, respectively. 25
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