Diagnostic value of galactomannan in bronchoalveolar lavage fluid for chronic respiratory disease with pulmonary aspergillosis

Abstract

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

Physicians' knowledge of invasive fungal disease in China

“…23 Meanwhile, nearly half of the physicians were not aware that the serum GM test was more sensitive than the BALF-GM test at detecting IA in patients with agranulocytosis. 24 In addition to the above, less than half of the physicians were aware of the risk factors of IM among patients with persistent fever and suspicious signs on CT, the role of CT in IM diagnosis, and the recommended first-line treatment options for IM. This low awareness may be related to physicians having only limited experience in the diagnosis and treatment of IM due to the low incidence of this disease.…”