Department of Microbiology, McGill University Health Center, Montreal, Quebec, Canada.
Diagn Microbiol Infect Dis. 2010 Oct;68(2):132-9. doi: 10.1016/j.diagmicrobio.2010.03.017.
We conducted a single-center retrospective cohort study to determine the performance characteristics of the galactomannan (GM) assay in bronchoalveolar lavage (BAL) in patients with hematologic malignancies. Patients were classified as proven, probable, possible, or no invasive pulmonary aspergillosis (IPA), according to international guidelines. A total of 173 BAL samples from 145 patients were included. There were 5 proven, 7 probable, and 35 possible cases of IPA. Using a GM index cutoff of ≥ 0.5, the sensitivity, specificity, and positive and negative predictive values (PPV and NPV, respectively) of the BAL GM assay were 100%, 78%, 26%, and 100%, respectively. Using a GM index cutoff of ≥ 2.0, the sensitivity and NPV remained 100%, but specificity and PPV increased to 93% and 50%, respectively. The BAL GM assay is a highly sensitive screening test for IPA in patients with hematologic malignancies. Increasing the cutoff value to 2.0 would improve the performance of this assay.
我们进行了一项单中心回顾性队列研究，以确定半乳甘露聚糖（GM）检测在血液恶性肿瘤患者支气管肺泡灌洗液（BAL）中的表现特征。根据国际指南，患者被分为确诊、可能、疑似或无侵袭性肺曲霉病（IPA）。共纳入 145 例患者的 173 份 BAL 样本。其中 5 例为确诊 IPA，7 例为可能 IPA，35 例为疑似 IPA。使用 GM 指数截断值≥0.5，BAL GM 检测的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为 100%、78%、26%和 100%。使用 GM 指数截断值≥2.0，敏感性和 NPV 仍保持 100%，但特异性和 PPV 分别提高至 93%和 50%。BAL GM 检测是血液恶性肿瘤患者 IPA 的一种高度敏感的筛查试验。将截断值提高到 2.0 可以提高该检测的性能。
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