[Application of detecting bronchoalveolar lavage fluid Aspergillus galactomannan antigen in the diagnosis of pulmonary aspergillosis].

OBJECTIVE

To prospectively evaluate the utility of detecting bronchoalveolar lavage fluid (BALF) Aspergillus galactomannan antigen (GM) in the diagnosis of pulmonary aspergillosis.

METHODS

From August 2008 to April 2012, 121 patients suspected of pulmonary aspergillosis were recruited and classified into pulmonary aspergillosis group (n = 57) and non-pulmonary disease group (n = 64) according to the 2008 diagnostic criteria and classification of European Organization for Research and Treatment of Cancer/National Institute of Mycoses Study Group(EORTC/MSG). The absorbency (A) and I value of GM in the patients' serum and BALF were detected by enzyme-linked immunosorbent assay (ELISA). And their values were compared and analyzed.

RESULTS

Twenty cases were confirmed by pathological examinations and 37 cases by clinical diagnosis in the pulmonary aspergillosis group. The mean rank of GM's I value in the serum and BALF samples was 88.21 and 86.49. And they significantly increased compared with the non-pulmonary aspergillosis group (36.77, 38.30) (P < 0.01). At a different serum GM threshold I = 0.5, 0.8, 1.0, the sensitivities were 0.842, 0.649 and 0.228; the specificities 0.906, 0.938, 0.929; the positive predictive values 0.889, 0.902, 0.984 and the negative predictive values 0.866, 0.750, 0.589 respectively. And at a different BALF GM threshold I = 0.5, 0.8, 1.0, the sensitivities were 0.930, 0.657, 0.561; the specificities 0.766, 0.922, 0.969; the positive predictive values 0.779, 0.884, 0.941 and the negative predictive values 0.925, 0.756, 0.713 respectively.

CONCLUSION

The detection of GM in BALF may be employed for the clinical diagnosis of pulmonary aspergillosis.