血液病患者的侵袭性肺曲霉病评估:三级医院三年来的成果。

0 MEDICINE, RESEARCH & EXPERIMENTAL Biomolecules & biomedicine Pub Date : 2025-03-07 DOI:10.17305/bb.2024.10766
Mine Aydın Kurc, Betül Günaydın, Seval Akpınar, Birol Safak, Nuri Kiraz
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引用次数: 0

摘要

侵袭性肺曲霉菌病(IPA)是血液恶性肿瘤患者最常见的侵袭性真菌病。血清半乳甘露聚糖(GM)抗原监测被认为有助于IPA的诊断。本研究旨在确定血清样本中的 GM 检测在诊断血液病患者 IPA 中的作用。研究人员对2017年1月至2019年12月期间在血液科门诊住院并随访的366名免疫抑制患者的数据进行了回顾性分析。对患者的临床和放射学检查结果以及每周两次申请的 GM 结果进行了评估。在这项研究中,疑似和可能IPA的发生率被确定为15.3%(56/366)。在发现的病例中,28 例(50.0%)被诊断为急性髓性白血病(AML),34 例(60.7%)临床和检查结果相符的患者开始接受抗真菌治疗。此外,还通过接收器操作特征(ROC)分析计算了曲线下面积(AUC)值,结果表明,当 IPA 疾病 GM 检测的临界值为 0.5 时,诊断效率更具预测性。检测血清中的 GM 抗原是诊断免疫抑制血液病患者 IPA 疾病的一种非常有用且快速的方法。然而,GM 检测结果应与临床和放射学检查结果一起评估,以便早期诊断,并确定相应的治疗方法。
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Invasive pulmonary aspergillosis evaluation in hematology patients: Three years results of tertiary hospital.

Invasive pulmonary aspergillosis (IPA) is the most frequent invasive fungal disease occurring in patients with hematological malignancies. Serum galactomannan (GM) antigen monitoring is thought to be helpful in the diagnosis of IPA. The aim of this study was to determine the role of a GM assay in serum samples for the diagnosis of IPA in patients with hematological disease. The data of 366 immunosuppressed patients that were hospitalized and followed up in the hematology clinic from January 2017 to December 2019 were retrospectively analyzed. The clinical and radiological findings of the patients and the GM results, requested twice a week, were evaluated. In this study, the incidence of probable and possible IPA was determined to be 15.3% (56/366). Of the cases detected, 28 (50.0%) were patients diagnosed with acute myeloid leukemia (AML), and 34 (60.7%) patients who had compatible clinical and examination findings were started on antifungal treatment. Additionally, area under the curve (AUC) values were calculated by receiver operating characteristic (ROC) analysis, and it was determined that the diagnostic efficiency was more predictive when the cut-off was 0.5 in the GM test for IPA disease. The detection of GM antigen in serum is a very useful and rapid method for diagnosing IPA disease in immunosuppressed hematology patients. However, GM results should be evaluated together with clinical and radiological findings for early diagnosis, and the treatment approach should be determined accordingly.

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