Pediatrics Department, University Hospital of Besançon, Besançon, France.
Pediatric Allergy Department, University Hospital of Nancy, Nancy, France.
Allergy. 2017 Sep;72(9):1365-1373. doi: 10.1111/all.13148. Epub 2017 Apr 12.
Accurate assessment of atopic sensitization is pivotal to clinical practice and research. Skin prick test (SPT) and specific IgE (sIgE) are often used interchangeably. Some studies have suggested a disagreement between these two methods, and little is known about their association with allergic diseases. The aims of our study were to evaluate agreement between SPT and sIgE, and to compare their association with allergic diseases in 10-year-old children.
Skin prick test, sIgE measurements, and assessment of allergic diseases were performed in children aged 10 years in the Protection against Allergy: STUdy in Rural Environments (PASTURE) cohort. The agreement between SPT and sIgE was assessed by Cohen's kappa coefficient with different cutoff values.
Skin prick tests and sIgE were performed in 529 children. The highest agreement (κ=.44) was found with a cutoff value of 3 and 5 mm for SPT, and 3.5 IU/mL for sIgE. The area under the curve (AUC) obtained with SPT was not significantly different from that obtained with sIgE. For asthma and hay fever, SPT (cutoff value at 3 mm) had a significantly higher specificity (P<.0001) than sIgE (cutoff value at 0.35 IU/mL) and the specificity was not different between both tests (P=.1088).
Skin prick test and sIgE display moderate agreement, but have a similar AUC for allergic diseases. At the cutoff value of 3 mm for SPT and 0.35 IU/mL for sIgE, SPT has a higher specificity for asthma and hay fever than sIgE without difference for sensitivity.
准确评估过敏状态对于临床实践和研究至关重要。皮肤点刺试验（SPT）和特异性 IgE（sIgE）常被互换使用。一些研究表明这两种方法之间存在差异，而对于它们与过敏性疾病的相关性知之甚少。本研究旨在评估 SPT 和 sIgE 之间的一致性，并比较它们在 10 岁儿童中与过敏性疾病的相关性。
在保护过敏：农村环境研究（PASTURE）队列中，对 10 岁儿童进行皮肤点刺试验、sIgE 测量和过敏性疾病评估。通过 Cohen's kappa 系数评估不同截值下 SPT 和 sIgE 之间的一致性。
对 529 名儿童进行了皮肤点刺试验和 sIgE 检测。SPT 截值为 3 和 5 mm，sIgE 截值为 3.5 IU/mL 时，两者的一致性最高（κ=.44）。SPT 的曲线下面积（AUC）与 sIgE 无显著差异。对于哮喘和花粉热，SPT（截值为 3 mm）的特异性（P<.0001）明显高于 sIgE（截值为 0.35 IU/mL），且两种检测方法的特异性无差异（P=.1088）。
皮肤点刺试验和 sIgE 显示出中等程度的一致性，但对于过敏性疾病具有相似的 AUC。对于 SPT（截值为 3 mm）和 sIgE（截值为 0.35 IU/mL），SPT 对于哮喘和花粉热的特异性高于 sIgE，而敏感性无差异。
