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자궁근종환자에서 자궁적출술 전후 혈청 인슐린유사 성장인자 결합단백-3 분해효소의 동향에 관한 연구

Insulin-like growth factor binding protein-3 protease profiles in sera of patients with uterine myoma before and after hysterectomy

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목적 : 자궁근종환자에서 자궁적출술 후 Western ligand blot (WLB)과 면역방사법으로 측정한 혈청 IGFBP-3의 변화양상에 차이가 있는지와 자궁적출술 후 IGFBP-3 단백분해효소 활성양상을 분석하고자 하였다. 연구 방법 : 자궁적출술이 시행되는 자궁근종환자에서 수술 전 및 수술 후 2일째 및 6일째에 채취된 혈액 내 IGFBP-3를 WLB과 면역방사선법으로, IGFBP-3 단백분해효소의 활성도를 요오드화된 IGFBP-3를 이용한 검사법으로 측정하였고 난관재문합술을 시행하는 자궁근종이 없는 환자를 대조환자로 하였다. 결과 : 측정방법에 관계없이 자궁근종 환자군과 대조군 사이에 수술 전후의 혈청 IGFBP-3 농도 차이가 없었다. 두 군 모두에서 수술 후 2일째 WLB으로 측정한 혈청 IGFBP-3 농도는 수술 전보다 유의하게 감소하였다가, 수술 후 6일째에는 수술 전 수준으로 회복하였으나 면역방사선법으로 혈청 IGFBP-3를 측정한 경우에는 수술 후 그 농도의 유의한 변화가 없었다. 두 군 모두에서 혈청 IGFBP-3 단백분해효소 활성은 수술 후 2일째 수술 전보다 유의하게 증가하였다가 수술 후 6일째에 수술전 수준으로 다시 감소하였다. 결론 : 면역방사선법에 의하여 측정되는 혈청 IGFBP-3 농도는 수술 후 변화하지 않으나 수술 후 2일에 IGFBP-3 단백분해효소 증가에 의하여 WLB으로 측정한 IGFBP-3 농도가 감소한다.

Abstract

Objective : To investigate change in the activity of insulin-like growth factor binding protein-3 (IGFBP-3) protease and change in serum IGFBP-3 levels measurable by western ligand blot and immunoradiometric assay after hysterectomy, in patients with uterine myoma. Methods : IGFBP-3 was analyzed by Western ligand blot (WLB) and immunoradiometric assay in sera obtained from patients (n=14) with uterine myoma undergoing hysterectomy, and IGFBP-3 protease activity were measured by protease assay using [125I] IGFBP-3 as substrate. Patients (n=13, control patients) undergoing tubal reanastomosis were served as controls. Results : No significant differences in the preoperative and postoperative levels of serum IGFBP-3, and IGBPF-3 protease activity between patients with myoma and control patients were noted. In both group, serum IGFBP-3 level measured by WLB decreased significantly on 2nd day after operation and restored toward the preoperative level on 6th day after operation, while there was no significant change in postoperative serum IGFBP-3 levels measured by immunoradiometric assay. Serum IGFBP-3 protease activity increased significantly on 2nd day after operation and returned to the preoperative level on 6th day after operation in both group. Conclusion : Circulating IGFBP-3 levels measurable by immunoradiometric assay does not change postoperatively and an increase in IGFBP-3 protease activity on 2nd day after operation result in a decrease in circulating IGFBP-3 levels measurable by WLB.

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