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Detection of invasive aspergillosis by serum galactomannan test: A systematic review

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单位: [a]Department of Hematology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, WuHan 430030, China [b]Department of Rheumatology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, WuHan 430030, China
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关键词: Cutoff value Diagnostic test Galactomannan Invasive aspergillosis Systematic review

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Objective To assess the quality of current domestic literature about enzyme-linked immunosorbent assay (ELISA) for invasive aspergillosis diagnosis by detecting Aspergillus galactomannan (GM) antigen, and to analyze the sources of bias and variability, as well as the diagnostic ability of different thresholds. Methods& Both computer-based online search and manual retrieval were employed to identify relevant articles. The statistical information and quality of science were assessed and classified. The data were analyzed using Meta Disc 1.4 software. The best cutoff value for defining a positive test result was selected by summarizing the following statistical indicators as sensitivity, specificity, likelihood ratio (LR) and summary receiver operating characteristic curve (SROC curve), and by calculating the area under the curve (AUC) as well. Results A total of 20 studies among 2658 literatures were included in accordance with the inclusion criteria, and were divided into different groups based on different cutoff values. Though heterogeneity tests showed no threshold effect, and there were other reasons of heterogeneity. So the data were analyzed by random effects model. The results showed that, compared with other groups, the one with cutoff value set at 0.7 (AUC=0.9456, Q*= 0.8846) showed the best accuracy in diagnosing. Conclusion ELISA detection of Aspergillus GM antigen with cutoff value set at 0.7 has important significance in the early diagnosis of invasive aspergillosis, and it can be conducive to reduce mortality in patients at high risk for Aspergillus infection. © 2011 Editorial Board of Chin J Evid-based Med.

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第一作者单位: [a]Department of Hematology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, WuHan 430030, China
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