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The utility of galactomannan antigen in the bronchial washing and serum for diagnosing pulmonary aspergillosis.
[allergic bronchopulmonary aspergillosis]
The
diagnosis
of
pulmonary
aspergillosis
is
difficult
because
the
sensitivity
of
the
conventional
methods
for
the
detection
of
Aspergillus
such
as
culture
and
cytology
,
is
poor
.
To
improve
the
sensitivity
for
Aspergillus
detection
,
the
detection
of
galactomannan
antigen
has
been
investigated
.
The
serum
galactomannan
(
GM
)
antigen
has
been
recognized
to
be
a
useful
tool
for
the
diagnosis
of
invasive
pulmonary
aspergillosis
.
However
,
the
utility
of
the
galactomannan
antigen
for
the
diagnosis
of
pulmonary
aspergillosis
other
than
invasive
pulmonary
aspergillosis
(
IPA
)
has
been
unclear
.
The
GM
antigen
using
serum
and
bronchial
washing
(
BW
)
using
bronchofiberscopy
for
the
diagnosis
of
pulmonary
aspergillosis
other
than
IPA
were
measured
.
In
45
enrolled
patients
,
7
patients
had
pulmonary
aspergillosis
,
5
of
these
patients
had
chronic
necrotizing
pulmonary
aspergillosis
and
2
patients
had
allergic
bronchopulmonary
aspergillosis
.
The
area
under
the
receiver
operating
characteristic
(
ROC
)
curve
was
0
.
89
for
the
BW
GM
antigen
detection
test
,
and
0
.
41
for
the
serum
GM
antigen
detection
test
,
suggesting
that
the
BW
GM
antigen
detection
test
exhibits
a
better
diagnostic
performance
than
the
serum
GM
antigen
detection
test
.
The
BW
GM
antigen
detection
test
had
a
sensitivity
of
85
.
7
%
and
a
specificity
of
76
.
3
%
at
a
cut-off
level
of
≥
0
.
5
,
which
was
the
optimal
cut-off
level
obtained
by
the
ROC
curve
.
The
BW
GM
antigen
detection
test
is
thought
to
be
a
promising
test
for
the
diagnosis
of
pulmonary
aspergillosis
other
than
IPA
.
