Early antigen diagnosis of invasive fungal infection in patients with hematological malignancies and patients receiving hematopoietic stem cell transplantation.
- Author:
Jie XU
1
;
Zi-Min SUN
;
Xing-Bing WANG
;
Xu-Han ZHANG
Author Information
1. Department of Hematology, Anhui Provincial Hospital, Hefei 230001, Anhui Province, China.
- Publication Type:Journal Article
- MeSH:
Adolescent;
Adult;
Aged;
Antigens, Fungal;
analysis;
Child;
Child, Preschool;
Early Diagnosis;
Female;
Hematologic Neoplasms;
complications;
microbiology;
Hematopoietic Stem Cell Transplantation;
Humans;
Male;
Middle Aged;
Mycoses;
diagnosis;
etiology;
immunology;
Sensitivity and Specificity;
Young Adult
- From:
Journal of Experimental Hematology
2010;18(5):1302-1305
- CountryChina
- Language:Chinese
-
Abstract:
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.
