Diagnostic Value Of Gm Test Of Bronchoalveolar Lavage Fluid For Invasive Pulmonary Aspergillosis

Research BackgroundInvasive pulmonary aspergillosis is an infectious disease caused by the growth of Aspergillus mycelium invading the lung parenchyma.Galactomannans are a class of highly specific and highly conserved polysaccharides present in the cell wall of Aspergillus.As a specific molecular marker for Aspergillus detection,the enzyme-linked immunosorbent assay is a more common galactomannan detection method.At present,there are multiple clinical serological GM tests for detection.Serological GM tests are used for rapid diagnosis of invasive fungal infections It is of great value to guide medication and evaluate the efficacy,but the false positive rate and false negative rate are higher.After reviewing multiple literatures,it was found that there is no significant difference in the sensitivity,specificity and diagnostic coincidence rate between the two diagnostic methods of serum and BALF GM test.Even the sensitivity,specificity and diagnostic coincidence rate of BALF GM test are significantly higher than that of serum.The author retrospectively analyzed the clinical data of 46 patients with suspected invasive pulmonary aspergillosis in our hospital,and explored the diagnostic value of bronchial alveolar lavage fluid GM test for invasive pulmonary aspergillosis.ObjectiveTo investigate the diagnostic value of bronchoalveolar lavage fluid galactomannan test for invasive pulmonary aspergillosis.MethodsThe clinical data of 46 patients with suspected invasive pulmonary aspergillosis(IPA)admitted in our hospital were retrospectively analyzed,including 12 cases in the diagnosis group,25 cases in the clinical diagnosis group,and 9 cases in the proposed diagnosis group.Cases specifically excluded patients with IPA as a control group.The clinical diagnosis and clinical diagnosis were regarded as the gold standard positive,and the exclusion was regarded as the gold standard negative.The GM value in the GM test ? the proposed GM threshold was positive for the diagnostic test,and the receiver operating characteristic(ROC)curve was drawn.To understand the diagnostic efficiency of the Bronchoalveolar lavage fluid(BALF)GM test for IPA at different thresholds,and to determine the best diagnosis point of BALF GM in this study with the Yoden index.ResultsBased on the BALF GM results,a ROC curve was made.The area under the curve was 0.829.When the BALF GM value was 0.6 ng/m L,this was used as the most diagnostic point,with a sensitivity of 81% and a specificity of 85%.The serum GM threshold was 0.5ng / m L as the critical value,and the BALF GM threshold was 0.6ng / m L as the critical value.The positive rate was calculated,and the positive rate of the BALF GM test(83.33%,80.00 %,88.89%)are greater than the positive rate of serum GM test(25.00%,28.00%,22.22%).ConclusionThe GM test of bronchoalveolar lavage fluid has important diagnostic value for patients with suspected invasive pulmonary aspergillosis,and can provide early diagnosis basis for IPA patients.