Cao Guo-Jun, Xing Zhi-Fang, Hua Li, Ji Yu-Hua, Sun Jia-Bin, Zhao Zhen
Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China.
Department of Blood Transfusion, Minhang Hospital, Fudan University, Shanghai 201199, P.R. China.
Exp Ther Med. 2017 Nov;14(5):4208-4214. doi: 10.3892/etm.2017.5081. Epub 2017 Aug 31.
Timely diagnosis of invasive fungal diseases (IFDs) is important, as delays in treatment initiation are associated with increased mortality rates. However, early diagnosis of IFDs in immunocompromised patients remains difficult. The conventional diagnostic methods currently used for IFDs are not sufficiently effective. Molecular tests, such as polymerase chain reaction (PCR)-based assays, have great potential to improve the early diagnosis of IFDs due to their sensitivity and specificity. In the present study, the diagnostic performance of panfungal PCR assays in IFD patients who received bone marrow transplantation was evaluated. The results suggested that panfungal PCR assay offered a quick and convenient guide for clinical decision-making by identifying higher numbers of fungal species in comparison with the conventional blood culture method. Furthermore, panfungal PCR assay exhibited a sensitivity of 93% and a specificity of 71% in the diagnosis of IFD patients based on the EORTC/MSG criteria. Thus, the present study concluded that the reported PCR-based method was effective and sensitive in early IFD diagnosis and should be integrated into clinical decision-making for the treatment of IFDs in the future.
侵袭性真菌病(IFDs)的及时诊断很重要,因为治疗开始的延迟与死亡率增加有关。然而,免疫功能低下患者中IFDs的早期诊断仍然困难。目前用于IFDs的传统诊断方法不够有效。分子检测,如基于聚合酶链反应(PCR)的检测方法,因其敏感性和特异性,在改善IFDs早期诊断方面具有巨大潜力。在本研究中,评估了泛真菌PCR检测在接受骨髓移植的IFD患者中的诊断性能。结果表明,与传统血培养方法相比,泛真菌PCR检测通过识别更多种类的真菌,为临床决策提供了快速便捷的指导。此外,根据欧洲癌症研究与治疗组织/美国国立医学图书馆(EORTC/MSG)标准,泛真菌PCR检测在IFD患者诊断中表现出93%的敏感性和71%的特异性。因此,本研究得出结论,所报道的基于PCR的方法在IFD早期诊断中有效且敏感,未来应纳入IFDs治疗的临床决策中。