{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:52:04Z","timestamp":1787028724104,"version":"build-2736575974"},"reference-count":21,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,6,12]],"date-time":"2021-06-12T00:00:00Z","timestamp":1623456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["109-2314-B-002-185-MY3"],"award-info":[{"award-number":["109-2314-B-002-185-MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008903","name":"Ministry of Health and Welfare","doi-asserted-by":"publisher","award":["MOHW109-CDC-C-114-000108"],"award-info":[{"award-number":["MOHW109-CDC-C-114-000108"]}],"id":[{"id":"10.13039\/100008903","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Objectives: Aspergillus-specific IgG (Asp-IgG) cut-off level in diagnosing chronic pulmonary aspergillosis (CPA) remains unknown. Methods: We prospectively recruited participants with clinical suspicion of CPA in three centers in Taiwan during 2019 June to 2020 August. Serum Aspergillus fumigatus-specific IgG (Asp-IgG) (Phadia, Uppsala, UPPS, Sweden) was examined. Optimal cut-off level was determined by Youden\u2019s index and validated. Results: A total of 373 participants were recruited. In the derivation cohort (n = 262), Asp-IgG had an area under the receiver-operating-characteristic curve (AUC) of 0.832. The optimal cut-off level was 40.5 mgA\/L. While applying this cut-off level to the validation cohort (n = 111), the sensitivity and specificity were 86.7% and 80.2%. Lowering the cut-off level from 40.5 to 27 mgA\/L, the sensitivity was steady (30\/36, 83.3% to 31\/36, 86.1%) while specificity dropped from 81.9% (276\/337) to 63.5% (214\/337). Restricting CPA diagnosis to only chronic cavitary pulmonary aspergillosis (CCPA) and chronic fibrosing pulmonary aspergillosis (CFPA) yielded a cut-off level of 42.3 mgA\/L in the derivation cohort with a sensitivity of 100% and specificity of 84.4% in the validation cohort. Conclusions: Serum Asp-IgG performs well for CPA diagnosis and provides a low false-positive rate when using a higher cut-off level (preferably around 40 mgA\/L).<\/jats:p>","DOI":"10.3390\/jof7060480","type":"journal-article","created":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T22:25:46Z","timestamp":1623709546000},"page":"480","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Establishing Aspergillus-Specific IgG Cut-Off Level for Chronic Pulmonary Aspergillosis Diagnosis: Multicenter Prospective Cohort Study"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7220-4833","authenticated-orcid":false,"given":"Meng-Rui","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital, Taipei 10002, Taiwan"},{"name":"Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu 30059, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8809-0546","authenticated-orcid":false,"given":"Hung-Ling","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan"},{"name":"Division of Pulmonary and Critical Care Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Kaohsiung 80708, Taiwan"},{"name":"Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Kaohsiung 80708, Taiwan"},{"name":"Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Ta","family":"Keng","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital, Taipei 10002, Taiwan"},{"name":"Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu 30059, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsu-Liang","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan"},{"name":"Division of Pulmonary and Critical Care Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Kaohsiung 80708, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7979-3749","authenticated-orcid":false,"given":"Chau-Chyun","family":"Sheu","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Kaohsiung 80708, Taiwan"},{"name":"Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Kaohsiung 80708, Taiwan"},{"name":"Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9416-4094","authenticated-orcid":false,"given":"Pin-Kuei","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan"},{"name":"Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung 40254, Taiwan"},{"name":"College of Human Science and Social Innovation, Hungkuang University, Taichung 43302, Taiwan"},{"name":"Department of Computer Science, Tunghai University, Taichung 40704, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3406-366X","authenticated-orcid":false,"given":"Jann-Yuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital, Taipei 10002, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8328-8684","authenticated-orcid":false,"given":"Inn-Wen","family":"Chong","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Kaohsiung 80708, Taiwan"},{"name":"Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Kaohsiung 80708, Taiwan"},{"name":"Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan"},{"name":"Departments of Respiratory Therapy, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan"},{"name":"Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2854-5067","authenticated-orcid":false,"given":"Jin-Yuan","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital, Taipei 10002, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5664-9392","authenticated-orcid":false,"given":"Chong-Jen","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital, Taipei 10002, Taiwan"},{"name":"Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu 30059, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1183\/13993003.00583-2015","article-title":"Chronic 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