Cobbaert Christa M, Jonker Geert Jan
Department of Clinical Chemistry, Amphia Hospital, Location Langendijk, Breda, The Netherlands.
Clin Chem Lab Med. 2005;43(7):772-81. doi: 10.1515/CCLM.2005.132.
We aimed to evaluate the diagnostic performance of the IMMULITE 2000 Allergy System from Diagnostic Products Corporation (DPC) for the detection of inhalant and food allergies, focusing on inhalant and food screens, mixes and single allergens.
Serum samples were collected from new, unselected patients who were referred to the allergist for a suspected allergy. Patients were classified as study diagnosis-positive for inhalant (food) allergy if they had both a positive clinical examination/history and a positive skin test for inhalant (food) allergy; otherwise - failing one or both of these criteria - they were classified as study diagnosis-negative. Classification and testing of the serum samples was carried out in a blinded fashion. Values greater than 0.35 kU/L were considered positive.
Of the 118 patients included, 63 were considered study diagnosis-positive for inhalation and/or food allergy. DPC inhalation screening showed 82% total agreement (TA) and 91% sensitivity relative to the study diagnoses. The DPC food panel showed 96% TA and 98% specificity relative to the study diagnoses. Relative to specific intracutaneous testing (ICT), the DPC D1, E1 and E5 assays had sensitivity of 82-90%; tree and grass panels had sensitivity of 74% and 95%. The DPC weed panel and initial lots of DPC E5 had poor sensitivity (<40%); mold panel sensitivity was equally low for both DPC and the routinely used Pharmacia assay (36%). Relative to skin prick testing (SPT), specific food allergens had TA of 94-98% and specificity of 95-100%.
In patients classified by the combination of clinical examination/history and skin test results, the DPC IMMULITE 2000 Allergy System generally demonstrated acceptable sensitivity, specificity and TA compared to the study diagnoses, both at the screening level and at the level of panels and single allergens.
我们旨在评估诊断产品公司(DPC)的IMMULITE 2000过敏检测系统对吸入性和食物过敏的诊断性能,重点关注吸入性和食物筛查、混合物及单一过敏原检测。
收集新的、未经挑选的因疑似过敏而转诊至过敏症专科医生处的患者的血清样本。若患者临床检查/病史呈阳性且吸入性(食物)过敏皮肤试验呈阳性,则被分类为吸入性(食物)过敏研究诊断阳性;否则,若未满足其中一项或两项标准,则被分类为研究诊断阴性。血清样本的分类和检测以盲法进行。大于0.35 kU/L的值被视为阳性。
纳入的118例患者中,63例被认为吸入性和/或食物过敏研究诊断阳性。相对于研究诊断,DPC吸入性筛查的总一致性(TA)为82%,敏感性为91%。DPC食物检测组相对于研究诊断的TA为96%,特异性为98%。相对于特定皮内试验(ICT),DPC D1、E1和E5检测的敏感性为82% - 90%;树木和草类检测组的敏感性分别为74%和95%。DPC杂草检测组及DPC E5的初始批次敏感性较差(<40%);霉菌检测组对于DPC和常规使用的法玛西亚检测的敏感性同样较低(36%)。相对于皮肤点刺试验(SPT),特定食物过敏原的TA为94% - 98%,特异性为95% - 100%。
在通过临床检查/病史及皮肤试验结果综合分类的患者中,与研究诊断相比,DPC IMMULITE 2000过敏检测系统在筛查水平以及检测组和单一过敏原水平上,总体表现出可接受的敏感性、特异性和TA。