Chang Suk Won, Nam Jae Sung, Ha Jong-Gyun, Kim Na Won, Almarzouq Wasan F, Kim Chang-Hoon, Yoon Joo-Heon, Cho Hyung-Ju
Department of Otorhinolaryngology, Jeju National University College of Medicine, Jeju, Korea.
Department of Otorhinolaryngology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemoon-gu, Seoul, 03722, Korea.
Eur Arch Otorhinolaryngol. 2022 Feb;279(2):793-800. doi: 10.1007/s00405-021-06857-8. Epub 2021 May 6.
The serum galactomannan test has been used for diagnosing acute invasive fungal sinusitis (AIFS), especially invasive Aspergillus. We aimed to assess the accuracy of the test to diagnose acute invasive Aspergillus sinusitis (AIAS).
We searched all relevant articles published in PubMed, Embase, the Cochrane Library, and Web of Science databases up until September 14, 2020. The available data for serum galactomannan test to diagnose AIAS from selected studies were assessed. The diagnostic odds ratio (DOR), summary receiver operating characteristics (SROC), sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were estimated. Additionally, we analysed four studies with a cut-off value of 0.5.
Five eligible articles were selected in this study. The total number of enrolled patients was 118, and 62 patients had confirmed AIAS. Among these 62 patients, the summary estimates of the serum galactomannan assay were as follows: DOR, 3.37 (95% confidence interval [CI]: 1.47-6.66); sensitivity, 0.63 (95% CI 0.50-0.74); specificity, 0.65 (95% CI 0.51-0.76); PLR, 1.83 (95% CI 1.21-2.74); NLR, 0.58 (95% CI 0.39-0.83). The SROC was 0.68.
In this current meta-analysis, the serum galactomannan test was classified as less accurate for purposes of diagnosing confirmed AIAS. These results suggest that the initial diagnosis of AIAS should not solely be dependent upon serum galactomannan test results. More studies of the test are needed in patients with AIAS to more accurately assess its diagnostic value.
血清半乳甘露聚糖检测已用于诊断急性侵袭性真菌性鼻窦炎（AIFS），尤其是侵袭性曲霉菌感染。我们旨在评估该检测诊断急性侵袭性曲霉菌性鼻窦炎（AIAS）的准确性。
我们检索了截至2020年9月14日在PubMed、Embase、Cochrane图书馆和科学网数据库中发表的所有相关文章。对所选研究中血清半乳甘露聚糖检测诊断AIAS的可用数据进行了评估。估计了诊断比值比（DOR）、汇总受试者工作特征（SROC）、敏感性、特异性、阳性似然比（PLR）和阴性似然比（NLR）。此外，我们分析了四项截断值为0.5的研究。
本研究选取了五篇符合条件的文章。纳入患者总数为118例，其中62例确诊为AIAS。在这62例患者中，血清半乳甘露聚糖检测的汇总估计值如下：DOR为3.37（95%置信区间[CI]：1.47 - 6.66）；敏感性为0.63（95%CI 0.50 - 0.74）；特异性为0.65（95%CI 0.51 - 0.76）；PLR为1.83（95%CI 1.21 - 2.74）；NLR为0.58（95%CI 0.39 - 0.83）。SROC为0.68。
在本次荟萃分析中，血清半乳甘露聚糖检测在诊断确诊的AIAS方面准确性较低。这些结果表明，AIAS的初始诊断不应仅依赖于血清半乳甘露聚糖检测结果。需要对AIAS患者进行更多该检测的研究，以更准确地评估其诊断价值。
