Author/Authors :
Hu, Yue Department of Pulmonary and Critical Care Medicine - The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China , Zheng, Lin Department of Microbiology - The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China , Pan, Deng Department of Cell - Clinicopathological Diagnosis Center of Ningbo, Ningbo, Zhejiang, China , Shao, Lei Department of Cell - Clinicopathological Diagnosis Center of Ningbo, Ningbo, Zhejiang, China , Xu, Xianfa Department of Cell - Clinicopathological Diagnosis Center of Ningbo, Ningbo, Zhejiang, China , Yu, Yiming Department of Pulmonary and Critical Care Medicine - The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China , Zhuang, Qidong Department of Pulmonary and Critical Care Medicine - The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China , Deng, Zaichun Department of Pulmonary and Critical Care Medicine - The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China , Chen, Zhongbo Department of Pulmonary and Critical Care Medicine - The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China
Abstract :
In recent years, various biomarkers have been gradually applied on bronchoalveolar lavage (BAL) fluid for the diagnosis of
invasive pulmonary aspergillosis (IPA). 0e objective of this study is to assess the value of the liquid-based cytopathology test
(LCT) for improving the identification of IPA in BAL fluid from possible IPA patients, following special staining with periodic
acid-Schiff staining (PAS) or Grocott’s methenamine silver (GMS). A total of 47 consecutive possible IPA patients who underwent
bronchoscopy with BAL fluid from January 2017 to December 2018 were included. 45 people had a pair of BAL fluid specimens
and 2 patients had two BAL fluid specimens. 0e 49 pairs of BAL fluid specimens were processed for culture, tuberculosis acid fast
staining smear, direct microbial smear, and LCT with special staining (PAS and GMS), respectively. 0en, we compared the
sensitivity and specificity of PAS and GMS in BAL fluid in high-risk patients. Among 47 possible IPA patients, 25 patients had
proven/probable IPA, and 11 patients had other invasive fungal diseases. 0e sensitivity of GMS was higher than that of PAS
(92.11% versus 81.58%; P = 0.175). 0e specificity of GMS was 81.82%, which was higher than that of PAS (81.82% versus 72.73%;
P = 0.611). 0e negative predictive value (NPV) for PAS and GMS were 53.33% and 75.00%, respectively. 0e positive predictive
value (PPV) for PAS and GMS were 91.18% and 94.59%, respectively. 0is study showed that special staining of LCT in BAL fluid
may be a novel method for the diagnosis of IPA, and the GMS of LCT had higher sensitivity and specificity, which was superior
to PAS.
Keywords :
Liquid-Based Cytopathology , Bronchoalveolar Lavage , Diagnosis of Invasive , Pulmonary Aspergillosis
