Diagnostic Value Of GM Test Of Bronchoalveolar Lavage Fluid For Invasive Pulmonary Fungal Infection

Objective: To explore the diagnostic value of Aspergillus galactomannan antigen in bronchoalveolar lavage fluid for invasive pulmonary fungal infections.Methods: Collect the GM test results of serum and bronchoalveolar lavage fluid and clinical information from 30 cases diagnosed with invasive pulmonary fungal infection and 32 randomly selected patients excluded this disease in the Department of Respiratory Medicine of the First Affiliated Hospital of Guangxi Medical University from January 2016 to December 2017,calculating the sensitivity,specificity,positive predictive value,negative predictive value of GM test in serum,bronchoalveolar lavage fluid and combined detection,and discussing the optimal diagnostic threshold.analyze the diagnostic value of bronchoalveolar lavage fluid for different fungal species.Results: when the GM cut-off value is 0.500,the sensitivity of BALF GM test was 76.7%,specificity was 71.9%,positive predictive value was 71.9%,and negative predictive value was 76.7%.The results of these four indicator of serum GM test was 66.7%,71.9%,69.0%,69.7%.The optimal GM cut-off valuefor bronchoalveolar lavage fluid was 0.514,and the optimal GM cut-off value for serum was 0.500.When combined with the two specimens,the sensitivity of the GM test was 83.8%,specificity was 62.5%,positive predictive value was67.6%,and negative predictive value was 80.0%.The positive rate of BALF-GM was 83.3% in patients with pulmonary infection caused by Aspergillus,62.5% in cryptococcus and 66.7% in Candida.Conclusion: The detection of GM antigen in bronchoalveolar lavage fluid has high sensitivity and positive predictive value,negtive predictive value,and its diagnostic value for invasive pulmonary fungal infection is higher than that of serum.It has the highest diagnostic value for invasive pulmonary aspergillosis,this method is worthy of clinical promotion.Combined detection may increase sensitivity,decrease specificity,and may lead to an increase in misdiagnosis rates.Bronchoalveolar lavage fluid has a higher diagnostic value for invasive pulmonary aspergillosis than other fungi.