자궁내막증에서 혈청 CA 125, CA 19-9 및 호산구의 임상적 의의
he clinical significance of serum CA 125, CA 19-9 and eosinophil levels in endometriosis
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목적: 본 연구는 자궁내막증의 진단 및 재발에 대한 예측인자로써의 혈청 CA 125, CA 19-9 및 호산구 분율 값의 유용성을 알아보고자 하였다. 연구 방법: 2000년 1월부터 2006년 12월까지 본원 산부인과에 내원환자 중 자궁내막증이 확진된 환자 117명과 종합검진센터에 내원한 가임기 여성 중 특이소견이 없는 50명을 대상으로 하였다. 환자군에서 혈청 CA 125, CA 19-9, 호산구 수치 등의 치료 전후 혈청검사를 포함한 증상, 골반초음파 소견, 치료, 조직병리학적 병기, 재발 여부 등을 조사하였다. 말초 정맥혈의 채취는 수술 시행 전 한달 이내와 술후 1~6개월에 시행하였고 이를 자궁내막증 병기별, 증상별로 수술 전후 수치의 변화를 분석하였다. 결과: 호산구 분율은 자궁내막증 환자군에서 대조군에 비해 통계적으로 유의하게 낮았다. 치료 전후의 혈청값 비교에서 CA 125 및 CA 19-9은 치료 후에 유의하게 감소한 반면, 호산구 분율은 치료 전, 후에 유의한 변화가 없었다. CA 125와 CA 19-9 검사의 양성률은 각각 68.9%, 60.0%, 병합 시 양성률은 82.2%였다. 결론: 자궁내막증의 진단 및 추적관찰에서 혈청 CA 125와 CA 19-9은 병합검사로써 활용하는 것이 좋을 것으로 사료되고, 혈청 호산구 분율은 자궁내막증의 비침습적 선별검사로써 유용하지 않은 것으로 사료된다.
Abstract
Objective: To evaluate the usefulness of serum CA 125, CA 19-9, and eosinophil as biological markers for the diagnosis and recurrence of endometriosis. Methods: One hundred seventeen patients who underwent operations for endometriosis between January 2000 and December 2006 at our department were included. A total of 50 reproductive aged women who visited our health care center were the control group. Data on serum level of CA 125, CA 19-9, and eosinophil was collected. Patients symptoms, sonographic findings, stage, treatment, recurrence were also collected. Venous blood sampling was performed 1 month before operation and 1 to 6 months after operation. We analyzed the serum level of CA 125, CA 19-9, and eosinophil according to the endometriosis stage and symptoms. We also analyzed the differences between preoperative and postoperative serum marker levels. Results: The serum level of CA 125 and CA 19-9 was available in 88 patients and 45 patients, respectively. The mean eosinophil count was significantly lower in endometriosis group than in control group. In comparison between preoperative values and postoperative values, the CA 125 and CA 19-9 level showed significant reduction (P<0.05), however the eosinophil level showed no difference. The positive rate of serum CA 125 and CA 19-9 were 68.9% and 60.0% as a single test, whereas the combined positive rate of CA 125 and CA 19-9 was 82.2%. Conclusion: For the diagnosis and follow-up of endometriosis, serum CA 125 and CA 19-9 combination test will be valuable. Serum eosinophil count seems to be unsuitable for the screening and follow up test of endometriosis.
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