Diagnostic Value of Antigen Antibody Detection Combined with CT Examination for IPA in Non-neutropenic Population
Objective To investigate the clinical value of BALF-GM antigen,Aspergillus IgG antibody combined with CT examination in the diagnosis of IPA in non-neutropenic population.Methods A total of 143 non-neutropenic patients with suspected invasive pulmonary aspergillosis(IPA)were selected from January 2020 to February 2023 in our hospital.According to the diagnostic criteria established by EORTC/MSG,11 cases were diagnosed,97 cases were clinically diagnosed,12 cases were suspected,and 23 cases were excluded from Aspergillus infection.The sensitivity,specificity,AUC value and Youden index of BALF-GM,Aspergillus IgG antibody,CT examination and the combination of three detection methods in the diagnosis of IPA in non-neutropenic population were analyzed,and the ROC curve was drawn.The levels of BALF-GM in patients with empirical antifungal therapy and those without empirical antifungal therapy were compared.Results The sensitivity of BALF-GM,Aspergillus IgG antibody,CT examination and the combination of the three detection methods to IPA in non-neutropenic population was 87.96％,79.63％,86.11％and 83.33％,respectively;the specificity was 91.30％,91.30％,65.22％and 100.00％,respectively;the AUC values were 0.896,0.855,0.757 and 0.918,respectively;the Youden index was 0.793,0.709,0.513 and 0.833,respectively.There was a statistically significant difference in BALF-GM levels between patients with empirical antifungal therapy and those without empirical antifungal therapy(P＜0.05).Conclusion BALF-GM,Aspergillus IgG antibody combined with CT examination can improve the diagnostic specificity of IPA in non-neutropenic patients.However,due to the low sensitivity of BALF-GM detection in patients with empirical antifungal therapy,the combination of the three detection methods is suitable for non-neutropenic IPA patients without empirical antifungal therapy.For patients with empirical antifungal therapy,clinicians need to comprehensively evaluate the test results and clinical symptoms of patients to make a reasonable diagnosis.
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