[Early antigen diagnosis of invasive fungal infection in patients with hematological malignancies and patients receiving hematopoietic stem cell transplantation].
This study was purposed to evaluate the sensitivity and specificity of G/(1, 3-β-D glucan)/GM (galactomannan) combined detection for early diagnosis of invasive fungal disease (IFD), determine the GM positive cut-off value, and investigate the change of diagnostic level before and after G/GM test and the relation of GM value with therapeutic effect. The ELISA with double antibody sandwich was used to detect the serum levels of G and G/M. The results showed that according to determined GM positive cut-off value, the sensitivity, specificity, positive and negative predictive value of G/GM combined detection were 100%, 65.7%, 67.6% and 100%, respectively. The case number of the clinical diagnosis of IFD increased from 1 to 24 cases, the diagnosis of 12 non-infective patients was changed as suspected IFD with the help of G/GM combined detection; the GM cut-off value decreased in patients whose GM cut-off value was higher before therapy and antifungal therapy was effective, while the GM cut-off value increased in patients no-responded to therapy. It is concluded that G/GM combined detection can increased the sensitivity of the diagnosis and reduce false negative rate in the early diagnosis of IFD. The dynamically monitoring G/GM cut-off value can be used as evaluation indicator of therapeutic efficacy.
Department of Hematology, Anhui Provincial Hospital, Hefei 230001, Anhui Province, China.
Jie
J
Xu
Zi-Min
ZM
Sun
Xing-Bing
XB
Wang
Xu-Han
XH
Zhang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000946:Antigens, Fungal / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D042241:Early Diagnosis; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications* / Q000382:microbiology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D012680:Sensitivity and Specificity; D055815:Young Adult
D000946:Antigens, Fungal