상피성 난소암에서 수술 전 혈청 CA-125 농도의 임상적 의의 (CLINICAL SIGNIFICANCE OF PREOPERATIVE SERUM CA-125 LEVEL IN EPITHELIAL OVARIAN CANCER)

서지정보

· 발행기관 : 대한산부인과학회
· 수록지 정보 : Obstetrics & Gynecology Science / 55권 / 2호 / 69 ~ 75페이지
· 저자명 : 이승호, 류혜승, 신진우, 박찬용

초록

목적상피성 난소암에서 수술 전 혈청 CA-125 농도의 임상적 의의를 알아보기 위하여 시행되었다.
연구방법79명의 환자를 대상으로 의무기록을 후향적을 분석하여 시행되었다. 생존율은 Kaplan-Meier 방법에 의해서 산출하였으며 생존곡선 간의비교는 log-rank test를 이용하였다. 다변량 분석은 Cox proportional hazard model을 이용하였다.
결과환자들의 평균 나이는 52.3세였고, 평균 body mass index는 24.0 kg/m2이었다. 조직학적 유형별로는 장액성 암종이(60.1%), 분화도별로는 grade III가(58.2%), International Federation of Obstetrics and Gynecology (FIGO) 병기별로는 III기(58.2%)가 가장 많았다. 46명(58.2%)에서 수술 후 잔류 종괴가 1 cm 이하였다. 단변량 분석에서 연령(P = 0.01), FIGO 병기(P = 0.00), 수술 후 잔류 종괴(P = 0.01), 수술 전 혈청CA-125 농도(P = 0.03) 등이 유의한 예후 인자였다. 50세 이하에서 50세 초과보다, FIGO 병기 I/II기에서 III/IV기보다, 수술 후 잔류 종괴가1 cm 이하인 경우에서 1 cm 초과인 경우보다, 수술 전 혈청 CA-125 농도가 500 U/mL 미만인 경우에서 500 U/mL 이상인 경우보다 생존율이 유의하게 높았다. 그러나, 다변량 분석에서 생존에 유의한 영향을 미치는 인자는 없었다.
결론상피성 난소암에서 수술 전 혈청 CA-125 농도의 임상적 중요성을 알아보기 위하여 전향적인 연구가 필요하다.

영어초록

Objective This study was performed to evaluate the clinical signifi cance of preoperative CA-125 level in epithelial ovarian cancer.
Methods Seventy nine patients with epithelial ovarian cancer who were operated at Gachon University Gil Hospital from January 2002 to December 2009 were included. Medical records including pathologic reports were reviewed retrospectively. Overall survival was analyzed by Kaplan-Meier method and log-rank test was used for curve comparison. Cox proportional hazards model was used for multivariate analysis.
Results Mean age was 52.3 years old and mean body mass index was 24.0. Histologically, malignant serous tumor was the most common histologic type (60.1%) and 46 patients had grade III tumor (58.2%). FIGO stage III was most common (58.2%) and 46 patients (58.2%) had residual disease less than 1 cm. In univariate analysis, age (P = 0.01), stage (P = 0.00), residual disease (P = 0.01) and preoperative CA-125 level (P = 0.03) were signifi cant prognostic factors affecting survival. Patients less than 50 years old showed longer overall survival rate than patients over 50 years old. Stage I/II patients showed longer overall survival rate than stage III/IV patients. Patients with residual disease less than 1 cm showed longer overall survival rate than patients with residual disease over 1 cm. Patients with CA-125 level under 500 U/mL had signifi cantly longer survival rate than patients with CA-125 level over 500 U/mL. However, multivariate analysis revealed none of these factors were signifi cant independent prognostic factors.
Conclusion To evaluate the clinical signifi cance of preoperative CA-125 level in epithelial ovarian cancer, prospective study is needed.

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