title: Diagnostic value of the serum galactomannan and (1, 3)-β-D-glucan assays for invasive pulmonary aspergillosis in non-neutropenic patients.
abstract: OBJECTIVE
  Galactomannan (GM) and (1, 3)-β-D-glucan (BG) are considered useful seromarkers for the diagnosis of invasive pulmonary aspergillosis (IPA) in patients with neutropenia. However, there is still limited data on these seromarkers for testing non-neutropenic patients who are at the risk of IPA. The aim of this study was to evaluate the value of these two serum antigen assays for the early diagnosis of IPA in patients without neutropenia.
  
  
  METHODS
  Between January 2011 and December 2012, 97 patients with suspected IPA admitted to the department of respiratory diseases and the respiratory intensive care unit were prospectively monitored. Serum GM and BG assays were performed before the patients received antifungal therapy.
  
  
  RESULTS
  Patients were classified as proven IPA (n=11), probable IPA (n=16), possible IPA (n=4), or non-IPA (n=66). The most common underlying disease of patients with IPA was chronic obstructive pulmonary disease (18.5%), and 22.2% patients with IPA had no known diseases. The sensitivities, specificities, and positive and negative predictive values of the GM and BG assays and at least one positive on both assays were 40.7%/89.4%/61.1%/78.7%, 48.1%/78.8%/48.1%/78.8%, and 70.4%/75.8%/54.3%/86.2%, respectively.
  
  
  CONCLUSIONS
  Compared with the testing of neutropenic patients, the serum GM or BG assay alone was less useful for the diagnosis of IPA in non-neutropenic patients. However, at least one positive result of the two serum assays appeared to be useful in the diagnosis of IPA in non-neutropenic patients.
authors.affiliation: Department of Respiratory Diseases, Chinese People's Liberation Army General Hospital, China.
authors.forename: Xuejiu
authors.initials: X
authors.lastname: Cai
authors.forename: Wentao
authors.initials: W
authors.lastname: Ni
authors.forename: Chuanqi
authors.initials: C
authors.lastname: Wei
authors.forename: Junchang
authors.initials: J
authors.lastname: Cui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002681:China; D042241:Early Diagnosis; D005260:Female; D005690:Galactose / Q000031:analogs & derivatives; D006801:Humans; D007362:Intensive Care Units; D055744:Invasive Pulmonary Aspergillosis / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D008297:Male; D008351:Mannans / Q000097:blood*; D008875:Middle Aged; D009503:Neutropenia; D011509:Proteoglycans; D012680:Sensitivity and Specificity; D055815:Young Adult; D047071:beta-Glucans / Q000097:blood*
chemical_list: D015415:Biomarkers; D008351:Mannans; D011509:Proteoglycans; D047071:beta-Glucans; C012990:galactomannan; C010770:polysaccharide-K; D005690:Galactose