Background

Several studies to evaluate the accuracy of galactomannan (GM) in bronchoalveolar lavage fluid (BALF) as a diagnostic tool have been carried out; however, there are still controversies about the optimal cut-off point of BALF GM.

Aims

The objective of this study was to determine the diagnostic accuracy and the optimal cut-off point on BALF GM from patients with suspected invasive pulmonary aspergillosis (IPA) in a tertiary care hospital.

Methods

A cross-sectional study with 188 patients (≥18 years) that had undergone a bronchoscopy with BAL due to suspected IPA was carried out. IPA was diagnosed according to the EORTC/MSG guidelines.

Results

The optimal optical density cut-off point for BALF GM was 0.67, with sensitivity, specificity, positive predictive value, and negative predictive value of 100%, 70%, 32.3%, and 100%, respectively.

Conclusions

BALF GM detection proved to be a useful supplementary technique in the early diagnosis of IPA in both neutropenic and non-neutropenic patients.

中文翻译：

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疑似侵袭性肺曲霉病患者支气管肺泡灌洗液中半乳甘露聚糖的诊断准确性评估

背景

已经进行了几项研究来评估支气管肺泡灌洗液 (BALF) 中半乳甘露聚糖 (GM) 作为诊断工具的准确性；但是，关于 BALF GM 的最佳截止点仍然存在争议。

目标

本研究的目的是确定三级医院疑似侵袭性肺曲霉病 (IPA) 患者对 BALF GM 的诊断准确性和最佳截止点。

方法

对 188 名患者（≥18 岁）进行了一项横断面研究，这些患者因疑似 IPA 而接受了 BAL 支气管镜检查。根据 EORTC/MSG 指南诊断 IPA。

结果

BALF GM 的最佳光密度截止点为 0.67，敏感性、特异性、阳性预测值和阴性预测值分别为 100%、70%、32.3% 和 100%。

结论

BALF GM 检测被证明是早期诊断中性粒细胞减少症和非中性粒细胞减少症患者 IPA 的有用补充技术。