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.
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.