| Objective:At present, the main means on the preoperative diagnosis of fungal sinusitis rely on CT image data, it,s not difficult to diagnose the fungal sinusitis with typical imaging features. As it,s difficult to diagnose the patients in early fungal sinusitis and lack of typical imaging features before operation. Therefore, searching for a better fungal sinusitis preoperative diagnosis method is very necessary. The purpose of this research is to make fungal sinusitis patients and chronic bacterial sinusitis patients as the experimental object, Clear(1,3)-β-D-glucan and galactomannan antigen detection in the value of the preoperative diagnosis of fungal sinusitis by analysing the sensitivity and specificity, positive and negative, predictive values of fungal sinusitis diagnosis through detecting(1,3)-β-D glucan and galactomannan antigen Methods : Choose the inpatients cases were in Ya’an People’s Hospital,Otolaryngology Head and neck surgery department from July 2013 to December 2014.Collect 67 cases that conformed to the standards according to the inclusion and exlusion criteria. Collected the blood samples for the suspected fungal sinusitis patients according to the symptoms, signs, nasal endoscopy, imaging diagnosis(patients signed the informed consent) and recorded operation data in details.sent the newborn lesion of the focus or secretions in nasal sinus to pathologic detection in operation.the pathological examination of newborn focus is conducted by HE staining of paraffin section; Sand like or purulent secretion stained by smear HE. At the same time, conducted the Gomori,s methenamine silver stain for the sinus mucosa affected nasal sinus.make the postoperative pathological results as golden standard,Brought the cases were found with fungal infection evidence into the experimental group and brought the cases were found without fungal infection into the control group after pathologic detection.(2)Detected(1,3)-β-D-glucan concentration in plasma of subjective patients by using the dynamic turbidimetric method.( 3) Detected galactomannan antigen concentration in serum of subjective patients by using ELISA method(GM test), Analysed sensitivity and specificity, positive and negative predictive values in the two groups.RESULTS:(1)By HE staining and GMS staining,Made the 31 cases with evidence of fungal infection found in pathologic detection as experimental group which male 11 cases, female 20 cases, average age is 54.71 years old; Made the 36 cases without evidence of fungal infection in pathologic detection as control group which male 12 cases, female 24 cases, average age is 47.85 years old. The pathological slices of the 31 cases in pathological group are all showed aspergillus infection, and 4 cases among it whose GMS slice resulted in positive;(2)There is statistical significance in the diagnostic difference of experimental group and the control group by G test and GM test.(χ2=24.901,P<0.001; χ2=4.85,P<0.05);(3)G sensitivity test. was 74%, the specificity was 86%, the positive predictive value was 82%, the negative predictive value was 79%, the diagnostic coincidence degree was 0.81;(4)GM test sensitivity was 29%, specificity was 90%, the positive predictive value was 75%, the negative predictive value was 60%, the diagnostic coincidence degree is 0.63;(5)Among 31 cases in the experimental group, there were 7 cases can be diagnosed with fungal sinusitis both in G experiment and GM experiment, 4 cases among the 7 cases were positive in GMS.,the 4 cases showed positive result by both G test and GM test.Conclusion:(1) There is a reliable value for preoperative diagnosis of fungal sinusitis by G test and GM test, G test and GM test can be used effectively diagnosed for fungal sinusitis early, rapidly and accurately.(2)The ability of G test to diagnose fungal sinusitis is stronger than that of GM test.(3)The specificity is rather high by comparing GM test and G test, we speculated that it’s prone to happen positive result in invasive fungal sinusitis by GMS staining in GM test. |
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