Talbot G H, Weiner M H, Gerson S L, Provencher M, Hurwitz S
J Infect Dis. 1987 Jan;155(1):12-27. doi: 10.1093/infdis/155.1.12.
Six hundred sixteen sera from 79 hematology patients admitted on 152 occasions were analyzed for validation of the Aspergillus fumigatus antigen radioimmunoassay (RIA). Invasive aspergillosis developed on 24 admissions of 22 patients. Maximal antigenic activity was significantly higher in patients with invasive aspergillosis than in controls (P less than .0005). At the level of antigenic activity selected as the cutoff value, the sensitivity of the RIA was 74%, the specificity 90%, the positive predictive value 82%, and the negative predictive value 85%. Antigen was detected before invasive aspergillosis was suspected during 30% of admissions and before pathological or even preliminary microbiological evidence for disease in 46%. In 17 (77%) of the 22 episodes of pulmonary aspergillosis, the RIA would have been the first positive diagnostic test for aspergillosis or would have confirmed a diagnosis established by other means. Overall, the test would have been of clinical usefulness in diagnosis, management, and prognosis in 80% of 16 fatal cases.
对79例血液学患者在152次住院期间采集的616份血清进行分析，以验证烟曲霉抗原放射免疫测定法（RIA）。22例患者中有24次住院发生了侵袭性曲霉病。侵袭性曲霉病患者的最大抗原活性显著高于对照组（P<0.0005）。在选定为临界值的抗原活性水平上，RIA的敏感性为74%，特异性为90%，阳性预测值为82%，阴性预测值为85%。在30%的住院期间，在怀疑侵袭性曲霉病之前就检测到了抗原，在46%的病例中，在出现疾病的病理甚至初步微生物学证据之前就检测到了抗原。在22例肺曲霉病发作中的17例（77%）中，RIA本可以是曲霉病的首个阳性诊断试验，或者本可以证实通过其他方法确立的诊断。总体而言，在16例致命病例中的80%中，该检测在诊断、管理和预后方面本可以具有临床实用性。
