（1,3）-β-D-葡聚糖、甘露聚糖、抗甘露聚糖 IgG 和 IgM 抗体在侵袭性念珠菌病诊断中的临床价值。
Clinical value of (1,3)-β-D-glucan, mannan, antimannan IgG and IgM antibodies in diagnosis of invasive candidiasis.
机构信息
Center for Clinical Laboratory Medicine, PLA General Hospital, Beijing, China.
School of Life Science, Nankai University, Tianjin, China.
出版信息
Med Mycol. 2019 Nov 1;57(8):976-986. doi: 10.1093/mmy/myy158.
Diagnosis of invasive candidiasis (IC) is still challenging due to absence of specific clinical signs and symptoms. In this study we investigate the clinical value of (1,3)-β-D-glucan (BDG), mannan (MN), antimannan immunoglobulin G (AM-IgG), and antimannan immunoglobulin M (AM-IgM) assay in diagnosis of IC. During 2016 to 2018 serum samples from 71 patients with IC and 185 patients without IC were collected. Serum samples from 41 patients with bacteremia were also enrolled as additional control. Significant differences in mean serum biomarkers levels between IC and control group were observed. At low cutoff threshold the sensitivity and specificity of BDG (70 pg/ml), MN (50 pg/ml), AM-IgG (80 AU/ml), and AM-IgM (80 AU/ml) assay were 64.8% and 90.8%, 64.8 and 89.2%,74.6% and 87.0%, 57.7% and 60.0%, respectively. Combined use of BDG/MN, BDG/AM-IgG and MN/AM-IgG improved the sensitivity and specificity to 85.9% and 81.1%, 85.9% and 80.0%, 81.7% and 81.6%, respectively. The combination of BDG/MN, BDG/AM-IgG, or MN/AM-IgG may provide an encouraging approach for diagnosis of IC.
由于缺乏特定的临床体征和症状，侵袭性念珠菌病 (IC) 的诊断仍然具有挑战性。在这项研究中，我们研究了 (1,3)-β-D-葡聚糖 (BDG)、甘露聚糖 (MN)、抗甘露聚糖 IgG (AM-IgG) 和抗甘露聚糖 IgM (AM-IgM) 检测在 IC 诊断中的临床价值。在 2016 年至 2018 年期间，收集了 71 例 IC 患者和 185 例非 IC 患者的血清样本。还纳入了 41 例菌血症患者的血清样本作为额外对照。观察到 IC 组和对照组之间平均血清生物标志物水平存在显著差异。在低截断阈值下，BDG(70 pg/ml)、MN(50 pg/ml)、AM-IgG(80 AU/ml)和 AM-IgM(80 AU/ml)检测的敏感性和特异性分别为 64.8%和 90.8%、64.8%和 89.2%、74.6%和 87.0%、57.7%和 60.0%。BDG/MN、BDG/AM-IgG 和 MN/AM-IgG 的联合使用将敏感性和特异性提高到 85.9%和 81.1%、85.9%和 80.0%、81.7%和 81.6%。BDG/MN、BDG/AM-IgG 或 MN/AM-IgG 的联合使用可能为 IC 的诊断提供一种有希望的方法。
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