title: Diagnostic value of (1 → 3)-β-D-glucan in bronchoalveolar lavage fluid for invasive fungal disease: A meta-analysis.
abstract: The serum (1 → 3)-β-D-glucan (BG) assay has been approved for diagnosing invasive fungal diseases (IFDs). However, the performance of (1 → 3)-β-D-glucan assay in bronchoalveolar lavage (BAL) fluid is various among studies. The present study aimed to assess the accuracy of (1 → 3)-β-D-glucan assay in bronchoalveolar lavage fluid for the diagnosis of invasive fungal diseases by means of meta-analysis and systematic review of relevant studies.
  
  
  
  The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (OR) and a summary receiver-operating characteristic curve of BAL-BG for diagnosing invasive fungal diseases were pooled using meta-analysis. We also performed meta-regression analysis.
  
  
  
  A total of 838 patients (138 with proven or probable invasive fungal diseases), included in 6 studies, were analyzed. The pooled sensitivity, specificity, PLR, NLR and diagnostic odds ratio were 0.52 (95%CI, 0.38-0.53), 0.58 (95%CI, 0.55-0.61), 1.34 (95%CI, 1.08-1.66), 0.82 (95% CI, 0.63-1.07) and 1.71 (95%CI, 1.01-2.92) respectively. The area under the summary receiver operating characteristic curve, with 95% confidence intervals was 0.61 (95%CI, 0.67-0.55).
  
  
  
  The accuracy of (1 → 3)-β-D-glucan test in bronchoalveolar lavage fluid is marginal, so that the results should not be interpreted alone but can be used as a part of full assessment with clinical features, image findings and other laboratory results for the diagnosis of invasive fungal diseases.
authors: Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
authors: Xin-Yu
authors: XY
authors: Shi
authors: Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
authors: Yao
authors: Y
authors: Liu
authors: Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
authors: Xian-Min
authors: XM
authors: Gu
authors: Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
authors: Sheng-Yu
authors: SY
authors: Hao
authors: Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
authors: Yu-Hong
authors: YH
authors: Wang
authors: Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
authors: Di
authors: D
authors: Yan
authors: Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China. Electronic address: shixinyusxy@126.com.
authors: Shu-Juang
authors: SJ
authors: Jiang
mesh_terms: D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry*; D006801:Humans; D000072742:Invasive Fungal Infections / Q000175:diagnosis* / Q000378:metabolism; D009181:Mycoses / Q000175:diagnosis* / Q000378:metabolism; D011237:Predictive Value of Tests; D011509:Proteoglycans; D012680:Sensitivity and Specificity; D047071:beta-Glucans / Q000032:analysis*
chemical_list: D011509:Proteoglycans; D047071:beta-Glucans; C010770:polysaccharide-K
keywords: (1 → 3)-β-D-glucan; Bronchoalveolar lavage fluid; Invasive fungal disease