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Establishing Aspergillus-Specific IgG Cut-Off Level for Chronic Pulmonary Aspergillosis Diagnosis: Multicenter Prospective Cohort Study

Objectives: Aspergillus-specific IgG (Asp-IgG) cut-off level in diagnosing chronic pulmonary aspergillosis (CPA) remains unknown. Methods: We prospectively recruited participants with clinical suspicion of CPA in three centers in Taiwan during 2019 June to 2020 August. Serum Aspergillus fumigatus-sp...

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Autores principales: Lee, Meng-Rui, Huang, Hung-Ling, Keng, Li-Ta, Chang, Hsu-Liang, Sheu, Chau-Chyun, Fu, Pin-Kuei, Wang, Jann-Yuan, Chong, Inn-Wen, Shih, Jin-Yuan, Yu, Chong-Jen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8231598/
https://www.ncbi.nlm.nih.gov/pubmed/34204844
http://dx.doi.org/10.3390/jof7060480
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author Lee, Meng-Rui
Huang, Hung-Ling
Keng, Li-Ta
Chang, Hsu-Liang
Sheu, Chau-Chyun
Fu, Pin-Kuei
Wang, Jann-Yuan
Chong, Inn-Wen
Shih, Jin-Yuan
Yu, Chong-Jen
author_facet Lee, Meng-Rui
Huang, Hung-Ling
Keng, Li-Ta
Chang, Hsu-Liang
Sheu, Chau-Chyun
Fu, Pin-Kuei
Wang, Jann-Yuan
Chong, Inn-Wen
Shih, Jin-Yuan
Yu, Chong-Jen
author_sort Lee, Meng-Rui
collection PubMed
description Objectives: Aspergillus-specific IgG (Asp-IgG) cut-off level in diagnosing chronic pulmonary aspergillosis (CPA) remains unknown. Methods: We prospectively recruited participants with clinical suspicion of CPA in three centers in Taiwan during 2019 June to 2020 August. Serum Aspergillus fumigatus-specific IgG (Asp-IgG) (Phadia, Uppsala, UPPS, Sweden) was examined. Optimal cut-off level was determined by Youden’s index and validated. Results: A total of 373 participants were recruited. In the derivation cohort (n = 262), Asp-IgG had an area under the receiver-operating-characteristic curve (AUC) of 0.832. The optimal cut-off level was 40.5 mgA/L. While applying this cut-off level to the validation cohort (n = 111), the sensitivity and specificity were 86.7% and 80.2%. Lowering the cut-off level from 40.5 to 27 mgA/L, the sensitivity was steady (30/36, 83.3% to 31/36, 86.1%) while specificity dropped from 81.9% (276/337) to 63.5% (214/337). Restricting CPA diagnosis to only chronic cavitary pulmonary aspergillosis (CCPA) and chronic fibrosing pulmonary aspergillosis (CFPA) yielded a cut-off level of 42.3 mgA/L in the derivation cohort with a sensitivity of 100% and specificity of 84.4% in the validation cohort. Conclusions: Serum Asp-IgG performs well for CPA diagnosis and provides a low false-positive rate when using a higher cut-off level (preferably around 40 mgA/L).
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spelling pubmed-82315982021-06-26 Establishing Aspergillus-Specific IgG Cut-Off Level for Chronic Pulmonary Aspergillosis Diagnosis: Multicenter Prospective Cohort Study Lee, Meng-Rui Huang, Hung-Ling Keng, Li-Ta Chang, Hsu-Liang Sheu, Chau-Chyun Fu, Pin-Kuei Wang, Jann-Yuan Chong, Inn-Wen Shih, Jin-Yuan Yu, Chong-Jen J Fungi (Basel) Article Objectives: Aspergillus-specific IgG (Asp-IgG) cut-off level in diagnosing chronic pulmonary aspergillosis (CPA) remains unknown. Methods: We prospectively recruited participants with clinical suspicion of CPA in three centers in Taiwan during 2019 June to 2020 August. Serum Aspergillus fumigatus-specific IgG (Asp-IgG) (Phadia, Uppsala, UPPS, Sweden) was examined. Optimal cut-off level was determined by Youden’s index and validated. Results: A total of 373 participants were recruited. In the derivation cohort (n = 262), Asp-IgG had an area under the receiver-operating-characteristic curve (AUC) of 0.832. The optimal cut-off level was 40.5 mgA/L. While applying this cut-off level to the validation cohort (n = 111), the sensitivity and specificity were 86.7% and 80.2%. Lowering the cut-off level from 40.5 to 27 mgA/L, the sensitivity was steady (30/36, 83.3% to 31/36, 86.1%) while specificity dropped from 81.9% (276/337) to 63.5% (214/337). Restricting CPA diagnosis to only chronic cavitary pulmonary aspergillosis (CCPA) and chronic fibrosing pulmonary aspergillosis (CFPA) yielded a cut-off level of 42.3 mgA/L in the derivation cohort with a sensitivity of 100% and specificity of 84.4% in the validation cohort. Conclusions: Serum Asp-IgG performs well for CPA diagnosis and provides a low false-positive rate when using a higher cut-off level (preferably around 40 mgA/L). MDPI 2021-06-12 /pmc/articles/PMC8231598/ /pubmed/34204844 http://dx.doi.org/10.3390/jof7060480 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lee, Meng-Rui
Huang, Hung-Ling
Keng, Li-Ta
Chang, Hsu-Liang
Sheu, Chau-Chyun
Fu, Pin-Kuei
Wang, Jann-Yuan
Chong, Inn-Wen
Shih, Jin-Yuan
Yu, Chong-Jen
Establishing Aspergillus-Specific IgG Cut-Off Level for Chronic Pulmonary Aspergillosis Diagnosis: Multicenter Prospective Cohort Study
title Establishing Aspergillus-Specific IgG Cut-Off Level for Chronic Pulmonary Aspergillosis Diagnosis: Multicenter Prospective Cohort Study
title_full Establishing Aspergillus-Specific IgG Cut-Off Level for Chronic Pulmonary Aspergillosis Diagnosis: Multicenter Prospective Cohort Study
title_fullStr Establishing Aspergillus-Specific IgG Cut-Off Level for Chronic Pulmonary Aspergillosis Diagnosis: Multicenter Prospective Cohort Study
title_full_unstemmed Establishing Aspergillus-Specific IgG Cut-Off Level for Chronic Pulmonary Aspergillosis Diagnosis: Multicenter Prospective Cohort Study
title_short Establishing Aspergillus-Specific IgG Cut-Off Level for Chronic Pulmonary Aspergillosis Diagnosis: Multicenter Prospective Cohort Study
title_sort establishing aspergillus-specific igg cut-off level for chronic pulmonary aspergillosis diagnosis: multicenter prospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8231598/
https://www.ncbi.nlm.nih.gov/pubmed/34204844
http://dx.doi.org/10.3390/jof7060480
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