Abstract Background To investigate the seroprevalence of Aspergillus IgG antibodies among patients with chronic invasive Aspergillus rhinosinusitis (CIARS) and to assess their prognostic value for extrasinonasal involvement and therapeutic outcomes. Methods A total of 132 patients with histopathologically confirmed CIARS were included. Serum Aspergillus IgG antibody levels were measured by enzyme-linked immunosorbent assay. Univariate and multivariate analyses were conducted to identify independent predictors of extrasinonasal involvement. To evaluate the prognostic value of antibody monitoring, serial Aspergillus IgG levels were assessed, and their association with radiological remission was analyzed. Results Among the 132 patients, 50 (37.9%) tested positive for Aspergillus IgG antibodies. Seropositivity was significantly higher among patients with extrasinonasal involvement than among those without such involvement (59.2% vs. 8.9%; P .001). Multivariable analysis identified positive serum Aspergillus IgG antibodies (odds ratio OR = 11.28, 95% confidence interval CI: 3.67–34.64, P .001), sphenoid sinus involvement (OR = 4.72, 95% CI: 1.89–11.79, P .001), and ethmoid sinus involvement (OR = 5.22, 95% CI: 1.53–17.86, P = .008) as independent predictors of extrasinonasal involvement. Serial antibody monitoring was conducted to evaluate treatment outcomes, revealed a significant decrease in Aspergillus IgG levels in the radiological and clinical remission groups after antifungal therapy (median = 16.12 NovaTec units NTU; interquartile range IQR = 12.87–21.96 vs. median = 9.21 NTU; IQR = 6.52–13.23; P .001). In contrast, no significant change was observed in the stable disease group. Conclusions Aspergillus IgG antibody is a promising noninvasive biomarker associated with extrasinonasal invasion and disease progression in CIARS.
Huang et al. (Thu,) studied this question.