Background

There are several clinical diagnostic criteria for allergic bronchopulmonary aspergillosis (ABPA). However, these criteria have not been validated in detail, and no criteria for allergic bronchopulmonary mycosis (ABPM) are currently available.

Objective

This study proposes new diagnostic criteria for ABPA/ABPM, consisting of 10 components, and compares its sensitivity and specificity to existing methods.

Methods

Rosenberg-Patterson criteria proposed in 1977, the International Society for Human and Animal Mycology (ISHAM) criteria proposed in 2013, and this new criteria were applied to 79 cases with pathological ABPM and the control population with allergic mucin in the absence of fungal hyphae (n = 37), chronic eosinophilic pneumonia (n = 64), Aspergillus-sensitized severe asthma (n = 26), or chronic pulmonary aspergillosis (n = 24). These criteria were also applied to the 179 cases with physician-diagnosed ABPA/ABPM in a nationwide Japanese survey.

Results

The sensitivity for pathological ABPM with Rosenberg-Patterson criteria, ISHAM criteria, and this new criteria were 25.3%, 77.2%, and 96.2%, respectively. The sensitivity for physician-diagnosed ABPA/ABPM were 49.2%, 82.7%, and 94.4%, respectively. The areas under the curve for the receiver-operating characteristic curves were 0.85, 0.90, and 0.98, respectively. The sensitivity for ABPM cases that were culture-positive for non-Aspergillus fungi were 13.0%, 47.8%, and 91.3%, respectively.

Conclusions

The new diagnostic criteria, compared with existing criteria, showed better sensitivity and specificity for diagnosing ABPA/ABPM.

中文翻译：

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变应性支气管肺曲霉病/真菌病临床诊断新标准及其验证

背景

过敏性支气管肺曲霉病 (ABPA) 有多种临床诊断标准。然而，这些标准尚未得到详细验证，目前尚无过敏性支气管肺真菌病 (ABPM) 的标准。

客观的

本研究提出了 ABPA/ABPM 的新诊断标准，由 10 个组成部分组成，并将其敏感性和特异性与现有方法进行了比较。

方法

1977 年提出的 Rosenberg-Patterson 标准，2013 年提出的国际人类和动物真菌学学会 (ISHAM) 标准，并将这一新标准应用于 79 例病理性 ABPM 病例和无真菌菌丝的过敏性粘蛋白对照人群。 n = 37)、慢性嗜酸性粒细胞性肺炎 (n = 64)、曲霉菌致敏的严重哮喘 (n = 26) 或慢性肺曲霉病 (n = 24)。这些标准也适用于日本全国调查中的 179 例医生诊断为 ABPA/ABPM 的病例。

结果

Rosenberg-Patterson 标准、ISHAM 标准和新标准对病理性 ABPM 的敏感性分别为 25.3%、77.2% 和 96.2%。医生诊断的 ABPA/ABPM 的敏感性分别为 49.2%、82.7% 和 94.4%。接受者操作特征曲线的曲线下面积分别为 0.85、0.90 和 0.98。对于非曲霉属真菌培养阳性的 ABPM 病例的敏感性分别为 13.0%、47.8% 和 91.3%。

结论

与现有标准相比，新的诊断标准对诊断 ABPA/ABPM 显示出更好的敏感性和特异性。