ROC曲线评价1,3--D葡聚糖对侵袭性真菌病的诊断价值

Diagnostic efficacy of 1,3--D-glucan ROC curve analysis in invasive fungal disease

摘要: 目的:探讨侵袭性真菌病(IFD)血清1,3--D葡聚糖(BDG)阈值,并评价其临床意义。方法:收集34例IFD患者及105例非IFD患者的血清,动态比浊法测定BDG含量,采用ROC曲线确定BDG的最佳诊断值。结果:BDG的ROC曲线下面积为0.921,最佳诊断阈值为33.76 pg/ml,其对应的灵敏度、特异度、阳性预测值和阴性预测值分别为88.2%、87.6%、69.8%和95.8%。结论:BDG检测对于IFD具有较好的诊断价值,以33.76 pg/ml为阈值可提高诊断效率,但需结合其他检查、临床危险因素等。

Abstract: Objective:To investigate the diagnostic threshold of serum level of 1,3--D-glucan(BDG) for invasive fungal disease(IFD),and evaluate its clinical significance.Methods:Total serum samples of 34 IFD patients and 105 non-IFD cases were collected,BDG level was detected by kinetic turbidimetric limulus test,ROC curve analysis was used to determine the optimal diagnostic value of BDG.Results:ROC analysis showed that the area under the ROC curve of BDG was 0.921 and the optimal diagnostic threshold was33.76 pg/ml,the corresponding sensitivity,specificity,positive predictive value and negative predictive values were 88.2%,87.6%,69.8% and 95.8%,respectively.Conclusions:Serum BDG can serve as a good diagnostic indicator for IFD and the cut-off value of33.76 pg/ml plays the highest diagnostic efficiency,but it needs to combine with other examinations and clinical risk factors.