Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, PR China; Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, PR China.
Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, PR China; Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, PR China.
Am J Otolaryngol. 2021 Mar-Apr;42(2):102871. doi: 10.1016/j.amjoto.2020.102871. Epub 2020 Dec 29.
The purpose of the present study was to investigate the values of the serum (1,3)-β-D-glucan test (G test) alone, the galactomannan test (GM test) alone, and their combination in the diagnosis of invasive fungal rhinosinusitis (IFRS).
The present study retrospectively analysed the clinical data of 98 patients who were preliminarily diagnosed with "space-occupying lesions in nose". Of these 98 patients, 88 received the G test, 55 received the GM test, and 45 received both. A pathology analysis was used as the gold standard to diagnose IFRS. All data were analysed using SPSS 19.0.
The sensitivities (Se) of the G and GM tests alone were 60.0% and 28.6%, respectively, whereas the specificities (Sp) were 92.3% and 93.8%, respectively. Moreover, the positive predictive values (PPV) of the G and GM tests alone were 50.0% and 40.0%, respectively, and the negative predictive values (NPV) were 94.7% and 90.0%, respectively. In addition, the diagnostic odds ratios (DOR) were 18.0 and 6.0, respectively, and the Kappa values were 0.48 (P < 0.05) and 0.25 (P > 0.05), respectively. When the G and GM tests were parallel combined, the Se was 66.7%, the Sp was 92.3%, the PPV was 57.1%, the NPV was 94.7%, the DOR was 24.0, and the Kappa value was 0.55 (P < 0.05). The present study was unable to evaluate the serial diagnosis due to the lack of patients testing positive.
The G/GM tests exhibited low Se and PPV when used to diagnose IFRS, while high Sp and NPV. Parallel diagnosis improved the diagnostic Se and DOR values.
本研究旨在探讨血清（1,3）-β-D-葡聚糖试验（G 试验）、半乳甘露聚糖试验（GM 试验）单独及联合检测在侵袭性真菌性鼻-鼻窦炎（IFRS）诊断中的价值。
本研究回顾性分析了 98 例初步诊断为“鼻内占位性病变”患者的临床资料。其中 88 例行 G 试验，55 例行 GM 试验，45 例行两项联合检测。以病理分析为金标准诊断 IFRS。所有数据均采用 SPSS 19.0 进行分析。
G 试验和 GM 试验单独检测的灵敏度（Se）分别为 60.0%和 28.6%，特异度（Sp）分别为 92.3%和 93.8%。此外，G 试验和 GM 试验单独检测的阳性预测值（PPV）分别为 50.0%和 40.0%，阴性预测值（NPV）分别为 94.7%和 90.0%。诊断优势比（DOR）分别为 18.0 和 6.0，Kappa 值分别为 0.48（P<0.05）和 0.25（P>0.05）。当 G 试验和 GM 试验平行联合检测时，Se 为 66.7%，Sp 为 92.3%，PPV 为 57.1%，NPV 为 94.7%，DOR 为 24.0，Kappa 值为 0.55（P<0.05）。由于阳性病例数不足，本研究无法评估串联诊断。
G/GM 试验单独用于诊断 IFRS 时，Se 和 PPV 较低，而 Sp 和 NPV 较高。平行诊断可提高诊断 Se 和 DOR 值。
