Abstract

ObjectiveThe aim of this study was to investigate the diagnostic performance of serum 1,3-β-D-gluan as biomarker for invasive fungal infection through meta-analysis.MethodsThe electronic databases of Medline, Cochrane, Embase, Web of Science, OVID and CNKI were systematic searched to identified the case-control or Cohort studies relevant to diagnostic efficacy of serum 1,3-β-D-glucan for invasive fungal infection. The data of true positive (tp), false positive (fp), false negative (fn) and true negative (tn) patients number were extracted from each of the original included studies. The diagnostic sensitivity, specificity and systematic receiver operating characteristic (SROC) curve were calculated and pooled through random or fixed effect method. The publication bias was evaluated by the Deek’s funnel plot.ResultsThirty-seven relevant studies were fulfilled the inclusion criteria and included in our present meta-analysis. The combined sensitivity, specificity, positive likely hood ratio (+lr), negative likely hood ratio (-lr) and diagnostic odds ratio(dor) for 1,3-β-D-glucan in diagnosis of invasive fungal infectionwere 0.83 (95%CI:0.38-0.61), 0.81 (95%CI:0.80-0.82), 5.13 (95%CI:3.98-6.62), 0.23 (95%CI:0.18-0.30), and 29.68 (95%CI:18.94-46.52) respectively. The pooled area under the ROC curve (AUC) was 0.91.The Deek’s funnel plot asymmetry test showed there was no publication bias for 1,3-β-D-glucan in diagnosis of invasive fungal infection of the included 37 studies.ConclusionSerum 1,3-β-D-glucan assay was a promising biomarker for invasive fungal infection diagnosis.

Highlights

  • Invasive fungal infections (IFIs) are serious kinds of fungal diseases that invade the body, grow and reproduce in body tissues, organs and blood, and cause inflammation and tissue damage [1]

  • The below terms were used for electronic databases searching. (1) invasive fungal infection/IFI; (2) invasive fungal disease/IFD; (3) 1,3-β-D-glucan/BG/BDG

  • The diagnostic efficacy for 1,3-β-D-glucan for invasive fungal infection was pooled by MetaDiSc 1.4 software by the equation of sensitivity=true positive/(true positive+ false negative), specificity=true negative/( true negative+ false positive)

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Summary

Introduction

Invasive fungal infections (IFIs) are serious kinds of fungal diseases that invade the body, grow and reproduce in body tissues, organs and blood, and cause inflammation and tissue damage [1]. The diagnosis of invasive fungal infection was not easy in clinical practice [3]. Invasive fungal infection often requires fungal culture or histopathological examination to confirm the diagnosis. The diagnostic performance of 1,3-β-D-glucan was quite different according to the previously published studies because of different 1,3-β-D-glucan assays and cutoff value [4]. We performed this meta-analysis and pooled the diagnostic efficacy to further assess it clinical value

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