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악성 임파종에서 혈청 β₂microglobulin에 관한 연구

Other Titles
 (A) study on serum β₂microglobulin in malignant lymphoma 
Issue Date
1986
Description
의학과/석사
Abstract
[한글] β^^2 microglobulin(β^^2 MG)은 저분자량의 단백질로서 유핵세포의 세포막에 존재하며, 정상 혈청농도는 유리형으로 약 1,500-2,000 ㎍/L이다. β^^2 MG은 악성종양에서 증가하는데 특히 임파증식성 질환, 다발성 골수종, 만성 임파성 백혈병 및 신장질환등에서 증가하며 이들 질환의 진단 및 치료효과 판정에 유용하다. 이에 저자는 악성임파종에서 임상경과와 혈청 β^^2 MG간의 상관관계를 고찰하고자 1984년 9월부터 1985년 7월까지 연세의료원에 입원하여 악성 임파종으로 진단받은 환자중 blood urea nitrogen(BUN)과 혈청 creatinine치가 정상이었던 33예와 대조군으로서는 건강한 38예를 대상으로 혈청 β^^2 MG을 측정하여 다음과 같은 결과를 얻었다. 대조군 38예의 혈청 β^^2 MG 평균치는 1,827±546 ㎍/L (mean±SD)이었음에 비하여 악성 임파종 35예의 혈청 β^^2 MG 평균치는 2,298 ± 1,117 ㎍/L로 통계학적으로 유의하게 높았다 (P<0.05). 임상적 stage에 따른 혈청 β^^2 MG은 stage가 높아질수록 증가하는 경향을 관찰할 수 있었으며 stage Ⅰ, Ⅱ에 속하는 14예의 혈청 β^^2 MG 평균치는 1, 160±688㎍/L이었고, stave Ⅲ, Ⅳ에 속하는 19예의 혈청 β^^2 MG 평균치는 2,754±1,19㎍/L로서 양군간에 통계학적으로 유의한 차이가 있었다(P<0.005). 혈청 β^^2 MG이 2,000㎍/L이상으로 증가된 경우는 악성 임파종 32예(HD : 4예, NHL : 29예 )에서는 stage Ⅰ, Ⅱ 14예중 5예( 35.7%), stage Ⅲ, Ⅳ 18예중 14예 ( 77.8%)에서 였으며 HD의 경우 stage Ⅲ, Ⅳ 4예중 3예 (75.0%), NHL의 경우 stage Ⅰ, Ⅱ 14예중 5예(35.7%), stage Ⅲ, Ⅳ 14예중 11예(87.5%)에서 였다. 전신증상('B' 증상)을 동반하였던 16예의 혈청 β^^2 MG 평균치는 2,870±1,203㎍/L로 전신증상을 동반하지 않았던 17예의 혈청β^^2 MG 평균치 1,744±765 ㎍/L보다 통계학적으로 유의하게 높았다(P<0.005). 치료시작 전·후 임상경과에 따라 혈청 β^^2 MG을 측정하여 관찰할 수 있었던 환자는 13예로서 이중 치료에 반응을 보였던 환자는 6예로 치료전 혈청 β^^2 MG 평균치 (1,900 ㎍/L)도 낮았고 임상경과가 호전됨에 따라 혈청 β^^2 MG도 감소하였다. 치료에 반응이 없었던 나머지 7예는 치료전 혈청 β^^2 MG 평균치(2,340㎍/L)도 높았고 치료에도 불구하고 혈청 β^^2 MG은 더 증가하는 경향을 관찰할 수 있었다. 이상의 결과로 미루어 악성 임파종에서 혈청 β^^2 MG의 변화는 임상경과, 치료효과 및 예후등과 유관하다고 생각되며 향후연구를 계속하면 하나의 tumor marker로서 이용될 수 있을 것으로 생각한다.
[영문] Beta 2 microglobu1in, a low molecular weight polypeptide, exists in the plasma membrane of all nucleated cells and its normal serum concentration, in free form, is in the range of 1,500 to 2,000 ㎍/L. Serum β^^2 microglobulin is increased in malignant tumors expecially in B-cell lymphoproliferative disorders, and thus the serum concentration is of help for the diagnosis, therapeutic response and prognosis of these disorder. The author attempted to correlate the serum β^^2 microglobulin levels and the clinical courses of malignant lymphomas. Serum β^^2 microglobulhin levels were measured on a total of 35 proven malignant lymphoma patients with normal BUN and serum creatinine levels. These patients were collected from the in-patients of Severance Hospital, Yonsei Medical Center during the period of September 1984 to July 1985. As a control group, the serum β^^2 microglobu1in levels of 38 healthy subjects were also measured. The following results were obtained. 1. The serum β^^2 microglobulin of 35 healthy subjects was 1,827±546㎍/L. The serum β^^2 microglobulin of 35 patients with malignant lymphoma was 2,298±1,117 ㎍/L. Thus the serum β^^2 microglobulin of malignant lymphoma was higher than that of control group significantly. 2. The serum β^^2 microglobulin level according to clinical stage showed increasing tendency with higher stages. Fourteen patients of stage Ⅰ or Ⅱ showed the mean serum β^^2 micioglobulin level of 1,660±688 ㎍/L and 19 patients of stage Ⅲ or Ⅳ showed 2,754±1,196 ㎍/L. The statistical difference between those 2 groups was significant. The serum macroglobulin was increased (>2,000 ㎍/L) in 35.7% of stage Ⅰ and Ⅱ and 77.8% of stage Ⅲ and Ⅳ untreated active malignant lymphoma. Among the non-Hodgkin's lymphoma group(n=29), serum microglobulin was increased in 35.7% of patients of stage Ⅰ and Ⅱ and in 78.5% of those of stage Ⅲ and .Ⅳ. The same increased level was observed in 75.0% of Hodgkin's disease(n=4) of stage Ⅲ and Ⅳ. 3. The serum β^^2 micro히obulin level of 16 patients with the systemic symptoms('B'symptom) was 2,870±1,203 ㎍/L and the 17 patients without the systemic symptoms was 1,744±765 ㎍/L. The difference was statistically significant. 4. In 13 patients, serum β^^2 microglobulin levels were monitored prior to and after the treatment. Six of these patients were responsive to the treatment and their serum β^^2 microglobulin levels prior to treatment were rather low than normal. Also their serum β^^2 microglobulin decreased as their clinical courses improved. On the other hand, the other 7 patients whose serum β^^2 microglobulin, levels were considerably high, showed increasing tendency of serum β^^2 microglobu1in despite the treatment. Based on these studies, it can be suggested that the serum β^^2 microglobulin determination is a valuable laboratory study in following up malignant lymphoma.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/116863
Appears in Collections:
2. 학위논문 > 1. College of Medicine (의과대학) > 석사
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