최근 2년간 Polycheck Allergy 검사 결과의 분석: Skin Prick Test 및 ImmunoCAP과의 비교
Analysis of Polycheck Allergy Results of the Recent Two Years: Comparison with Skin Prick Test and ImmunoCAP
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배경: Multiple Antigen Simultaneous Test (MAST)-immunoblot assay는 간편하고 경제적인 검사로 최근 국내에 도입되었다. 저자들은 MAST-immunoblot assay (Polycheck Allergy; Biocheck GmbH,Germany)의 검사 효용성을 알아보고자 하였다. 방법: Polycheck Allergy가 의뢰된 3,153명의 환자를 대상으로 분석을 실시하여 ImmunoCAP (Pharmacia AB, Sweden), 피부단자시험 결과와 각각 532명 및 75명의 환자에서 비교하였다. VIDAS (Biomerieux SA., France)로 측정한 총 IgE 결과와의 상관성도 분석하였다. 결과: 피부단자시험과의 일치율은 Polycheck Allergy 흡입형이87.8%, 음식형이 89.3%였고 ImmunoCAP은 95.2%이었다. 양성률은 D. farinae (46.2%), D. pteronyssinus (40.0%)가 가장 높은 비율을 차지하였으며 두 항원에 대해 피부단자시험을 기준으로 한일치율, 민감도, 특이도를 조사한 결과 Polycheck Allergy가 ImmunoCAP에비해 D. pteronyssinus의 특이도를 제외하고는 일치율(D. farinae; 76.0 vs. 70.7%, D. pteronyssinus; 76.0 vs. 74.4%), 민감도(D. farinae; 72.7 vs. 68.2%, D. pteronyssinus; 75.0 vs. 71.2%),특이도(D. farinae; 85.0 vs. 81.3%, D. pteronyssinus; 78.3 vs. 87.5%)모두가 높았다. 총 IgE는 100 kU/L 초과 시 특이 IgE 양성을 보이는환자가 음성을 보이는 환자보다 유의하게 많았다(흡입형 P<0.0001,음식형 P =0.0008). 결론: Polycheck Allergy는 기존 검사(ImmunoCAP)와 비슷하거나우수한 일치율, 민감도, 특이도를 보이고 VIDAS 총 IgE와도 연관성을 가지고 있어 알레르기 질환의 진단과 치료에 효과적으로 사용될 것으로 판단하였다.
Abstract
Background: Multiple Antigen Simultaneous Test (MAST)-immunoblot assay is a practical and economical test, which has been recently introduced nationwide. Authors investigated test efficiency of a MAST-immunoblot assay, Polycheck Allergy (PA). Methods: A total of 3,153 patients were tested by PA and the results were compared with the results of ImmunoCAP and skin prick test (SPT) in 532 and 75 patients, respectively. The correlation with the lgE results measured by VIDAS was also analyzed. Results: The agreements of PA with SPT were 87.8% in the Inhalant Panel and 89.3% in the Food Panel and the agreement of ImmunoCAP with SPT was 95.2%. The most common allergens giving positive reactions were Dermatophagoides farinae (46.2%) and Dermatophagoides pteronyssinus(40.0%). SPT taken as a reference, PA compared with ImmunoCAP showed higher agreement (D. farinae, 76.0 vs. 70.7%; D. pteronyssinus, 76.0 vs. 74.4%), sensitivity (D. farinae, 72.7 vs. 68.2%; D. pteronyssinus, 75.0 vs. 71.2%) and specificity (D. farinae, 85.0 vs. 81.3%) except for the specificity for D. pteronyssinus (78.3 vs. 87.5%). The rate of allergen specific IgE positive patients was higher than that of negative patients when total IgE was over 100 kU/L. Conclusions: Our results showed that the agreement, sensitivity and specificity of PA were similar to or better than those of the previously established test, ImmunoCAP. The allergen specific IgE results of PA were in correlation with total IgE. PA may be used for testing allergen specific IgE to diagnose and treat allergic diseases.
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