Detection of Galactomannan and (1-3)-β-D-glucan for Early Diagnosis of Invasive Aspergillosis in Hematological Cancer Patients

Invasive Aspergillosis (IA) is one of the most common life-threatening opportunistic invasive mycosis in hematological cancer patients. Early diagnosis of IA is difficult; the need for early clinical diagnosis and management presents the need for new noninvasive, culture-independent diagnostic tools. Galactomannan (GM) and (1-3)-β-D-glucan (BG) antigenemia can serve as useful markers for IA. The current study was conducted to prospectively evaluate the clinical significance of GM and BG detection in the diagnosis of IA in patients with hematological malignancies in China. In 378 patients with hematological malignancies, GM and BG were detected. Analysis of sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of GM and BG assay were performed. Detection of BG for diagnosis of IA with plasma reported sensitivity, specificity, PPV and NPV values as 66, 92, 86 and 78%, respectively. The GM detection for diagnosis of IA in serum reported sensitivity, specificity, PPV and NPV values as 48, 97, 93 and 71%, respectively. Combination of the two tests improved the specificity (to 100%) and PPV value (to 100%) of each individual test without affecting the sensitivity and NPV. The study concluded that serum GM and plasma BG can serve as potential markers of Aspergillosis. The detection of GM and BG has shown high specificity and PPV for screening high-risk hematological patients. The combined measurement of GM and BG appeared to be useful for early diagnosis of IA.