HLA 검사 신빙도조사 결과(2003-2004년) = HLA Typing Proficiency Survey in Korea, 2003-2004

다국어 초록 (Multilingual Abstract)

Background : HLA proficiency survey in Korea started in 1996 and the results of the survey were last reported in 1999. In this report, we summarized the results of the survey performed in recent 2 years. Methods : A total of four proficiency surveys were performed, in which 54-59 laboratories participated. Each survey included 3 tests for HLA class I (serology and DNA) and class II (DNA) typing and 6 for HLA crossmatch test (3 cells×2 sera). Results : Overall concordance of serologic typing was 99.5% (436/438) for HLA-A, 95.7% (419/438) for HLA-B, and 94.8% (199/210) for HLA-C. The antigens assigned incorrectly by more than 5% of the participating laboratories were B54 (10.3%), B55 (10.3%), B27 (5.4%), Cw6 (22.9%), and C-blank (5.7%). Overall concordance rates of DNA typing were 99.7% (393/394) for HLA-A, 99.8% (415/416) for HLA-B, 100% (156/156) for HLA-C. Correct assignment of HLA-DRB1 and -DQB1 was reportred by 99.7% (98.1-100%) and 99.2% (88.9-100%) for generic and 99.2% and 98.1% (80-100%) for allelic level, respectively. Most laboratories (93.5-97.9%) were using sensitive methods of crossmatch such as T-long, T-AHG, and flowcytometry. The proportion of laboratories evaluated as unacceptable was on the average 3.1% of total laboratories. Conclusions : The rate of correct identification of HLA antigens was higher this time than in the previous survey in 1999. The rate of unacceptable crossmatch was also low enough to be satisfactory. It is thought that the proficiency survey has contributed to the high quality of HLA tests in the participating laboratories and should be continued to maintain the proficiency in Korea.

국문 초록 (Abstract)

배경 : 국내에서는 ’96년 처음 HLA 검사 신빙도 조사가 시작되었으며 ’9년에 그 결과가 종합보고된 이후 유사 보고가 없었다. 본 연구에서는 최근 2년간의 국내 HLA 검사 신빙도조사 결과를 종합 보고하고자 한다.방법 : 국내 54-59개 HLA 검사실을 대상으로 4회에 걸쳐 신빙도 조사를 실시하였다. 각 조사시 검사항목은 HLA class Ⅰ 혈청학 및 DNA 항원검사 3건, class Ⅱ DNA검사 3건, HLA 교차시험 검사 6건을 포함하였다.결과 : 혈청학적 검사의 정답률은 HLA-A 99.5% (436/438),HLA-B 95.7% (419/438), HLA-C 94.8% (199/210)이었다.5% 이상의 기관에서 오답을 보였던 항원은 B54 (10.3%), B55(10.3%), B27 (5.4%), Cw6 (22.9%), C-Blank (5.7%)이었다.DNA 검사의 정답률은 HLA-A 99.7% (393/394), HLA-B99.8% (415/416), HLA-C 100% (156/156)이었다. HLA-DRB1DNA검사의 저해상도 수준 정답률은 99.7% (98.1-100%)이었고,고해상도 대립유전자 정답률은 99.2% (90-100%)이었다. HLA-DQB1 DNA은 저해상도 99.2% (88.9-100%), 고해상도 98.1%(80-100%)의 정답률을 보였다. HLA 교차시험의 경우 예민한방법을 사용하는 기관의 비율이 매우 높았는데(1차 93.5%-14차97.9%), unacceptable로 평가된 기관의 수는 0-9.3% (평균 3.1%)의 분포를 보였다.
결론 : ’99년 조사에 비해 항원검사의 정답률이 향상되었으며, 교차시험의 unacceptable 비율도 낮아 만족할 만한 신빙도를 보여주었다. 신빙도 조사 프로그램이 국내 HLA 검사 신빙도 향상에 일부 기여했다고 생각하며 높은 수준의 신빙도를 유지하기 위해 지속적인 운영이 필요하다.

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