Lateral flow assay as radiological prognosis factor of pulmonary cryptococcosis: A single center retrospective study in China

Abstract Background Lateral flow assay (LFA) showed high sensitivity and specificity for diagnosing cryptococcosis. However, its predictive value for therapeutic efficacy of pulmonary cryptococcosis (PC) was rarely reported. Methods We conducted a retrospective analysis on HIV-negative PC to present the clinical profile and identify the potential predictors for radiological prognosis. Results All the 168 participants received antifungal therapy with a triazole agent. Of these, 84.5% experienced partial or complete absorption of pulmonary lesions. The results of the gamma test, chi-square trend test, and ordinal logistic regression all indicated that baseline LFA and changes in LFA after treatment were both predictors of imaging prognosis. The degree of radiological improvement showed a downward trend as the baseline LFA positive grade increased (P for linear-by-linear association: 0.011, Spearman correlation coefficient = -0.17; γ= -0.368, P = 0.045). Patients who experienced a decrease in LFA after therapy had a significantly better radiological prognosis than those with equal or increased LFA (linear-by-linear association, P = 0.014, Spearman correlation coefficient = 0.188; γ = 0.371, P = 0.012). Moreover, favorable outcomes were more likely in cases with lesions restricted in the right lung. Conclusions LFA is potential to monitor radiological outcomes of PC.