Improved diagnostic markers for invasive pulmonary aspergillosis in COPD patients
BackgroundThe prevalence of invasive pulmonary aspergillosis (IPA) among patients with chronic obstructive pulmonary disease (COPD) is steadily increasing, leading to high mortality. Although early diagnosis can significantly reduce mortality, the efficacy of current diagnostic methods is limited. C...
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| Format: | Article |
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Frontiers Media S.A.
2024-04-01
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| Series: | Frontiers in Cellular and Infection Microbiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcimb.2024.1294971/full |
| _version_ | 1827295848046788608 |
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| author | Zhiwei Long Xiaotong Li Zhengtu Li Jieying Hu Ye Qiu Shaoqiang Li Yangqing Zhan Feng Ye Yan Wang |
| author_facet | Zhiwei Long Xiaotong Li Zhengtu Li Jieying Hu Ye Qiu Shaoqiang Li Yangqing Zhan Feng Ye Yan Wang |
| author_sort | Zhiwei Long |
| collection | DOAJ |
| description | BackgroundThe prevalence of invasive pulmonary aspergillosis (IPA) among patients with chronic obstructive pulmonary disease (COPD) is steadily increasing, leading to high mortality. Although early diagnosis can significantly reduce mortality, the efficacy of current diagnostic methods is limited. Consequently, there is a need for novel approaches for early IPA detection.MethodsThis retrospective study involved 383 hospitalized COPD patients with GOLD stages III and IV. The IPA group (67 patients) and non-IPA group (316 patients) were identified at the First Affiliated Hospital of Guangzhou Medical University between January 2016 and February 2022. We analyzed common serological indicators in our hospital to identify predictive indicators for the early diagnosis of IPA in COPD patients.ResultsThe sensitivity and specificity of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), lactate dehydrogenase (LDH), and ceruloplasmin (CER) for diagnosing IPA in COPD patients were as follows: CRP (91.2%, 57.7%), ESR (77.5%, 73.0%), PCT (60.5%, 71.4%), LDH (50.0%, 88.8%), and CER (60.7%, 74.3%). Combinations of biomarkers, such as CRP-ESR, CRP-LDH, ESR-LDH, ESR-CER, and LDH-CER, showed promising diagnostic potential, with larger area under the curve (AUC) values for IPA diagnosis in COPD patients. However, no statistically significant difference was observed between the diagnostic efficacy of single biomarkers and combined biomarkers. Notably, compared to those in the unassisted ventilation group, the patients in the assisted ventilation group (including noninvasive ventilation and tracheal intubation/incision-assisted ventilation group) exhibited significantly greater PCT and LDH levels, while the CER significantly decreased (p=0.021). There were no significant differences in biomarker levels between the ICU group and the non-ICU group. CRP (p<0.01), ESR (p=0.028), PCT (p<0.01), and CER (p<0.01) were positively correlated with hospitalization duration, whereas LDH was not correlated with hospitalization duration.ConclusionOur study highlights the diagnostic potential of CRP, ESR, PCT, LDH, and CER for IPA in COPD patients. CRP and LDH can also initially predict the need for assisted ventilation, while CRP can initially estimate the length of hospitalization. This study represents the first report of the potential of CER for diagnosing IPA, suggesting its significance for further research. |
| first_indexed | 2024-04-24T14:27:18Z |
| format | Article |
| id | doaj.art-d057c1d7fff14fa4956ca88013a76522 |
| institution | Directory Open Access Journal |
| issn | 2235-2988 |
| language | English |
| last_indexed | 2024-04-24T14:27:18Z |
| publishDate | 2024-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cellular and Infection Microbiology |
| spelling | doaj.art-d057c1d7fff14fa4956ca88013a765222024-04-03T04:32:42ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882024-04-011410.3389/fcimb.2024.12949711294971Improved diagnostic markers for invasive pulmonary aspergillosis in COPD patientsZhiwei LongXiaotong LiZhengtu LiJieying HuYe QiuShaoqiang LiYangqing ZhanFeng YeYan WangBackgroundThe prevalence of invasive pulmonary aspergillosis (IPA) among patients with chronic obstructive pulmonary disease (COPD) is steadily increasing, leading to high mortality. Although early diagnosis can significantly reduce mortality, the efficacy of current diagnostic methods is limited. Consequently, there is a need for novel approaches for early IPA detection.MethodsThis retrospective study involved 383 hospitalized COPD patients with GOLD stages III and IV. The IPA group (67 patients) and non-IPA group (316 patients) were identified at the First Affiliated Hospital of Guangzhou Medical University between January 2016 and February 2022. We analyzed common serological indicators in our hospital to identify predictive indicators for the early diagnosis of IPA in COPD patients.ResultsThe sensitivity and specificity of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), lactate dehydrogenase (LDH), and ceruloplasmin (CER) for diagnosing IPA in COPD patients were as follows: CRP (91.2%, 57.7%), ESR (77.5%, 73.0%), PCT (60.5%, 71.4%), LDH (50.0%, 88.8%), and CER (60.7%, 74.3%). Combinations of biomarkers, such as CRP-ESR, CRP-LDH, ESR-LDH, ESR-CER, and LDH-CER, showed promising diagnostic potential, with larger area under the curve (AUC) values for IPA diagnosis in COPD patients. However, no statistically significant difference was observed between the diagnostic efficacy of single biomarkers and combined biomarkers. Notably, compared to those in the unassisted ventilation group, the patients in the assisted ventilation group (including noninvasive ventilation and tracheal intubation/incision-assisted ventilation group) exhibited significantly greater PCT and LDH levels, while the CER significantly decreased (p=0.021). There were no significant differences in biomarker levels between the ICU group and the non-ICU group. CRP (p<0.01), ESR (p=0.028), PCT (p<0.01), and CER (p<0.01) were positively correlated with hospitalization duration, whereas LDH was not correlated with hospitalization duration.ConclusionOur study highlights the diagnostic potential of CRP, ESR, PCT, LDH, and CER for IPA in COPD patients. CRP and LDH can also initially predict the need for assisted ventilation, while CRP can initially estimate the length of hospitalization. This study represents the first report of the potential of CER for diagnosing IPA, suggesting its significance for further research.https://www.frontiersin.org/articles/10.3389/fcimb.2024.1294971/fullinvasive pulmonary aspergillosischronic obstructive pulmonary diseaseC-reactive proteinerythrocyte sedimentation rateprocalcitoninlactate dehydrogenase |
| spellingShingle | Zhiwei Long Xiaotong Li Zhengtu Li Jieying Hu Ye Qiu Shaoqiang Li Yangqing Zhan Feng Ye Yan Wang Improved diagnostic markers for invasive pulmonary aspergillosis in COPD patients Frontiers in Cellular and Infection Microbiology invasive pulmonary aspergillosis chronic obstructive pulmonary disease C-reactive protein erythrocyte sedimentation rate procalcitonin lactate dehydrogenase |
| title | Improved diagnostic markers for invasive pulmonary aspergillosis in COPD patients |
| title_full | Improved diagnostic markers for invasive pulmonary aspergillosis in COPD patients |
| title_fullStr | Improved diagnostic markers for invasive pulmonary aspergillosis in COPD patients |
| title_full_unstemmed | Improved diagnostic markers for invasive pulmonary aspergillosis in COPD patients |
| title_short | Improved diagnostic markers for invasive pulmonary aspergillosis in COPD patients |
| title_sort | improved diagnostic markers for invasive pulmonary aspergillosis in copd patients |
| topic | invasive pulmonary aspergillosis chronic obstructive pulmonary disease C-reactive protein erythrocyte sedimentation rate procalcitonin lactate dehydrogenase |
| url | https://www.frontiersin.org/articles/10.3389/fcimb.2024.1294971/full |
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