曲霉
医学
抗体
四分位间距
曲菌病
金标准(测试)
免疫学
胃肠病学
内科学
病理
生物
微生物学
作者
Helmut J.F. Salzer,Maja Reimann,Carolin Oertel,Jesper Rømhild Davidsen,Christian B. Laursen,Eva Van Braeckel,Ritesh Agarwal,Korkut Avsar,Oxana Munteanu,Muhammad Irfan,Christoph Lange
标识
DOI:10.1016/j.cmi.2023.08.032
摘要
Abstract
Objectives
To evaluate the performance of Aspergillus-specific IgG antibodies for diagnosing chronic pulmonary aspergillosis (CPA) by using a cohort of patients with histologically proven CPA as a reference standard. Methods
We collected Aspergillus-specific IgG antibody titres from patients with histologically proven CPA in collaboration with CPAnet study sites in Denmark, Germany, Belgium, India, Moldova, and Pakistan (N = 47). Additionally, sera from diseased and healthy controls were prospectively collected at the Medical Clinic of the Research Center, Borstel, Germany (n = 303). Aspergillus-specific IgG antibody titres were measured by the ImmunoCAP® assay (Phadia 100, Thermo Fisher Scientific, Uppsala, Sweden). An Aspergillus-specific IgG antibody titre ≥50 mgA/L was considered positive. Results
Using patients with histologically proven CPA as the reference standard, the ImmunoCAP® Aspergillus-specific IgG antibody test had a sensitivity and specificity of 85.1% (95% CI: 71.7–93.8%) and 83.6% (95% CI: 78.0–88.3%), respectively. Patients with histologically proven CPA had significantly higher Aspergillus-specific IgG antibody titre with a median of 83.45 mgA/L (interquartile range 38.9–115.5) than all other cohorts (p < 0.001). False-positive test results occurred in one-third of 79 healthy controls. Discussion
Our study results confirm a high sensitivity of the Aspergillus-specific IgG antibody test for the diagnosis of CPA when using patients with histologically proven CPA as a reference standard. However, positive test results should always match radiological findings as false-positive test results limit the interpretation of the test.
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