BACKGROUND
The use of galactomannan testing in plasma and bronchoalveolar lavage fluid (BALF) has improved diagnosis of invasive pulmonary aspergillosis(IPA) in COPD patients; However, the high false positive rate leads to overdiagnosis. This study aimed to investigate the diagnostic value of PTX3 in COPD patients with invasive pulmonary aspergillosis.
METHODS
A total of 165 patients initially suspected of COPD with invasive pulmonary aspergillosis were included in the study. Among these, 35 cases were proven or probable to be invasive pulmonary aspergillosis (35 plasma samples and 28 BALF samples). The remaining 130 cases were non-aspergillosis controls(130 plasma samples and 83 BALF samples). PTX3 levels and GM were measured by enzyme-linked immunosorbent assay.
Results
Median plasma and BLAF PTX3 level was significantly higher in COPD patients with invasive pulmonary aspergillosis compared with non-aspergillosis patients (3.74 [2.57–5.61]ng/ml vs 1.29[0.62–2.88] ng/ml,P < 0.001; 3.88[2.28–8.29]ng/ml vs 1.58[0.85–2.13]ng/ml, P < 0.001). When the plasma GM/PTX3 and BALF GM/PTX3 assays were used for patients included in the study, the sensitivity/specificity value were 60%/77.1%/78.6%/89.3%, 73.8%/69.2%/80.7%/77.1%, respectively. Thus, The sensitivity of PTX3 in plasma and BLAF was higher than that of GM. However, There was no significant difference in the specificity of PTX3 and GM between the IPA group and non-aspergillosis group. When PTX3 and GM were both positive in plasma or BLAF, the specificity for the diagnosis of pulmonary aspergillosis can reach more than 90%.
Conclusions
BALF and plasma PTX3 measurements were significantly higher among patients with IPA. The sensitivity of PTX3 was superior to GM in the diagnosis of IPA in COPD patients. The combination of GM and PTX3 is beneficial to the diagnosis of IPA in COPD patients.