파열되지 않은 대형 자궁내막종으로 종양 표지자CA 125가 극도로 상승한 1예
Extremely elevated CA 125 due to an unruptured large endometrioma: A Case Report
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=자궁내막증은 가임 여성의 3-10%와 불임여성의 25-35%에서 발생하는 흔한 질환으로, 통증과 불임을 유발하는 일련의 병태 생리적 과정이라고 할 수 있다. CA 125는 상피성 난소암때 상승하는 대표적인 종양 표지자이지만 일부 부인과 양성질환에서도 상승한다. 자궁내막증에서도 CA 125 농도가 증가하는데 자궁내막증 조직에서 정상적인 자궁내막과 다른 생화학적 체강상피 화생이 일어나거나, 자궁내막증으로 유발된 염증에 의해 CA 125 분자가 세포막으로부터 탈락하여 혈액으로의 유입이 촉진되기 때문일 것으로 추정된다. 그러나 혈청 CA 125가 100 IU/mL 이상 상승되는 경우는 매우 드물다. 저자 등은 자궁내막증으로 인해 CA 125치가 1,000 IU/mL 이상 상승한 예를 수술하고 경과를 관찰하였기에 이를 간단한 문헌고찰과 함께 보고하는 바이다.
Abstract
CA 125 is a high molecular weight glycoprotein expressed in the cell surface of some derivatives of embryonic coelomic epithelium. It presents in over 80% of non-mucinous epithelial ovarian carcinomas and it also occurs in the serum of healthy males and females at low concentrations (<35 IU/mL). Serum CA 125 concentration may also be moderately elevated in several benign conditions, such as pelvic inflammatory disease, uterine fibroids, pregnancy, spontaneous abortion with chromosomal abnormality, and especially in endometriosis. However serum CA 125 concentration is seldom over 100 IU/mL in endometriosis. In this paper, we present a patient with bilateral ovarian endometrioma associated with abnormally high serum CA 125 level (>1,000 IU/mL) and after excision of the ovarian tumor, the CA 125 levels returned to normal. Our case further emphasizes the association of high levels of CA 125 with benign gynecologic conditions and we discussed the possible explanations for this abnormal elevation of CA 125 levels.
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