위암환자에서 수술전후의 혈청 및 위액 CEA의 변화

Abstract

[한글]

Carcinoembryonic antigen은 1967년 Gold와 Freedman에 의해 처음 발견된 이래 현재 가장 널리 이용되고있는 종양항원의 일종이다. 방사면역측정법의 발달로 정확한 측정이 가능해짐에 따라 양성질환에서도 상승함이 밝혀wu 암에 있어서의 진단적 가치는 떨어졌으나, 암의 관행정도, 치료효과, 재발여부등의 측정에 좋은 지침이 되고있다. 최근 위장관계 종양의 환자에서 직접 위장관액으로부터 CEA를 측정한 결과 혈청치보다 현저하게 높은 치

를 나타냄으로써, 더욱 민감하고 정확하게 암의 존재를 반형함이 보고되고 있다.

이에 저자는 위암으로 확진되어 수술받은 환자 48령을 대상으로 수술전후의 혈청 및 위액 CEA를 측정하고, 대조군으로서 양성 담도계 질환 환자 15명을 대상으로 수술전후의 혈청 및 위액 CEA를 측정하여, 다음과 같은 결과를 얻었다.

1. 위암환자 및 양성담도계질환 환자의 위액 CEA는 모두 혈청 CEA보다 현저히 높았다.

2. 양성 담도계질환 환자의 혈청 CEA 및 위액 CEA는 각각 수술 전후에 차이가 없었다.

3. 위암환자의 혈청 CEA 및 위액 CEA는 수술전보다 수술후에 양자 모두 감소하였다.

4. 위암환자의 혈청 CEA는 수술전, 수술후 모두 대조군에 비하여 차이가 없었다.

5. 위암환자의 위액 CEA는 수술전, 수술후 모두 대조군에 비하여 현저히 높았다.

6. 혈청 CEA는 위암의 전 병기에서 수술후 수술전 보다 감소하였으나, 제 2 기에서만 의의있게 감소하였다(P<0.01).

7. 위액 CEA는 위암의 전 병기에서 수술후 수술전보다 하였으나 제 2 기와 제 3 기에서만 의의있게 감소하였다.

8. 위암환자의 수술전 혈청 CEA는 제 4 기에서 제 1 기 및 제 2 기 보다 의의있게 높았다.

9. 위암환자의 수술전 위액 CEA는 각 병기간에 의의있는 차이가 없었다.

[영문]

Carcinoembryonic antigen (CEA), first described in 1965 by Gold and Freedman, is a tummor associated antigen used most commonly today. With the development of radioimmunoassay, the accurate measurement of serum CEA levels became possible. Elevated serum CEA levels were occurred in various neoplasm of differing

histogenesis including tumors of lung, breast and ovary, and in a wide variety of non-neoplastic inflammatory disorders. Thus serum CEA was not specific for cancer and reliable as a teat for the detection of cancer. But the level of CEA may be uaeful in following patients after sugery, detecting the progress of the tumor and monitoring the effect of treatment in control of disease.

Recently, elevated levels of CEA have been detected in biological fluids from patients with gastrointestinal carcinoma. To date, most CEA- like matrials have been associated with epithelial surfaces of bellow viscera such as the gastrointestinal tract, lung and urinary bladder. It is therefore being suggested that perhaps more fruitful areas of investigation of CEA-like activities would be studies of fluids secreted by these organs for the early detection of cancer.

In present work, pre and postoperative level of CEA in serum and gastric juice was determind by radioimmunoassay in 15 patients with benign biliary tract diseases find 48 patients with gastric cancer.

The reaults are as follows:

1. The CEA level in gastric juice wag significantly higher than that of serum in both patients with benign biliary diseases and gastric cancer (p<0.01).

2. The preoperative level of CEA in serum and gastric juice in patients with benign biliary diseases was not different significantly from the postoperative level.

3. The postoperative level of CEA in serum and gastric juice in patients with gastric cancer was lower than preoperative level (p<0.05, p<0.01) respectively.

4. The pre and postoperative level of CBA in serum in patients with benign biliary diseases were not different from those of patients with gastric cancer.

5. The pre and postoperative level of CEA in gastric juice in patients with gastric cancer were higher than those of patients with benign biliary diseases (p<0.01).

6. The postoperative level of serum CEA in patients with gastric cancer in all stages was lower than preoperative level, but it was significant only in stage Ⅱ(p<0.01).

7. The postoperative level of gastric CEA of patients with gastric cancer in all stages was lower than preoperative level, but it was significantly only stage Ⅱ & Ⅲ(p<0.01).

8. The preoperative level of serum CEA in stage Ⅳ gastric cancer patients was higher than that of stageⅠ stare Ⅱ significantly(p<0.01).

9. There was no significant correlation between the stage of the cancer and gastric CEA level.