Usefulness of Two Aspergillus PCR Assays and Aspergillus Galactomannan and β-d-Glucan Testing of Bronchoalveolar Lavage Fluid for Diagnosis of Chronic Pulmonary Aspergillosis.
We evaluated the usefulness of anAspergillusgalactomannan (GM) test, a β-d-glucan (βDG) test, and two differentAspergillusPCR assays of bronchoalveolar lavage fluid (BALF) samples for the diagnosis of chronic pulmonary aspergillosis (CPA). BALF samples from 30 patients with and 120 patients without CPA were collected. We calculated the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio for each test individually and in combination with other tests. The optical density index values, as determined by receiver operating characteristic analysis, for the diagnosis of CPA were 0.5 and 100 for GM and βDG testing of BALF, respectively. The sensitivity and specificity of the GM test, βDG test, and PCR assays 1 and 2 were 77.8% and 90.0%, 77.8% and 72.5%, 86.7% and 84.2%, and 66.7% and 94.2%, respectively. A comparison of the PCR assays showed that PCR assay 1 had a better sensitivity, a better negative predictive value, and a better negative likelihood ratio and PCR assay 2 had a better specificity, a better positive predictive value, and a better positive likelihood ratio. The combination of the GM and βDG tests had the highest diagnostic odds ratio. The combination of the GM and βDG tests on BALF was more useful than any single test for diagnosing CPA.
Department of Respiratory Medicine, Toho University Omori Medical Center, Tokyo, Japan.
Naohisa
N
Urabe
Department of Respiratory Medicine, Toho University Omori Medical Center, Tokyo, Japan susumu1029@gmail.com.
Susumu
S
Sakamoto
Department of Respiratory Medicine, Toho University Omori Medical Center, Tokyo, Japan.
Go
G
Sano
Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan.
Junko
J
Suzuki
Department of Clinical Research, National Hospital Organization Tokyo National Hospital, Tokyo, Japan.
Akira
A
Hebisawa
Department of Respiratory Medicine, Toho University Omori Medical Center, Tokyo, Japan.
Yasuhiko
Y
Nakamura
Department of Respiratory Medicine, Toho University Omori Medical Center, Tokyo, Japan.
Kazuya
K
Koyama
Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan.
Yoshikazu
Y
Ishii
Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan.
Kazuhiro
K
Tateda
Department of Respiratory Medicine, Toho University Omori Medical Center, Tokyo, Japan.
Sakae
S
Homma
D000368:Aged; D000369:Aged, 80 and over; D001230:Aspergillus / Q000737:chemistry / Q000235:genetics / Q000302:isolation & purification*; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D005690:Galactose / Q000031:analogs & derivatives; D006801:Humans; D007118:Immunoassay / Q000379:methods*; D008297:Male; D008351:Mannans / Q000032:analysis*; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods*; D011237:Predictive Value of Tests; D011509:Proteoglycans; D055732:Pulmonary Aspergillosis / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D047071:beta-Glucans / Q000032:analysis*
D008351:Mannans; D011509:Proteoglycans; D047071:beta-Glucans; C012990:galactomannan; C010770:polysaccharide-K; D005690:Galactose
Aspergillus PCR assays; Aspergillus galactomannan test; chronic pulmonary aspergillosis; β-d-glucan test