{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:11:42Z","timestamp":1793725902161,"version":"4.6.1"},"reference-count":31,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/501100007129","name":"Shandong Province Natural Science Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Microbiology and Infectious Disease"],"published-print":{"date-parts":[[2026,12]]},"DOI":"10.1016\/j.diagmicrobio.2026.117612","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T15:08:29Z","timestamp":1786374509000},"page":"117612","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic accuracy of bronchoalveolar lavage fluid-based testing for pulmonary cryptococcosis: A systematic review and meta-analysis"],"prefix":"10.1016","volume":"116","author":[{"given":"Zongsheng","family":"Tian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueyan","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuojuan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingdi","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueliang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingdi","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"1","key":"10.1016\/j.diagmicrobio.2026.117612_bib0001","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s40249-023-01073-4","article-title":"Cryptococcus neoformans, a global threat to human health","volume":"12","author":"Zhao","year":"2023","journal-title":"Infect Dis Poverty"},{"issue":"1","key":"10.1016\/j.diagmicrobio.2026.117612_bib0002","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40249-025-01408-3","article-title":"Clinical spectrum, immune status, and prognostic factors of cryptococcosis: insights from a large, multi-center, ambispective cohort study in southeastern China","volume":"15","author":"Gu","year":"2026","journal-title":"Infect Dis Poverty"},{"issue":"1","key":"10.1016\/j.diagmicrobio.2026.117612_bib0003","doi-asserted-by":"crossref","DOI":"10.1128\/spectrum.01083-25","article-title":"Evaluation of a lateral flow immunochromatographic assay for detecting cryptococcal antigens in bronchoalveolar lavage fluid from HIV-negative patients with pulmonary cryptococcosis","volume":"14","author":"Chen","year":"2026","journal-title":"Microbiol Spectr"},{"issue":"1","key":"10.1016\/j.diagmicrobio.2026.117612_bib0004","doi-asserted-by":"crossref","first-page":"253","DOI":"10.3348\/jksr.2022.0008","article-title":"Clinicoradiological features of pulmonary cryptococcosis in immunocompetent patients","volume":"84","author":"Choi","year":"2023","journal-title":"J Korean Soc Radiol"},{"issue":"2","key":"10.1016\/j.diagmicrobio.2026.117612_bib0005","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1093\/mmy\/myy086","article-title":"Pulmonary cryptococcosis: a review of pathobiology and clinical aspects","volume":"57","author":"Setianingrum","year":"2019","journal-title":"Med Mycol"},{"issue":"12","key":"10.1016\/j.diagmicrobio.2026.117612_bib0006","doi-asserted-by":"crossref","first-page":"2301","DOI":"10.1007\/s10096-024-04946-0","article-title":"Comparison of performances of laboratory methods in diagnosing pulmonary cryptococcosis in 1508 patients having lung biopsy tissues collected: a 6-year retrospective study","volume":"43","author":"Liu","year":"2024","journal-title":"Eur J Clin Microbiol Infect Dis"},{"issue":"1","key":"10.1016\/j.diagmicrobio.2026.117612_bib0007","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1186\/s12890-024-03259-4","article-title":"The relationship between lung CT features and serum cryptococcal antigen titers in localized pulmonary cryptococcosis patients","volume":"24","author":"Dai","year":"2024","journal-title":"BMC Pulm Med"},{"key":"10.1016\/j.diagmicrobio.2026.117612_bib0008","article-title":"Diagnostic value of cryptococcal glucuronoxylomannan antigen testing of bronchoalveolar lavage fluid for pulmonary cryptococcosis in immunocompetent patients: a clinical study","volume":"20","author":"Dong","year":"2025","journal-title":"Ther Adv Pulm Crit Care Med"},{"issue":"10","key":"10.1016\/j.diagmicrobio.2026.117612_bib0009","doi-asserted-by":"crossref","first-page":"3088","DOI":"10.1128\/JCM.36.10.3088-3089.1998","article-title":"Utility of routine testing of bronchoalveolar lavage fluid for cryptococcal antigen","volume":"36","author":"Kralovic","year":"1998","journal-title":"J Clin Microbiol"},{"issue":"5","key":"10.1016\/j.diagmicrobio.2026.117612_bib0010","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1164\/ajrccm\/145.5.1226","article-title":"Detection of cryptococcal antigen in bronchoalveolar lavage fluid: a prospective study of diagnostic utility","volume":"145","author":"Baughman","year":"1992","journal-title":"Am Rev Respir Dis"},{"issue":"5\u20136","key":"10.1016\/j.diagmicrobio.2026.117612_bib0011","first-page":"422","article-title":"Value of assessing cryptococcal antigen in bronchoalveolar lavage and sputum specimens from patients with AIDS","volume":"65","author":"Bottone","year":"1998","journal-title":"Mt Sinai J Med"},{"issue":"1","key":"10.1016\/j.diagmicrobio.2026.117612_bib0012","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1093\/mmy\/myx010","article-title":"Examination of cryptococcal glucuronoxylomannan antigen in bronchoalveolar lavage fluid for diagnosing pulmonary cryptococcosis in HIV-negative patients","volume":"56","author":"Oshima","year":"2018","journal-title":"Med Mycol"},{"issue":"5","key":"10.1016\/j.diagmicrobio.2026.117612_bib0013","first-page":"765","article-title":"Performance of cryptococcal antigen lateral flow assay in bronchoalveolar lavage fluid in HIV-negative patients","volume":"53","author":"Yang","year":"2023","journal-title":"Ann Clin Lab Sci"},{"issue":"4","key":"10.1016\/j.diagmicrobio.2026.117612_bib0014","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1001\/jama.2017.19163","article-title":"Preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies: the PRISMA-DTA Statement","volume":"319","author":"McInnes","year":"2018","journal-title":"JAMA"},{"issue":"8","key":"10.1016\/j.diagmicrobio.2026.117612_bib0015","doi-asserted-by":"crossref","first-page":"529","DOI":"10.7326\/0003-4819-155-8-201110180-00009","article-title":"QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies","volume":"155","author":"Whiting","year":"2011","journal-title":"Ann Intern Med"},{"issue":"2","key":"10.1016\/j.diagmicrobio.2026.117612_bib0016","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.jmii.2021.05.002","article-title":"Examination of a Chinese-made cryptococcal glucuronoxylomannan antigen test in serum and bronchoalveolar lavage fluid for diagnosing pulmonary cryptococcosis in HIV-negative patients","volume":"55","author":"Li","year":"2022","journal-title":"J Microbiol Immunol Infect"},{"issue":"3","key":"10.1016\/j.diagmicrobio.2026.117612_bib0017","doi-asserted-by":"crossref","DOI":"10.1016\/j.diagmicrobio.2020.115276","article-title":"Diagnostic value of bronchoalveolar lavage fluid cryptococcal antigen-lateral flow immunochromatographic assay for pulmonary cryptococcosis in non-HIV patients","volume":"99","author":"Zeng","year":"2021","journal-title":"Diagn Microbiol Infect Dis"},{"issue":"8","key":"10.1016\/j.diagmicrobio.2026.117612_bib0018","first-page":"711","article-title":"Diagnostic value of the combinations of bronchoalveolar lavage fluid pathogen detection and cryptococcal antigen test in pulmonary cryptococcosis","volume":"44","author":"Qunfeng","year":"2021","journal-title":"Zhonghua Jie He He Hu Xi Za Zhi"},{"issue":"4","key":"10.1016\/j.diagmicrobio.2026.117612_bib0019","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1177\/147323000303100411","article-title":"Utility of testing bronchoalveolar lavage fluid for cryptococcal ribosomal DNA","volume":"31","author":"Takahashi","year":"2003","journal-title":"J Int Med Res"},{"key":"10.1016\/j.diagmicrobio.2026.117612_bib0020","doi-asserted-by":"crossref","DOI":"10.3389\/fcimb.2022.997256","article-title":"Diagnostic accuracy of metagenomic next-generation sequencing for cryptococcosis in immunocompetent and immunocompromised patients","volume":"12","author":"Su","year":"2022","journal-title":"Front Cell Infect Microbiol"},{"key":"10.1016\/j.diagmicrobio.2026.117612_bib0021","doi-asserted-by":"crossref","first-page":"2483","DOI":"10.2147\/IDR.S178391","article-title":"The performance of serum cryptococcal capsular polysaccharide antigen test, histopathology and culture of the lung tissue for diagnosis of pulmonary cryptococcosis in patients without HIV infection","volume":"11","author":"Zhou","year":"2018","journal-title":"Infect Drug Resist"},{"issue":"3","key":"10.1016\/j.diagmicrobio.2026.117612_bib0022","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1378\/chest.115.3.734","article-title":"Pulmonary cryptococcosis in patients without HIV infection","volume":"115","author":"Aberg","year":"1999","journal-title":"Chest"},{"issue":"5","key":"10.1016\/j.diagmicrobio.2026.117612_bib0023","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1086\/322597","article-title":"Cryptococcosis in human immunodeficiency virus-negative patients in the era of effective azole therapy","volume":"33","author":"Pappas","year":"2001","journal-title":"Clin Infect Dis"},{"issue":"6","key":"10.1016\/j.diagmicrobio.2026.117612_bib0024","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1093\/mmy\/myx092","article-title":"Cryptococcal antigen detection in broncho-alveolar lavage fluid","volume":"56","author":"Senghor","year":"2018","journal-title":"Med Mycol"},{"issue":"3","key":"10.1016\/j.diagmicrobio.2026.117612_bib0025","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1128\/CMR.00001-12","article-title":"The Cryptococcus neoformans capsule: a sword and a shield","volume":"25","author":"O'Meara","year":"2012","journal-title":"Clin Microbiol Rev"},{"key":"10.1016\/j.diagmicrobio.2026.117612_bib0026","doi-asserted-by":"crossref","first-page":"129","DOI":"10.3389\/fmed.2019.00129","article-title":"Immunomodulatory role of capsular polysaccharides constituents of cryptococcus neoformans","volume":"6","author":"Decote-Ricardo","year":"2019","journal-title":"Front Med (Lausanne)"},{"key":"10.1016\/j.diagmicrobio.2026.117612_bib0027","doi-asserted-by":"crossref","first-page":"8008","DOI":"10.1038\/srep08008","article-title":"Capsular polysaccharides from cryptococcus neoformans modulate production of neutrophil extracellular traps (NETs) by human neutrophils","volume":"5","author":"Rocha","year":"2015","journal-title":"Sci Rep"},{"issue":"1","key":"10.1016\/j.diagmicrobio.2026.117612_bib0028","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-018-34649-4","article-title":"Involvement of the capsular GalXM-induced IL-17 cytokine in the control of cryptococcus neoformans infection","volume":"8","author":"LaRocque-de-Freitas","year":"2018","journal-title":"Sci Rep"},{"issue":"3","key":"10.1016\/j.diagmicrobio.2026.117612_bib0029","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1007\/s11046-021-00558-w","article-title":"Production of secreted carbohydrates that present immunologic similarities with the cryptococcus glucuronoxylomannan by members of the trichosporonaceae family: a comparative study among species of clinical interest","volume":"186","author":"de Andrade","year":"2021","journal-title":"Mycopathologia"},{"issue":"12","key":"10.1016\/j.diagmicrobio.2026.117612_bib0030","doi-asserted-by":"crossref","first-page":"1988","DOI":"10.1128\/CVI.00446-12","article-title":"Comparison of four assays for the detection of cryptococcal antigen","volume":"19","author":"Binnicker","year":"2012","journal-title":"Clin Vaccine Immunol"},{"issue":"11","key":"10.1016\/j.diagmicrobio.2026.117612_bib0031","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0049541","article-title":"Clinical utility of the cryptococcal antigen lateral flow assay in a diagnostic mycology laboratory","volume":"7","author":"McMullan","year":"2012","journal-title":"PLoS One"}],"container-title":["Diagnostic Microbiology and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0732889326003627?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0732889326003627?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:09:29Z","timestamp":1792066169000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0732889326003627"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,12]]},"references-count":31,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,12]]}},"alternative-id":["S0732889326003627"],"URL":"https:\/\/doi.org\/10.1016\/j.diagmicrobio.2026.117612","relation":{},"ISSN":["0732-8893"],"issn-type":[{"value":"0732-8893","type":"print"}],"subject":[],"published":{"date-parts":[[2026,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Diagnostic accuracy of bronchoalveolar lavage fluid-based testing for pulmonary cryptococcosis: A systematic review and meta-analysis","name":"articletitle","label":"Article Title"},{"value":"Diagnostic Microbiology and Infectious Disease","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.diagmicrobio.2026.117612","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"117612"}}