Diagnostic value of BALF-GM combined with Aspergillus IgG and IgM in chronic pulmonary aspergillosis

Abstract

Objective To investigate the diagnostic value of bronchoalveolar lavage fluid-galactomannan （BALF-GM） in alveolar lavage fluid combined with Aspergillus IgG and IgM in chronic pulmonary aspergillosis （CPA）. Methods 88 patients with CPA were assigned into the study group, and 64 patients suspected with CPA who were excluded after diagnosis were divided into the control group. The levels of BALF-GM, Aspergillus IgG and IgM in all patients were analyzed retrospectively. The diagnostic value of BALF-GM, Aspergillus IgG, IgM and combined detection in CPA was analyzed by the receiver operating characteristic （ROC） curve. Results The diagnostic value of BALF-GM in CPA was higher, whereas that of Aspergillus IgG, IgM and combined detection was lower. The sensitivity of BALF-GM combined with Aspergillus IgG/IgM was significantly improved, but the specificity was decreased. The contents of BALF-GM, Aspergillus IgG and IgM in the study group were significantly higher than those in the control group （all P < 0.05）. The positive rates of BALF-GM, Aspergillus IgG, IgM and combined detection significantly differed between two groups （all P <0.05）. ROC curve analysis indicated that BALF-GM, BALF-GM+Aspergillus IgG/IgM yielded higher area under ROC curve （AUC）, sensitivity and specificity in the diagnosis of CPA. The diagnostic value of Aspergillus IgG, IgM and IgG/IgM combined detection was lower. Conclusions BALF-GM has high sensitivity and specificity in the diagnosis of CPA. BALF-GM combined with Aspergillus IgG/IgM can improve the diagnostic sensitivity, whereas significantly decrease the specificity. Therefore, it is necessary to integrate the high specificity of BALF-GM alone to minimize the incidence of false negative results.

Keywords

• |bronchoalveolar lavage fluid-galactomannan|aspergillus igg|aspergillus igm|chronic pulmonary aspergillosis|diagnosis