Aquino Valério R, Goldani Luciano Z, Pasqualotto Alesssandro C
Mycology Laboratory, Service of Clinical Pathology, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil.
Mycopathologia. 2007 Apr;163(4):191-202. doi: 10.1007/s11046-007-9010-2. Epub 2007 Apr 5.
The diagnosis of invasive fungal infections (IFI) remains a challenge, particularly for diseases caused by filamentous fungi such as Aspergillus species. Unfortunately, many patients affected by these conditions are not identified before autopsy. Therefore, there is a need for new diagnostic methods for IFI. Galactomannan is a soluble antigen released during hyphal growth in tissues. A commercially available sandwich ELISA assay that detects galactomannan has been used in Europe for many years and is now approved for use in the USA. The test has an excellent negative predictive value in the detection of invasive aspergillosis (IA) in high-risk patients. In addition, it is more sensitive than culture and allows IA to be diagnosed before clinical manifestations occur. However, false-negative and false-positive results in certain populations are the main limitations to its use. The purpose of this review is to summarize the current knowledge about galactomannan testing in patients at risk for IA.
侵袭性真菌感染（IFI）的诊断仍然是一项挑战，尤其是对于由丝状真菌（如曲霉菌种）引起的疾病。不幸的是，许多受这些病症影响的患者在尸检前未被识别。因此，需要新的IFI诊断方法。半乳甘露聚糖是在组织中菌丝生长期间释放的可溶性抗原。一种检测半乳甘露聚糖的市售夹心酶联免疫吸附测定（ELISA）法在欧洲已使用多年，现已在美国获批使用。该检测在高危患者侵袭性曲霉病（IA）检测中具有出色的阴性预测价值。此外，它比培养更敏感，能够在临床表现出现之前诊断IA。然而，某些人群中的假阴性和假阳性结果是其使用的主要局限性。本综述的目的是总结目前关于IA高危患者半乳甘露聚糖检测的知识。
