경계성 난소 종양 환자의 진단과 치료에 있어서 혈청 CA-125치의 임상적 의의 = Clinical Significance of Serum CA-125 in the Diagnosis and Management of Patients with Borderline Ovarian Tumors

국문 초록 (Abstract)

종양 표지물질인 CA-125는 악성 난소 종양의 진단 및 치료에 있어서 유용한 것으로 되어 있다. 그러나 경계성 난소 종양에 있어서는 아직 충분히 확립되지 못한 실정이다.
이에 저자들은 1989년 1월부터 1995년 12월까지 만 7년동안 인제대학교 의과대학 부속 서울백병원 산부인과에서 경계성 난소 종양으로 진단받았던 15명의 환자와 악성 난소 종양으로진단받았던 54명의 환자를 대상으로 각각에 대한 치료 전 및 치료 후 혈청 CA-125 치를 측정하여 비교 분석하여 경계성 난소 종양 환자의 진단과 치료에 있어서 혈청 CA-125치가 유용한지를 알아보고자 이 연구를 시행하였다.

다국어 초록 (Multilingual Abstract)

Serum tumor marker, CA-125 has been investigated extensively for it's usefulness in the diagnosis and management of malignant ovarian tumors. However, the role of serum CA-125in the diagnosis and management of patients with borderline ovarian tumors has not beenestablished. Retrospective analysis of serum CA-125 levels was performed in 15 patientsbefore operation and after treatment for borderline epithelial ovarian tumors at the Seoul Paik Hospital between 1989 and 1995.
The result obtained were as follows :
1.The incidence of borderline malignant ovarian tumor among 69 cases of total group was 21.7%.
2.According to FIGO classification the patients were classified as: stage Ia (66.6%), stage Ib (6.7%), swage Ic (13.3%), stage IIc (6.7%), stage IIIa (6.7%).
3.The tumor sizes between patients with normal(less than 35 U/ml) and positive (over than 35 U/ml) of serum CA-125 were 15.43±5.06 cm and 15.78±4.91 cm, respectively and there was no statistical difference between the two groups (p> 0.05).
4.100% of serous and 46.2% of mucinous tumors had elevated CA-125 levels, and there was no statistical difference between the two groups(p> 0.05).
5.Combining both cell types, 6(46.2%) of 13 patients with swage I disease and 2(100%) of 2 patients with stage II and III disease had positive preoperative levels. Serum CA-125 level was no statistical difference between the two groups (p=0.467).
6.Serum CA-125 revels in patients with serous tumors (N=2) were decreased after surgery from 259.00 U/ml to 152.23 U/ml(p=0.04), and wish mucinous tumors (N=13) from 152.23 U/ml to 12.98U/ml (p=0.04)
7.CA-125 levels in patients with positive CA-125 level(N=8) were decreased after surgery from 294.57 U/ml to 18.01 U/ml (p=0.04), and with normal CA-125 level (N=7) from 7.61 U/ml to 5.25 U/ml (p=0.01).
8.Preoperative serum CA-125 levels in patients with malignant epithelial ovarian turners were 372.85 U/ml, and with borderline epithelial ovarian tumors were 166.47 U/ml. There was statistical difference between the two groups (p=0.006).
These data suggest that preoperative serum CA-125 level correlates with stage of disease and serum CA-125 levels decrease after surgery regardless the initial level before treatment.

목차 (Table of Contents)

• Ⅰ.서론
• Ⅱ.연구대상 및 방법
• Ⅲ.결과
• 1.악성 난소 종양과 경계성 난소 종양의 빈도
• 2.연령분포
• 3.임상주소
• 4.경계성 난소 종양의 조직학적 분류
• 5.경계성 난소 종양의 병기분류
• 6.종괴 크기에 따른 수술 전 혈청 CA-125치
• 7.조직학적 유형에 따른 수술 전 혈청 CA-125
• 8.FIGO 병기에 따른 수술 전 혈청 CA-125
• 9.조직학적 유형에 따른 치료 전 및 치료 후 CA-125치의 변화
• 10.수술 전 혈청 CA-125 역가에 따른 치료 전 후의 혈청 CA-125치의 변화
• 11.악성 난소 종양과 경계성 난소 종양의 수술 전 혈청 CA-125치의 비교
• Ⅳ.고찰
• Ⅴ.결론