scholarly journals The role of pentraxin3 in plasma and bronchoalveolar lavage fluid in COPD patients with invasive pulmonary aspergillosis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qian He ◽  
Ming Zhang ◽  
Chunlai Feng
Keyword(s):  
Bronchoalveolar Lavage ◽  
Bronchoalveolar Lavage Fluid ◽  
False Positive Rate ◽  
Invasive Pulmonary Aspergillosis ◽  
Lavage Fluid ◽  
Diagnostic Value ◽  
Control Group ◽  
Chronic Obstructive ◽  
Pulmonary Aspergillosis ◽  
Copd Patients

Abstract Background The use of galactomannan (GM) testing in plasma and bronchoalveolar lavage fluid (BALF) has improved the diagnosis of invasive pulmonary aspergillosis (IPA) in patients with chronic obstructive pulmonary disease (COPD); however, the high false-positive rate leads to overdiagnosis. Pentraxin 3 (PTX3) as an indicator of inflammation plays an important role in resistance to Aspergillus infections. This study aimed to investigate the diagnostic value of PTX3 for diagnosing IPA with COPD. Methods We retrospectively collected data on patients with suspected COPD and IPA who had been hospitalized in the Third Affiliated Hospital of Soochow University between September 2017 and November 2020. PTX3 and GM were measured using enzyme-linked immunosorbent assays. Results A total of 165 patients were included in the study, of whom 35 had confirmed or probable IPA. The remaining 130 patients served as controls. The median plasma and BALF PTX3 levels were significantly higher in patients with IPA than in control patients (3.74 ng/mL vs. 1.29 ng/mL, P < 0.001; and 3.88 ng/mL vs. 1.58 ng/mL, P < 0.001 in plasma and BALF, respectively). The plasma GM, plasma PTX3, BALF GM, and BALF PTX3 assays had sensitivities of 60.0%, 77.1%, 78.6%, and 89.3%, respectively, and specificities of 73.8%, 69.2%, 80.7%, and 77.1%, respectively. The sensitivity of PTX3 in plasma and BALF was higher than that of GM. However, the specificity of PTX3 and GM did not differ significantly between the IPA group and the control group. The specificity of the assays for the diagnosis of IPA was > 90% in patients who were PTX3-positive and GM-positive in plasma and BALF. Conclusions BALF and plasma PTX3 levels were significantly higher in COPD patients with IPA. The sensitivity of PTX3 was superior to that of GM for diagnosing IPA in patients with COPD. The combination of GM and PTX3 is useful for the diagnosis of IPA in patients with COPD.

scholarly journals The Diagnosis of Invasive and Noninvasive Pulmonary Aspergillosis by Serum and Bronchoalveolar Lavage Fluid Galactomannan Assay

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Shuzhen Zhang ◽  
Sibu Wang ◽  
Zhe Wan ◽  
Ruoyu Li ◽  
Jin Yu
Keyword(s):  
Bronchoalveolar Lavage ◽  
Sensitivity And Specificity ◽  
Bronchoalveolar Lavage Fluid ◽  
False Positive Rate ◽  
Invasive Pulmonary Aspergillosis ◽  
Roc Curves ◽  
Lavage Fluid ◽  
Chronic Obstructive ◽  
Pulmonary Aspergillosis ◽  
Incidence And Mortality

The incidence and mortality of invasive pulmonary aspergillosis (IPA) are rising, particularly in critically ill patients and patients with severe chronic obstructive pulmonary disease (COPD). Noninvasive aspergillosis occurring in these patients requires special attention because of the possibility of developing subsequent IPA, given the poor health and worsened immune state of these patients. We compared the performance of the Platelia galactomannan (GM) enzyme immunoassay in the bronchoalveolar lavage fluid (BALF) and serum. The sensitivity, and specificity of BALF-GM were 85.4% and 62.4%, and those of serum-GM were 67.9% and 93.5% at the cutoff index of 0.5. As the cutoff index increased, the specificity of BALF-GM detection was increased with the detriment of sensitivity. The area under the ROC curves was 0.817 (95% CI: 0.718–0.916) for BALF-GM and 0.819 (95% CI: 0.712–0.926) for serum-GM. The optimal cutoff index was 1.19 for BALF-GM, and the sensitivity and specificity were 67.9% and 89.2%. The BALF-GM assay is more sensitive in detecting pulmonary aspergillosis than serum-GM assay and fungal cultures. However, BALF-GM assay has a high false-positive rate at the cutoff index of 0.5. Hence, the diagnostic cutoff index of the BALF-GM assay should be improved to avoid the overdiagnosis of pulmonary aspergillosis in clinic.

scholarly journals Galactomannan in Bronchoalveolar Lavage Fluid for Diagnosis of Invasive Pulmonary Aspergillosis with Nonneutropenic Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Qidong Zhuang ◽  
Hongying Ma ◽  
Yun Zhang ◽  
Lei Chen ◽  
Li Wang ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Bronchoalveolar Lavage Fluid ◽  
Invasive Pulmonary Aspergillosis ◽  
Final Analysis ◽  
Lavage Fluid ◽  
Control Group ◽  
Control Analysis ◽  
Pulmonary Aspergillosis ◽  
Significant Difference ◽  
Gm Detection

Background. We evaluated the utility of galactomannan (GM) in bronchoalveolar lavage fluid (BALF) for the diagnosis of invasive pulmonary aspergillosis (IPA) in nonneutropenic patients. Methods. A total of 183 patients were included in the final analysis. Bronchoscopies and the detection of GM in BALF were all performed on them. Results. Ten cases of IPA were diagnosed. ROC data demonstrated that, for diagnosing IPA, an optimal cutoff value for GM in BALF of 0.76 yielded a sensitivity of 100.0% and a specificity of 76.2%. Symptoms and radiological findings had no significant difference between proven or probable IPA group and non-IPA group. In our case-control analysis, although nine patients with false-positive results received treatment with Piperacillin/tazobactam, there was no significant difference between case and control group. Conclusions. BALF GM detection is a valuable adjunctive diagnostic tool. Our retrospective study suggests that the optimal value of GM detection in BALF is 0.76 in nonneutropenic patients.

scholarly journals Diagnostic Value of Galactomannan in Bronchoalveolar Lavage Fluid for Chronic Respiratory Disease with Pulmonary Aspergillosis

2020 ◽  
Vol 58 (3) ◽  
Author(s):  
Guangbin Lai ◽  
Chao Zeng ◽  
Jianming Mo ◽  
Wei-dong Song ◽  
Ping Xu
Keyword(s):  
Bronchoalveolar Lavage ◽  
Respiratory Disease ◽  
Bronchoalveolar Lavage Fluid ◽  
Lavage Fluid ◽  
Diagnostic Value ◽  
Chronic Respiratory Disease ◽  
Control Group ◽  
Case Group ◽  
Pulmonary Aspergillosis ◽  
Cutoff Value

ABSTRACT The objective of this study was to explore the diagnostic value of the bronchoalveolar lavage fluid galactomannan (BALF GM) test for chronic respiratory disease with pulmonary aspergillosis and to establish the optimal cutoff value. Samples from a total of 309 chronic respiratory disease patients seen at the respiratory medicine department of Peking University Shenzhen Hospital from September 2016 to September 2019 were analyzed. According to the diagnostic criteria, we divided the patients into a case group (n = 79, comprising 25 proven cases and 54 probable cases) and a control group (n = 230). Bronchoalveolar lavage fluid was collected, and the BALF GM test results were analyzed. A nonparametric rank sum test showed that the mean rank of the case group was 255.30, which was higher than that of the control group (120.55). The Z-value was −11.567 (P = 0.000), indicating that the general distributions of BALF GM differed between the two groups. A BALF GM cutoff value of 0.88 showed the highest diagnostic efficacy for pulmonary aspergillosis. The sensitivity, specificity, positive predictive value, and negative predictive value were 77.2%, 93%, 79.2%, and 92.2%, respectively. As the cutoff value increased, the specificity and sensitivity of the BALF GM test increased and decreased, respectively. The BALF GM test can be used confirm the diagnosis of patients with pulmonary aspergillosis and chronic respiratory disease. The optimum BALF GM cutoff value is 0.88.

scholarly journals Diagnostic value of galactomannan in bronchoalveolar lavage fluid for chronic respiratory disease with pulmonary aspergillosis

2019 ◽  
Author(s):  
Guangbin Lai ◽  
Chao Zeng ◽  
Jianming Mo ◽  
Wei-dong Song ◽  
Ping Xu
Keyword(s):  
Bronchoalveolar Lavage ◽  
Respiratory Disease ◽  
Predictive Value ◽  
Bronchoalveolar Lavage Fluid ◽  
Lavage Fluid ◽  
Diagnostic Value ◽  
Chronic Respiratory Disease ◽  
Control Group ◽  
Case Group ◽  
Pulmonary Aspergillosis

ABSTRACTObjectiveTo explore the diagnostic value of the bronchoalveolar lavage fluid galactomannan (BALF GM) test for chronic respiratory disease with pulmonary aspergillosis, and establish the optimal cut-off value.MethodsA total of 180 chronic respiratory disease patients seen at the Respiratory Medicine Department of Peking University Shenzhen Hospital from September 2017 to September 2018 were analyzed. According to the diagnostic criteria, we divided the patients into the case group (n = 70, comprising 5, 20, and 45 proven, probable, and possible cases, respectively) and the control group (n = 110). Bronchoalveolar lavage fluid was collected, and the BALF GM test results were analyzed.ResultsA non-parametric rank-sum test showed that the mean rank of the case group was 140.80, which was higher than that of the control group (58.49). The Z-value was 10.335 (P = 0.000), indicating that the general distribution of BALF GM differed between the two groups. A BALF GM cut-off value of 0.485 showed the highest diagnostic efficacy for pulmonary aspergillosis. The sensitivity, specificity, positive predictive value, and negative predictive value were 92.9%, 100%, 92.8%, and 100%, respectively. As the cut-off value increased, the specificity and sensitivity of the BALF GM test increased and decreased, respectively.ConclusionsThe BALF GM test can be used confirm the diagnosis of patients with pulmonary aspergillosis and chronic respiratory disease. The optimum BALF GM cut-off value was 0.485. Antifungal therapy is important for treating pulmonary aspergillus infection in patients with chronic respiratory disease.

scholarly journals Diagnostic Value of Galactomannan Antigen Test in Serum and Bronchoalveolar Lavage Fluid Samples from Patients with Nonneutropenic Invasive Pulmonary Aspergillosis

2017 ◽  
Vol 55 (7) ◽  
pp. 2153-2161 ◽  
Author(s):  
Wei Zhou ◽  
Hongxing Li ◽  
Yan Zhang ◽  
Mei Huang ◽  
Qian He ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Bronchoalveolar Lavage Fluid ◽  
Invasive Pulmonary Aspergillosis ◽  
Lavage Fluid ◽  
Diagnostic Value ◽  
Enzyme Linked Immunosorbent Assay ◽  
Serum Samples ◽  
Pulmonary Aspergillosis ◽  
Cutoff Value ◽  
Gm Detection

ABSTRACT The objective of this study was to compare the diagnostic value of galactomannan (GM) detection in bronchoalveolar lavage fluid (BALF) and serum samples from nonneutropenic patients with invasive pulmonary aspergillosis (IPA) and determine the optimal BALF GM cutoff value for pulmonary aspergillosis. GM detection in BALF and serum samples was performed by enzyme-linked immunosorbent assay (ELISA) in 128 patients with clinically suspected nonneutropenic pulmonary aspergillosis between June 2014 and June 2016. On the basis of the clinical and pathological diagnoses, 8 patients were excluded because their diagnosis was uncertain. The remaining 120 patients were diagnosed with either IPA ( n = 37), community-acquired pneumonia (CAP; n = 59), noninfectious diseases ( n = 19), or tuberculosis ( n = 5). At a cutoff optical density index (ODI) value of ≥0.5, the sensitivity of BALF GM detection was much higher than that of serum GM detection (75.68% versus 37.84%; P = 0.001), but there was no significant difference between their specificities (80.72% versus 87.14%; P = 0.286). At a cutoff value of ≥1.0, the sensitivity of BALF GM detection was still much higher than that of serum GM detection (64.86% versus 24.32%; P < 0.001), and their specificities were similar (90.36% versus 95.71%; P = 0.202). Receiver operating characteristic (ROC) curve analysis showed that when the BALF GM detection cutoff value was 0.7, its diagnostic value for pulmonary aspergillosis was optimized, and the sensitivity and specificity reached 72.97% and 89.16%, respectively. BALF GM detection was valuable for the diagnosis of IPA in nonneutropenic patients, and its diagnostic value was superior to that of serum GM detection. The optimal BALF GM cutoff value was 0.7.

Diagnosis values of IL-6 and IL-8 levels in serum and bronchoalveolar lavage fluid for invasive pulmonary aspergillosis in chronic obstructive pulmonary disease

2021 ◽  
pp. jim-2021-001857
Author(s):  
Fang Liu ◽  
Xin Zhang ◽  
Wenxiu Du ◽  
Junfeng Du ◽  
Yumin Chi ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Bronchoalveolar Lavage ◽  
Pulmonary Disease ◽  
Sensitivity And Specificity ◽  
Bronchoalveolar Lavage Fluid ◽  
Invasive Pulmonary Aspergillosis ◽  
Lavage Fluid ◽  
Chronic Obstructive ◽  
Pulmonary Aspergillosis ◽  
Obstructive Pulmonary Disease

Among immunologically normal hosts, patients with chronic obstructive pulmonary disease (COPD) are considered to be at high risk of invasive pulmonary aspergillosis (IPA), and early diagnosis and treatment are the key to improving the prognosis of patients. Here we aimed to evaluate whether interleukin (IL)-6 and IL-8 might be used in the detection and diagnosis of IPA in patients with COPD. We prospectively collected 106 patients with COPD and divided them into non-IPA (n=74), probable/possible IPA (n=26) and proven IPA (n=6). Platelia Aspergillus kit was used to detect galactomannan in bronchoalveolar lavage fluid (BALF), and serum and ELISA kit was used to detect IL-6 and IL-8 levels. Diagnostic efficiency of IL-6, IL-8 and galactomannan in serum and BALF was evaluated by receiver operating characteristic curve. Compared with the non-IPA group, the proven/probable IPA group showed significantly elevated levels of IL-6 and IL-8 in both serum and BALF, which were positively correlated with galactomannan levels. The sensitivity and specificity of IL-6 for diagnosing IPA were 74.32% and 81.25% (cut-off at 92.82 pg/mL, area under the curve (AUC)=0.8366) in serum and 68.92% and 71.88% (cut-off at 229.4 pg/mL, AUC=0.7694) in BALF. The sensitivity and specificity of IL-8 for diagnosing IPA were 83.78% and 81.25% (cut-off at 93.46 pg/mL, AUC=0.8756) in serum and 85.14% and 75.00% (cut-off at 325.4 pg/mL, AUC=0.8252) in BALF. The elevated levels of IL-6 and IL-8 in patients with IPA with COPD could be used as auxiliary indicators to diagnose IPA in addition to galactomannan.

Sign in / Sign up

Export Citation Format

Share Document