Establishing Aspergillus-Specific IgG Cut-Off Level for Chronic Pulmonary Aspergillosis Diagnosis: Multicenter Prospective Cohort Study

被引：16

作者：

Lee, Meng-Rui ^{[1
,2
]}

Huang, Hung-Ling ^{[3
,4
,5
,6
]}

Keng, Li-Ta ^{[1
,2
]}

Chang, Hsu-Liang ^{[3
,4
]}

Sheu, Chau-Chyun ^{[4
,5
,6
]}

Fu, Pin-Kuei ^{[7
,8
,9
,10
]}

Wang, Jann-Yuan ^{[1
]}

Chong, Inn-Wen ^{[4
,5
,6
,11
,12
]}

Shih, Jin-Yuan ^{[1
]}

Yu, Chong-Jen ^{[1
,2
]}

机构：

[1] Natl Taiwan Univ Hosp, Dept Internal Med, Taipei 10002, Taiwan

[2] Natl Taiwan Univ Hosp, Hsin Chu Branch, Dept Internal Med, Hsinchu 30059, Taiwan

[3] Kaohsiung Municipal Tatung Hosp, Dept Internal Med, Kaohsiung 80145, Taiwan

[4] Kaohsiung Med Univ Hosp, Div Pulm & Crit Care Med, Kaohsiung 80708, Taiwan

[5] Kaohsiung Med Univ Hosp, Dept Internal Med, Kaohsiung 80708, Taiwan

[6] Kaohsiung Med Univ, Coll Med, Grad Inst Med, Kaohsiung 80708, Taiwan

[7] Taichung Vet Gen Hosp, Dept Crit Care Med, Taichung 40705, Taiwan

[8] Natl Chung Hsing Univ, PhD Program Translat Med, Taichung 40254, Taiwan

[9] Hungkuang Univ, Coll Human Sci & Social Innovat, Taichung 43302, Taiwan

[10] Tunghai Univ, Dept Comp Sci, Taichung 40704, Taiwan

[11] Kaohsiung Med Univ Hosp, Dept Resp Therapy, Kaohsiung 80708, Taiwan

[12] Natl Yang Ming Chiao Tung Univ, Dept Biol Sci & Technol, Hsinchu 30010, Taiwan

来源：

JOURNAL OF FUNGI | 2021年 / 7卷 / 06期

关键词：

Aspergillus fumigatus; Aspergillus IgG; chronic pulmonary aspergillus; cut-off value; Taiwan; ASSAYS;

D O I：

10.3390/jof7060480

中图分类号：

Q93 [微生物学];

学科分类号：

071005 ; 100705 ;

摘要：

Objectives: Aspergillus-specific IgG (Asp-IgG) cut-off level in diagnosing chronic pulmonary aspergillosis (CPA) remains unknown. Methods: We prospectively recruited participants with clinical suspicion of CPA in three centers in Taiwan during 2019 June to 2020 August. Serum Aspergillus fumigatus-specific IgG (Asp-IgG) (Phadia, Uppsala, UPPS, Sweden) was examined. Optimal cut-off level was determined by Youden's index and validated. Results: A total of 373 participants were recruited. In the derivation cohort (n = 262), Asp-IgG had an area under the receiver-operating-characteristic curve (AUC) of 0.832. The optimal cut-off level was 40.5 mgA/L. While applying this cut-off level to the validation cohort (n = 111), the sensitivity and specificity were 86.7% and 80.2%. Lowering the cut-off level from 40.5 to 27 mgA/L, the sensitivity was steady (30/36, 83.3% to 31/36, 86.1%) while specificity dropped from 81.9% (276/337) to 63.5% (214/337). Restricting CPA diagnosis to only chronic cavitary pulmonary aspergillosis (CCPA) and chronic fibrosing pulmonary aspergillosis (CFPA) yielded a cut-off level of 42.3 mgA/L in the derivation cohort with a sensitivity of 100% and specificity of 84.4% in the validation cohort. Conclusions: Serum Asp-IgG performs well for CPA diagnosis and provides a low false-positive rate when using a higher cut-off level (preferably around 40 mgA/L).

引用

页数：13