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슂 諛 蹂옞삁寃궗 떊鍮숇룄議곗궗 寃곌낵蹂닿퀬(2017)
Annual Report on the External Quality Assessment Scheme for Urinalysis and Fecal Occult Blood Testing in Korea (2017)
J Lab Med Qual Assur 2018;40:128-135
Published online September 30, 2018
© 2018 Korean Association of External Quality Assessment Service.

쟾李쏀샇, 씠븘吏, 源긽寃, 꽌뿄꽍, 諛곗쁺泥
Chang-Ho Jeon, A-Jin Lee, Sang-Gyung Kim, Hun-Seok Suh, Young-Cheol Bae

援ш넧由븰援 쓽怨쇰븰 吏꾨떒寃궗쓽븰援먯떎

Department of Laboratory Medicine, School of Medicine, Catholic University of Daegu, Daegu, Korea
Correspondence to: Chang-Ho Jeon Department of Laboratory Medicine, Daegu Catholic University Medical Center, School of Medicine, Catholic University of Daegu, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 42472, Korea el: +82-53-650-4144 Fax: +82-53-653-8672 E-mail: chjeon@cu.ac.kr
援먯떊옄: 쟾李쏀샇 슦)42472 援ъ떆 궓援 몢瑜섍났썝濡 17湲 33, 援ш넧由븰援먮퀝썝 吏꾨떒寃궗쓽븰怨 Tel: 053)650-4144, Fax: 053)653-8672, E-mail: chjeon@cu.ac.kr
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract

2017뀈 슂寃쎄 諛 蹂옞삁寃궗(faecal occult blood, FOB) 젙룄愿由ъ궗뾽씠 1,544媛 湲곌씠 李몄뿬븯뿬 떆뻾릺뿀떎. 슂솕븰寃궗뒗 3쉶뿉 嫄몄퀜 떆뻾릺뿀怨, 궗吏꾪뙋룆뿉 쓽븳 슂移⑥궗臾 뙋젙 諛 FOB寃궗뒗 2쉶 떎떆븯떎. 슂솕븰寃궗뒗 pH, protein, glucose, ketone, bilirubin, blood, urobilinogen, nitrite, leukocyte 諛 specific gravity (SG) 벑 10빆紐⑹씠뿀떎. 슂솕븰寃궗 諛 슂떆뿕吏遊됱뿉 쓽븳 SG寃궗뒗 95% 씠긽쓽 슦닔븳 젙떟瑜좎쓣 굹궡뿀쑝굹, 슂移⑥궗臾쇨궗뒗 吏諛⑷뎄 諛 鍮꾩젙삎 슂궛寃곗젙뿉꽌 궙 젙떟쑉쓣 蹂댁떎. FOB 젙꽦 寃궗뿉꽌 82% 씠긽쓽 젙떟瑜좎쓣 蹂댁뿬 젙떟瑜좎씠 2016뀈뿉 鍮꾪븯뿬 떎냼 븯씫븯쑝굹, 쐞뼇꽦 臾몄젣뒗 媛쒖꽑릺뿀떎. FOB 젙웾寃궗뒗 옣鍮 媛꾩뿉 냽룄李⑥씠瑜 蹂댁쑝硫, 蹂 뼇 궗슜뿉 뵲瑜 냽룄李⑥씠瑜 蹂댁셿븯湲 쐞븯뿬 ug/g stool濡 蹂닿퀬븷 븘슂媛 吏냽쟻쑝濡 젣湲곕릺怨 엳떎.

In 2017, external quality assessment trials for urinalysis and fecal occult blood (FOB) were performed with 1,544 participants. Urine chemistry tests were performed three times and urine sediment and FOB tests were evaluated 2 times. Urine chemistry tests consisted of pH, protein, glucose, ketone, bilirubin, blood, urobilinogen, nitrite, leukocyte, and specific gravity analyses. The results of the urine chemistry and specific gravity tests showed accuracy rates >95%. The accuracy rate of urine sediments was low, especially for fat droplets and atypical uric acid crystals. In the FOB quality test, all reagents showed accuracy rates >82%, which suggested the persistent improvement of false-positive reactions. In the FOB quantitative test, discrepant results depending on the instrument used were observed. To compensate for the result differences caused by the amounts of stool samples, the results should be reported using another unit (쨉g/g of stool).

Keywords : Quality control, Urinalysis, Occult blood
꽌 濡

슂寃쎄븰遺꾧낵쓽 2017뀈룄 쇅遺젙룄愿由ъ궗뾽 깉濡쒖슫 쟾궛엯젰떆뒪뀥씠 븞젙솕릺뼱 寃곌낵遺꾩꽍 諛 蹂닿퀬媛 젣濡 씠猷⑥뼱議뚮떎. 슂솕븰寃궗뒗 3李 떆뻾븯怨 珥 12媛쒖쓽 愿由щЪ吏덉쓣 궗슜븯떎. 슂移⑥궗寃궗뒗 2쉶 떆뻾븯쑝硫 珥 8媛쒖쓽 궗吏꾩쓣 寃뚯떆븯뿬 뙋룆븯룄濡 븯떎. 蹂옞삁寃궗(faecal occult blood, FOB) 삉븳 2쉶 떆뻾븯쑝硫 珥 6媛쒖쓽 愿由щЪ吏덉쓣 궗슜븯떎. 슂솕븰寃궗 諛 FOB 떊鍮숇룄議곗궗뿉뒗 援궡뿉꽌 젣議곕맂 愿由щЪ吏덉쓣 궗슜븯떎.

2017뀈 떊鍮숇룄議곗궗 궗뾽寃곌낵뿉꽌 슂솕븰寃궗뒗 98% 씠긽쓽 젙떟瑜좎쓣 굹궡뿀怨 湲곌린쉶궗蹂꾨줈룄 젙떟瑜좎뿉 겙 李⑥씠媛 뾾뿀떎. 洹몃윭굹 Beckmann (Beckman Coulter Inc., Brea, CA, USA) 옣鍮꾨줈 뙋룆븳 諛깊삁援ш궗뿉꽌 궙 젙떟瑜(75%)쓣 蹂댁떎. 슂移⑥궗寃궗뿉꽌뒗 67.8%竊86.7%쓽 젙떟瑜좎쓣 굹궡뼱 媛쒖꽑쓽 뿬吏媛 븘슂븯떎. FOB뿉꽌뒗 젙떟瑜좎씠 90% 씠긽쑝濡 쐞뼇꽦瑜좎씠 넂븯뜕 2015뀈 씠썑 젙떟瑜좎쓽 媛쒖꽑씠 吏냽릺뿀떎[1].

옱猷 諛 諛⑸쾿

1. 긽

슂寃쎄븰遺꾧낵뿉꽌뒗 븳엫긽寃궗젙룄愿由ы삊쉶뿉 벑濡앸맂 湲곌쓣 긽쑝濡 2017뀈룄 4썡, 6썡, 8썡 3李⑥뿉 嫄몄퀜 젙룄愿由щЪ吏덉쓣 諛쒖넚븯떎. 諛쒖넚湲곌 닔뒗 1,544湲곌쑝濡 16뀈룄 1,487湲곌뿉 鍮꾪븯뿬 57湲곌씠 利앷릺뿀쑝硫 룊洹 쉶떊쑉쓣 88.3%떎.

2. 옱猷

슂솕븰寃궗瑜 쐞븳 愿由щЪ吏덉 1李(CU-17-01-04), 2李(CU-17-05-08), 3李(CU-17-09-12) 寃泥 紐⑤몢 援궡뿉꽌 젣議고븳 븸긽愿由щЪ吏 4醫낆뵫쓣 媛 쉶썝湲곌뿉 깋옣 룷옣븯뿬 諛쒖넚븯떎. 씠 以 1李 諛 3李⑥뿉뒗 蹂 삊쉶 솃럹씠吏뿉 寃뚯떆븳 슂移⑥궗 궗吏 8留 벑 紐⑤몢 20醫낆쓽 寃泥대 슦넚 諛 寃뚯떆븯뿬 젙룄愿由 떊鍮숇룄議곗궗瑜 떆뻾븯떎. 寃곌낵移섏쓽 엯젰 蹂 삊쉶뿉꽌 援ъ텞븳 떊鍮숇룄議곗궗궗뾽 솃럹씠吏뿉꽌 吏곸젒 엯젰븯뒗 諛⑹떇쓣 궗슜븯떎. FOB瑜 쐞븳 愿由щЪ吏덈룄 1李 諛 2李 寃泥 紐⑤몢 援궡뿉꽌 젣議고븳 젏븸꽦 遺꾨쭚愿由щЪ吏 3醫(CS-17-01-06)쓣 媛 쉶썝湲곌뿉 깋옣 룷옣븯뿬 諛쒖넚븯떎.

3. 젙룄愿由щЪ吏덉쓽 뿀슜移

슂솕븰 諛 FOB寃궗쓽 寃쎌슦 遺꾧낵쐞썝쉶뿉꽌 떎뿕븳 李멸퀬移, 媛 湲곌뿉꽌 쉶떊븳 寃곌낵쓽 씪移섎룄瑜 怨좊젮븯쑝硫, 젙꽦媛믪 理쒕퉰룄移샕1떒怨, 젙웾媛믪 룊洹졖2 standard deviation쓽 踰붿쐞瑜 뿀슜踰붿쐞濡 꽕젙븯떎.

寃 怨

1. 슂솕븰寃궗 9醫낆쓽 떊鍮숇룄議곗궗 꽦쟻

슂솕븰寃궗 9醫(pH, protein, glucose, ketone, bilirubin, blood, urobilinogen, nitrite, leukocyte)쓽 떊鍮숇룄議곗궗 꽦쟻 Table 1뿉 슂빟븯떎. Table 1 1李, 2李 諛 3李 떊鍮숇룄議곗궗뿉꽌 뼸뼱吏 룊洹 젙떟瑜좎쓣 援ы븳 옄猷뚯씠硫, 紐⑤뱺 빆紐⑹뿉꽌 95% 씠긽쓽 젙떟瑜좎쓣 굹궡뿀떎.

Table 1 . Number of participants and acceptable rates of urine chemistry QC.

꺿꺿긖ests1st QC2nd QC3rd QC



ParticipantsAcceptable (%)ParticipantsAcceptable (%)ParticipantsAcceptable (%)
pH1,31295.11,31097.31,45098.2
Protein1,31596.51,31597.51,45697.1
Glucose1,31298.81,31097.41,45198.1
Ketone1,28299.81,28199.61,41599.6
Bilirubin1,28299.11,28199.31,41599.2
Blood1,31297.91,31096.91,44998.6
Urobilinogen1,28299.61,28198.31,41599.6
Nitrite1,26699.31,26699.31,39399.7
Leukocyte1,25797.21,25798.71,38597.7

Abbreviation: QC, quality control..


2. 슂솕븰 遺꾩꽍湲곗뿉 뵲瑜 슂솕븰寃궗 떊鍮숇룄議곗궗 꽦쟻

媛 쉶궗蹂 슂솕븰 遺꾩꽍湲곗뿉 뵲瑜 슂솕븰寃궗쓽 떊鍮숇룄議곗궗 꽦쟻 Table 2 媛숇떎. YD (YD Diagnostics, Yongin, Korea)媛 42.8%濡 媛옣 留롮씠 궗슜븯怨 엳쑝硫 SD (Standard Diagnostics, Seoul, Korea) 20.2%, Roche (Roche, Mannheim, Germany) 16.0%, DFI (DFI Co. Ltd., Gimhae, Korea) 9.3% 닚씠뿀떎. 쉶궗蹂 옣鍮꾩뿉 뵲씪 슂솕븰寃궗쓽 젙떟瑜좎 李⑥씠瑜 蹂댁씠吏 븡븯쑝굹 Beckman 옣鍮 (Beckman Coulter Inc., Brea, CA, USA)뒗 諛깊삁援 寃異쒖뿉꽌 75%쓽 궙 젙떟瑜좎쓣 굹궡뿀쑝硫, 씠뒗 諛깊삁援 뼇꽦 寃泥대 쓬꽦쑝濡 뙋룆븳 뜲꽌 湲곗씤븯떎.

Table 2 . Acceptable rates according to urine analyzers from different companies.

귽ompanypHProteinGlucoseKetoneBilirubinBloodUrobilinogenNitriteLeukocyteTotal
YD97.698.498.697.999.898.699.799.697.4545 (42.8)
SD96.897.198.999.199.896.899.399.098.6256 (20.2)
Roche94.198.799.898.6100.098.798.099.399.1203 (16.0)
DFI96.285.595.498.699.097.699.699.397.8118 (9.3)
Siemens99.999.799.299.896.698.798.499.899.280 (6.3)
Eiken95.799.599.399.091.899.598.799.899.252 (4.1)
Arkray100.098.6100.0100.0100.098.099.599.7100.031 (2.5)
Symex100.098.5100.098.097.9100.098.9100.092.614 (1.1)
Beckman100.097.799.2100.099.278.9100.0100.075.09 (0.7)

Values are presented as % or number (%)..

The instruments used were from the following companies: YD (YD Diagnostics, Yongin, Korea), SD (Standard Diagnostics, Seoul, Korea), Roche (Roche diagnostics, Mannheim, Germany), DFI (DFI Co. Ltd., Gimhae, Korea), Siemens (Siemens Healthcare (Erlangen, Germany), Eiken (Eiken Chemical Co., Tokyo, Japan), Arkray (Arkray Inc., Kyoto, Japan), and Beckman (Beckman Coulter Inc., Brea, CA, USA)..


Beckman 옣鍮꾩쓽 쓬꽦 뙋룆 2016뀈遺꽣 吏냽릺뼱 洹 썝씤쓣 遺꾩꽍븯怨좎옄 븯떎[2]. 援ш넧由븰蹂묒썝 吏꾨떒寃궗쓽븰怨쇱뿉꽌뒗 솚옄뱾쓽 냼蹂쓣 YD궗쓽 Uriscan Super 옣鍮꾨줈 遺꾩꽍븯뿬 諛깊삁援 뼇꽦쑝濡 굹삩 132삁瑜 긽쑝濡, Beckman궗쓽 iChem Velocity 옣鍮꾨줈 옱寃븯떎. 124삁뿉꽌 1떒怨 씠븯쓽 씪移섎 蹂댁뿬 93.9%쓽 씪移섏쑉쓣 굹궡뼱, 솚옄 寃泥 遺꾩꽍뿉뒗 쐞쓬꽦 쁽긽씠 愿李곕릺吏 븡븯떎. 씠뿉 湲곗쭏슚怨(matrix effect)媛 쓽떖릺뼱 젙룄愿由щЪ吏덉쓣 븳援怨좊텇옄 떆뿕뿰援ъ냼(Seoul, Korea)뿉 쓽猶고븯뿬 遺꾩꽍븯떎. 遺꾩꽍寃곌낵 2-methyl-p-anisidine (4-methoxy-o-toluidine) 諛 n-methyl-p-anisidine씠 諛깊삁援 떆빟쓽 diazonium salt怨 諛섏쓳븯뒗 寃껋쑝濡 蹂닿퀬븯떎. 利 諛깊삁援ъ쓽 esterase 슚냼 떊 긽湲 몢 媛吏 臾쇱쭏씠 諛섏쓳븯뿬 뼇꽦 寃곌낵瑜 굹궦떎怨 븯떎. 씠뿉 젙룄愿由щЪ吏덉쓣 Beckman궗 YD궗쓽 슂떆뿕吏遊됱뿉 諛섏쓳떆궓 썑 쑁븞愿李곗쓣 떆룄븯떎(Fig. 1A). 諛깊삁援 떆빟뿉꽌 Beckman궗뒗 뿰븳 궡깋쑝濡 YD궗뒗 뿰옄二쇰튆쑝濡 諛쒖깋릺뿀떎. 諛깊삁援ъ뿉 쓽븳 Beckman궗쓽 슂떆뿕吏遊 諛쒖깋諛섏쓳 Fig. 1B 媛숈씠 옄二쇰튆쑝濡 諛쒖깋맂떎.

Figure 1.

(A) Gross examination of CU-17-04. Beckman (left) and YD (right) strips show results of urine chemistry reactions. At the leukocyte pads, the Beckman strip displays a slightly yellowish color, while the YD strip displays a pale purple color. (B) Color chart for leukocytes for the Beckman strip. Abbreviations: UBG, urobilinogen; Vit C, vitamin C; SG, specific gravity; WBC, white blood cell.


3. 슂솕븰 遺꾩꽍湲곕줈 떆뻾븳 슂鍮꾩쨷寃궗 떊鍮숇룄議곗궗 꽦쟻

슂鍮꾩쨷寃궗뒗 援댁젅怨 寃궗뒗 떆뻾븯吏 븡怨 슂솕븰 遺꾩꽍 옣湲곕줈 痢≪젙븯떎. Table 3뿉꽌 媛숈씠 紐⑤뱺 寃泥댁뿉꽌 95% 씠긽쓽 젙떟瑜좎쓣 굹궡뿀떎. 洹몃윭굹 寃곌낵엯젰 떆 옒紐삳맂 媛믪씠 엯젰릺뒗 寃쎌슦媛 諛쒖깮븯뿬 媛 湲곌뿉꽌 寃곌낵엯젰 떆 二쇱쓽媛 븘슂븯떎.

Table 3 . Acceptable rates of the urine specific gravity test.

긕pecimenParticipantsMean짹standard deviation95% Confidence intervalAcceptable (%)
CU-17-011,2611.005짹0.0281.001 to 1.01097.5
CU-17-021,2611.009짹0.0041.005 to 1.01597.0
CU-17-031,2611.008짹0.0281.005 to 1.01895.6
CU-17-041,2611.021짹0.0061.010 to 1.03098.2
CU-17-051,2631.005짹0.0281.001 to 1.01594.9
CU-17-061,2621.008짹0.0041.005 to 1.01597.8
CU-17-071,2621.008짹0.0041.005 to 1.01596.3
CU-17-081,2621.019짹0.0401.010 to 1.03097.9
CU-17-091,3881.006짹0.0271.001 to 1.01596.8
CU-17-101,3881.007짹0.0271.005 to 1.01596.7
CU-17-111,3881.006짹0.0471.005 to 1.01595.6
CU-17-121,3881.018짹0.0541.010 to 1.03097.5

4. 궗吏 寃泥대 씠슜븳 슂移⑥궗臾 寃궗寃곌낵

궗吏 寃泥대 궗슜븯뿬 떆뻾븳 슂移⑥궗臾 떊鍮숇룄議곗궗쓽 룊洹 젙떟瑜좎 68.67%뿉꽌 99.3%쓽 젙떟瑜좎쓣 蹂댁떎(Figs. 2, 3, Table 4). 吏諛⑷뎄(CUI-17-02)瑜 쟾遺꾩엯옄굹 諛깊삁援щ줈 뙋젙븯怨, 鍮꾩젙삎 슂궛寃곗젙(CUI-17-05)쓣 怨쇰┰썝二쇰굹 쟻삁援 썝二쇰줈 뙋젙븯떎. 삉븳 궔뼇썝二(CUI-17-07)瑜 珥덉옄썝二쇰줈 뙋젙븯怨, 씠뻾긽뵾꽭룷 꽭눊愿긽뵾꽭룷(CUI-17-06)쓽 援щ퀎씠 슜씠븯吏 븡븯떎. 뵲씪꽌 슂移⑥궗臾쇱뿉 븳 뙋룆 媛 湲곌쓽 吏냽쟻씤 媛쒖꽑 끂젰씠 븘슂븯떎.

Figure 2.

Images of urine sediments (with arrow) for the external quality assessment. (A) CUI-17-01 uric acid crystal (original magnification 횞400). (B) CUI-17-02 fat globule (original magnification 횞100). (C) Polarized microscopic images of panel B. (D) CUI-17-03 cystine crystal (original magnification 횞400). (E) CUI-17-04 cellular cast (original magnification 횞400).


Figure 3.

Images of urine sediments (with arrow) for the external quality assessment. (A) CUI-17-05 uric acid crystal (original magnification 횞200). (B) CUI-17-06 renal tubular epithelial cell (original magnification 횞400). (C) CUI-17-07 waxy cast (original magnification 횞100). (D) CUI-17-08 ammonium urate crystal (original magnification 횞400).


Table 4 . Acceptable rates for the urine sediment examination.

긕pecimen no.꺿꺿긓esultsParticipantsAnswersAcceptable (%)Unacceptable (%)
CUI-17-01Uric acid75274799.3
CUI-17-02Fat droplets75251668.6
CUI-17-02Starch granule752739.7
CUI-17-02Leukocyte752729.6
CUI-17-03Cystine75274498.9
CUI-17-04Granular cast coarsely75252369.5
CUI-17-04RBC/pigmented/muddy brown casts75212316.4
CUI-17-04Granular cast finely752618.1
CUI-17-04Cellular cast (RTE and/or neutrophil)752172.3
CUI-17-04Waxy cast752141.9
CUI-17-04Fatty cast752121.6
CUI-17-05Uric acid83866078.8
CUI-17-05Granular cast coarsely838404.8
CUI-17-05RBC/pigmented/muddy brown casts838404.8
CUI-17-05Fiber/fecal contamination838253.0
CUI-17-05Calcium oxalate838192.3
CUI-17-05Fatty cast838131.6
CUI-17-06Transitional epithelial cell83846855.8
CUI-17-06Renal tubular epithelial cell83833640.1
CUI-17-06Squamous epithelial cell838172.0
CUI-17-07Waxy cast83860372.0
CUI-17-07Fiber/fecal contamination83810512.5
CUI-17-07Hyaline cast838738.7
CUI-17-07Granular cast finely838273.2
CUI-17-07Cholesterol838192.3
CUI-17-08Ammonium biurate83879695.0
CUI-17-08Amorphous urates/phosphates838232.7
CUI-17-08Leucine838141.7

5. FOB 떆빟뿉 뵲瑜 FOB 젙꽦寃궗쓽 젙떟瑜 諛 떆빟쓽 遺꾪룷

FOB 떆빟뿉 뵲瑜 FOB 젙꽦寃궗쓽 젙떟瑜좎 Table 5뿉 굹궡뿀떎. 떆빟 SD FOB rapid test (268湲곌), YD FOB test (121湲곌), Eiken homocatch light (Eiken Chemical Co., Tokyo, Japan; 56湲곌), Asan FOB easy test (Asan Pharmaceutical, Seoul, Korea; 52湲곌) 닚쑝濡 궗슜븯떎. 紐⑤뱺 떆빟뿉꽌 뼇샇븳 젙떟瑜좎쓣 굹궡뿀쑝굹, FOB 쓬꽦 寃泥댁뿉꽌 SD FOB, Humasis FOB test (Humasis Co., Anyang, Korea) 諛 GC Genedia FOB (Green Cross Medial Science Co., Yongin, Korea) 떆빟뿉꽌 90% 씠븯쓽 궙 젙떟瑜좎쓣 굹궡뿀떎. 듅엳 Humasis궗 떆빟 쓬꽦 寃泥 2媛쒖뿉꽌 紐⑤몢 90% 씠븯쓽 젙떟瑜좎쓣 굹궡뼱 떆빟쓽 媛쒖꽑씠 븘슂븯떎.

Table 5 . Acceptable rates for the fecal occult blood quality test.

꺿꺿긓eagentsNo.CS-16-01CS-16-02CS-16-03CS-16-04CS-16-05CS-16-06

Negative (%)Positive (%)Positive (%)Positive (%)Negative (%)Positive (%)
SD FOB rapid test26892.999.6100.0100.086.2100.0
YD Occult Tech FOB test12194.4100.0100.0100.090.199.2
Eiken Hemocatch light56100.0100.098.2100.0100.0100.0
ASAN easy test FOB5292.7100.0100.0100.096.298.1
Humasis FOB test3984.6100.0100.0100.082.1100.0
Bio focus FOB rapid test3093.3100.0100.0100.093.3100.0
HBI HiSens FOB NCard2696.796.796.7100.096.2100.0
GC Genedia FOB1894.194.1100.0100.088.9100.0

Abbreviation: FOB, fecal occult blood..

The instruments used were from the following companies: SD (Standard Diagnostics, Seoul, Korea), YD (YD Diagnostics, Yongin, Korea), Eiken Chemical Co. (Tokyo, Japan), Asan Pharmaceutical (Seoul, Korea), Humasis Co. (Anyang, Korea), Bio Focus Co. (Uiwang, Korea), HBI Co. (Anyang, Korea), and GC (Green Cross Medial Science Co., Yongin, Korea)..


6. FOB 떆빟뿉 뵲瑜 FOB 젙웾寃궗쓽 젙떟瑜 諛 떆빟쓽 遺꾪룷

FOB 젙웾寃궗寃곌낵 遺꾪룷뒗 Table 6뿉 슂빟븯떎. 옣鍮꾨퀎濡 寃궗뿉 궗슜븯뒗 蹂 뼇씠 떖씪꽌 옣鍮 媛 鍮꾧탳媛 뼱젮썙 씠瑜 蹂댁젙븳 媛믪쓣 븿猿 鍮꾧탳븯떎. 궗슜옣鍮꾨뒗 Eiken (158湲곌), Alfresa (Alfresa Pharma Co., Osaka, Japan; 60湲곌), Kyowa (Kyowa Chemical Industry Co., Kagawa, Japan; 35湲곌) 닚쑝濡 遺꾪룷븯떎. 쟾泥 룊洹좎뿉 鍮꾪븯뿬 Alfresa 옣鍮꾨뒗 CS-17-01 諛 CS-17-05 寃泥댁뿉꽌 넂 닔移섎 蹂댁떎. 삉븳 Alfresa 옣鍮꾨뒗 CS-17-02, 17-03, 17-04 諛 17-06 寃泥댁뿉꽌 紐⑤몢 궙 냽룄瑜 굹궡뿀떎.

Table 6 . Distribution of results of the fecal occult blood quantitation test.

InstrumentsSpecimenNo.MedianMinimumMaximumAverage




ng/mL關g/g stoolng/mL關g/g stoolng/mL關g/g stoolng/mL關g/g stool
긂ikenCS-17-011574.00.80.00.024.04.84.81.0
귺lfresaCS-17-015856.010.63.00.6149.028.353.710.2
긊yowaCS-17-01331.01.00.00.055.055.02.52.5
긂ikenCS-17-02157195.039.082.016.4342.068.4195.439.1
귺lfresaCS-17-0258151.028.753.010.1213.040.5150.428.6
긊yowaCS-17-023348.048.00.00.096.096.048.648.6
긂ikenCS-17-03157390.078.065.013.0561.0112.2379.976.0
귺lfresaCS-17-0358264.550.358.011.0370.070.3259.749.3
긊yowaCS-17-0333107.0107.068.068.0165.0165.0103.9103.9
긂ikenCS-17-04158465.593.154.010.8620.0124.0450.490.1
귺lfresaCS-17-0460302.057.451.09.7400.076.0295.756.2
긊yowaCS-17-0435133.0133.075.075.0181.0181.0127.1127.1
긂ikenCS-17-051584.00.80.00.018.03.64.00.8
귺lfresaCS-17-056046.08.71.00.2122.023.254.510.4
긊yowaCS-17-05351.01.00.00.07.07.01.11.1
긂ikenCS-17-06158232.046.4107.021.4420.084.0226.045.2
귺lfresaCS-17-0660179.034.0111.021.1325.061.8180.534.3
긊yowaCS-17-063557.057.022.022.073.073.053.653.6

The instruments used were from the following companies: Eiken Chemical Co. (Tokyo, Japan), Alfresa Pharma Co. (Osaka, Japan), and Kyowa Chemical Industry Co. (Kagawa, Japan)..


怨 李

2017뀈쓽 젙룄愿由 떊鍮숇룄議곗궗뿉꽌 굹궃 듅吏뺤 李몄뿬湲곌쓽 利앷씠떎. 듅엳 3李 떊鍮숇룄議곗궗뿉꽌뒗 1,450湲곌씠 李멸븯뿬 1李⑥뿉 鍮꾪븯뿬 10.7%쓽 利앷瑜 蹂댁떎. 寃곌낵瑜 遺꾩꽍빐 蹂 븣 2016뀈 젙룄愿由 떊鍮숇룄궗뾽寃곌낵 留ㅼ슦 쑀궗븳 꽦쟻쓣 굹궡뿀떎[2]. 諛깊삁援щ 젣쇅븳 슂솕븰寃궗 諛 鍮꾩쨷寃궗뒗 슦닔븳 젙떟瑜좎쓣 쑀吏븯떎. 슂移⑥궗 떊鍮숇룄議곗궗뿉꽌룄 2016뀈 젙떟瑜 67.8%竊86.7%蹂대떎 議곌툑 긽뼢맂 꽦쟻쓣 蹂댁떎. FOB 젙꽦寃궗뿉꽌뒗 2016뀈怨 쑀궗븯寃 쓬꽦 寃泥댁뿉 븳 쐞뼇꽦瑜좎씠 넂吏 븡븘 援궡 떆빟쓽 吏 媛쒖꽑씠 씠猷⑥뼱吏 寃껋쑝濡 蹂댁씤떎.

슂솕븰寃궗뿉꽌뒗 2016뀈怨 룞씪븯寃 Beckman 옣鍮꾩뿉꽌 leukocytes 뼇꽦씤 寃泥대 쓬꽦쑝濡 뙋룆븯떎. 씠뿉 냼蹂, 蹂寃궗 쐞썝쉶 Beckman궗媛 怨듬룞쑝濡 썝씤遺꾩꽍쓣 떆뻾븯떎. Beckman궗 옣鍮꾨뒗 떎젣 솚옄뱾쓽 냼蹂 寃泥댁뿉꽌뒗 쐞쓬꽦쓣 蹂댁씠吏 븡븯쑝굹, 젙룄愿由 寃泥댁뿉꽌뒗 쐞쓬꽦쓣 蹂댁뿬 湲곗쭏슚怨쇰 쓽떖븯떎. 븳援怨좊텇옄 떆뿕뿰援ъ냼뿉꽌 젙룄愿由щЪ吏 遺꾩꽍쓣 쓽猶고븳 寃곌낵 諛깊삁援 떆빟諛섏쓳뿉 뼇꽦쓣 씪쑝궗 닔 엳뒗 2媛吏 臾쇱쭏쓣 諛쒓껄븯떎. Beckman궗 떆빟怨 YD궗 떆빟쓣 긽쑝濡 젙룄愿由щЪ吏덉쓣 諛섏쓳떆耳 쑁븞 뙋룆븳 寃곌낵, Beckman궗 떆빟뿉꽌뒗 諛쒖깋諛섏쓳씠 鍮꾪듅씠쟻쑝濡 씪뼱궗떎. 利 諛깊삁援ъ쓽 esterase怨 諛섏쓳븯뿬 諛쒖깋릺뒗 옄깋諛섏쓳씠 븘땲씪 궡깋諛섏쓳씠 굹굹꽌 옣鍮꾩뿉꽌 옒 寃異쒗븯吏 紐삵븯뒗 寃껋쑝濡 뙋떒릺뿀떎. 뵲씪꽌 Beckman궗 옣鍮꾨줈 떊鍮숇룄議곗궗瑜 떆뻾븷 寃쎌슦 옣鍮꾪뙋룆怨 쑁븞뙋룆쓣 紐⑤몢 떆뻾븯뿬, 鍮꾪듅씠쟻씤 諛쒖깋諛섏쓳쑝濡 씤븳 쐞쓬꽦 諛섏쓳씠 쓽떖릺뒗 寃쎌슦, 쑁븞뙋룆 寃곌낵瑜 蹂닿퀬븯뒗 寃껋씠 諛붾엺吏곹븷 寃껋씠떎.

슂鍮꾩쨷寃궗뒗 李몄뿬湲곌쓽 젙떟瑜좎씠 뼇샇븳뜲, 뱶臾쇨쾶 寃곌낵 엯젰삤瑜섍 諛쒓껄릺뿀떎. 0, 0.01, 0.02 벑 鍮꾩젙긽쟻씤 寃곌낵媛 엯젰릺뒗뜲, 엯젰諛⑸쾿쓣 옒 닕吏븯뿬 엯젰삤瑜섏뿉 쓽븳 遺덊빀寃⑺뙋젙쓣 諛쏆 븡븘빞寃좊떎.

슂移⑥궗 떊鍮숇룄議곗궗뿉꽌뒗 吏諛⑷뎄, 鍮꾩젙삎 슂궛寃곗젙 벑뿉꽌 궙 젙떟瑜좎쓣 湲곕줉븯떎. 몢 媛吏 移⑥궗 紐⑤몢 鍮덈쾲븯寃 굹굹뒗 삎깭뒗 븘땲吏留 媛곴컖 떊利앺썑援곌낵[3] 슂궛寃곗꽍쓣[4] 떆궗븷 닔 엳떎. 젙떟쑝濡 룊媛븯吏留 꽭눊愿 긽뵾꽭룷 씠뻾긽뵾꽭룷쓽 媛먮퀎 븘吏곷룄 옒 씠猷⑥뼱吏吏 紐삵븯怨 엳떎. 슂移⑥궗臾쇱쓣 젙솗븯寃 뙋룆븯젮硫 뙋룆寃쏀뿕씠 留롮븘빞 븯誘濡 媛 蹂묒썝뿉꽌 슂移⑥궗 뙋룆쟾臾멸瑜 1紐 씠긽 쑁꽦븯뒗 寃껋씠 諛붾엺吏곹븷 寃껋씠떎.

FOB 젙꽦寃궗뿉꽌 2015뀈 쟾 떆빟뿉꽌 쓬꽦 寃泥대 뼇꽦쑝濡 뙋룆븯뿬 삤떟瑜좎씠 89.0%뿉 떖븯뿬 臾몄젣젏쑝濡 遺媛곷릺뿀떎. 젙꽦떆빟쓽 怨쇰룄븳 誘쇨컧룄瑜 궙異붽린 쐞븯뿬 援궡 FOB 떆빟쉶궗뱾뿉寃 誘쇨컧룄 議곗젙쓣 슂泥븯怨, 2016뀈뿉 2쉶뿉 嫄몄퀜 FOB 쓬꽦씤 寃泥대줈 떊鍮숇룄議곗궗궗뾽쓣 떆뻾븳 寃곌낵 紐⑤몢 90% 씠긽쓽 젙떟瑜좎쓣 蹂댁떎. 2017뀈뿉룄 FOB 쓬꽦씤 寃泥댁뿉꽌 84.6% 씠긽쓽 젙떟瑜좎쓣 蹂댁뿬 떎냼 젙떟瑜좎씠 븯씫븯쑝굹, 쐞뼇꽦 臾몄젣뒗 빐寃곕맂 寃껋쑝濡 蹂댁떎. 蹂 쐞썝쉶뿉꽌뒗 떆뙋릺뒗 6媛 떆빟(SD, YD, Eiken, Asan, Humasis 諛 BioFocus)쓣 긽쑝濡 2017뀈 11썡 誘쇨컧룄 媛쒖꽑 뿬遺瑜 솗씤븯쑝硫, 20 ng/mL 씠븯쓽 솚옄 蹂 寃泥댁뿉꽌 룊洹 뼇꽦瑜 6.4%瑜 굹궡뿀떎(data not shown). 씠 寃곌낵뿉 븳 꽭遺궡슜 끉臾몄쑝濡 異쒗뙋븷 寃껋씠떎.

蹂옞삁 젙웾寃궗뿉꽌 Alfresa뒗 2016뀈怨 룞씪븯寃 냽룄 寃泥댁뿉꽌뒗 넂寃, 以묐벑 諛 怨좊냽룄 寃泥댁뿉꽌뒗 궙寃 痢≪젙븯떎. Kyowa 옣鍮꾨뒗 以묐벑 諛 怨좊냽룄 寃泥댁뿉꽌 떎냼 넂寃 痢≪젙릺뿀떎. FOB뒗 옣鍮꾩뿉 뵲씪 寃곌낵 李⑥씠瑜 蹂댁씪 닔 엳쑝硫[5], 듅엳 痢≪젙 떆 二쇱엯릺뒗 蹂 뼇씠 떖씪꽌 ng/mL쓽 떒쐞濡 蹂닿퀬븯硫 냽룄李⑥씠瑜 蹂댁씪 닔 엳떎. 씠瑜 蹂댁셿븯湲 쐞븯뿬 FOB쓽 삉 떎瑜 蹂닿퀬떒쐞씤 關g/g stool쓣 룄엯븯뿬 蹂묓뻾 궗슜쓣 異붿쭊븯쑝굹[6], 李멸湲곌뿉꽌 二쇱엯븯뒗 蹂 뼇쓣 젙솗븯寃 痢≪젙븯湲 뼱젮썙 2017뀈 떊鍮숇룄議곗궗궗뾽뿉꽌 떆뻾븯吏 紐삵븯떎. Table 6뿉 젣떆맂 關g/g stool뿉 쓽븳 닔移섎뒗 떎젣移섍 븘땲怨 옣鍮꾨퀎濡 二쇱엯릺뒗 蹂 뼇쓣 씪愿꾩쟻쑝濡 쟻슜븯뿬 궛異쒕맂 닔移섏씠誘濡 젙솗븯吏 븡떎. 뵲씪꽌 옣鍮꾨퀎濡 諛쒖깮븯뒗 FOB 寃곌낵李⑥씠뿉 븳 썝씤쓣 遺꾩꽍븯湲곕뒗 뼱젮슦硫, 궗슜븯뒗 湲곌뿉꽌 옣鍮꾨퀎 듅꽦쓣 옒 怨좊젮븯뿬 李멸퀬移섎 궛젙빐빞 븷 寃껋씠떎.

References
  1. Jeon CH, Lee AJ. Urinalysis and Routine Microscopy Subcommittee, Korean Association of External Quality Assessment Service. Annual report on the external quality assessment scheme for urinalysis and faecal occult blood testing in Korea (2015). J Lab Med Qual Assur 2016;38:120-8.
    CrossRef
  2. Jeon CH, Lee AJ, Kim SG, Suh HS, Bae YC. Annual report on the external quality assessment scheme for urinalysis and faecal occult blood testing in Korea (2016). J Lab Med Qual Assur 2017;39:117-23.
    CrossRef
  3. McPherson RA, Pincus MR. Henry's clinical diagnosis and management by laboratory methods. 23rd ed. St. Louis (MO): Elsevier, 2017.
  4. Cicerello E. Uric acid nephrolithiasis: an update. Urologia 2018;85:93-8.
    Pubmed CrossRef
  5. Kim JH, Hwang SY, Kim YJ. Evaluation of Hemo Techt NS-plus C15 Automatic Analyzer for fecal occult blood test. J Lab Med Qual Assur 2010;32:237-41.
  6. Sinatra MA, Young GP, St John DJ, Blake D, Ratnaike S. A study of laboratory based faecal occult blood testing in Melbourne, Australia. The Faecal Occult Blood Testing Study Group. J Gastroenterol Hepatol 1998;13:396-400.
    Pubmed CrossRef