혈중 CA19-9이 지속적으로 상승되었던 기관지 확장증 환자 1예

A Case of Bronchiectasis with High Serum CA19-9

  • 허정훈 (동아대학교 의과대학 호흡기내과학교실) ;
  • 이수미 (동아대학교 의과대학 호흡기내과학교실) ;
  • 구태형 (동아대학교 의과대학 호흡기내과학교실) ;
  • 신봉철 (동아대학교 의과대학 호흡기내과학교실) ;
  • 엄수정 (동아대학교 의과대학 호흡기내과학교실) ;
  • 양두경 (동아대학교 의과대학 호흡기내과학교실) ;
  • 이수걸 (동아대학교 의과대학 호흡기내과학교실) ;
  • 손춘희 (동아대학교 의과대학 호흡기내과학교실) ;
  • 노미숙 (동아대학교 의과대학 해부병리학교실) ;
  • 김기남 (동아대학교 의과대학 영상의학교실) ;
  • 이기남 (동아대학교 의과대학 영상의학교실) ;
  • 최필조 (동아대학교 의과대학 흉부외과학교실)
  • Huh, Jung Hun (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Lee, Su Mi (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Koo, Tae Hyoung (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Shin, Bong Chul (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Um, Soo Jung (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Yang, Doo Kyung (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Lee, Soo-Keol (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Son, Choonhee (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Rho, Mee Sook (Department of Pathology, Dong-A University College of Medicine) ;
  • Kim, Ki Nam (Department of Radiology, Dong-A University College of Medicine) ;
  • Lee, Ki Nam (Department of Radiology, Dong-A University College of Medicine) ;
  • Choi, Pil Jo (Department of Thoracic and Cardiovascular Surgery, Dong-A University College of Medicine)
  • 투고 : 2008.04.01
  • 심사 : 2008.05.09
  • 발행 : 2008.05.30

초록

CA19-9의 상승은 췌장 및 담도계 악성 종양을 시사하는 소견이다. 하지만, 최근에 양성 소화기계 질환 뿐 아니라 특발성 간질성 폐렴, 교원성 폐 질환, 미만성 범세기관지염, 기관지확장증 등 다양한 양성 폐 질환에서도 혈중 CA19-9 수치가 증가되어 있다고 보고된다. 저자들은 최근 지속적으로 혈중 CA19-9 수치는 증가되어 있지만, 내시경적 역류성 담도 췌장 조영술, 복부 전산화 단층 촬영, PET-CT에서 악성 종양이 발견되지 않은 기관지확장증 1예를 경험 하였다. 3년 10개월의 추적 관찰 기간 중에도 췌장암과 같은 악성 종양은 발견되지 않아서, 혈중 CA19-9 수치의 상승은 기관지확장증에 의한 것으로 추정 되었다. 혈중 CA19-9 수치의 상승은 환자의 임상 양상과 연관하여 조심스럽게 판단하여야 될 것으로 생각된다.

An elevated serum CA19-9 level is an indication of pancreatic and biliary tract cancer. However, it has recently become known that nonmalignant gastrointestinal diseases and a variety of nonmalignant respiratory diseases, such as idiopathic interstial pneumonia, collagen vascular disease associated lung diseases, diffuse panbronchiolitis and bronchiectasis, can also show an elevated serum CA19-9 level. We recently encountered a case of bronchiectasis with persistently elevated serum CA19-9, but without any evidence of malignant disease in endoscopic retrograde pancreatocholangiography, abdominal computed tomography, and positron emission tomography. After serial follow-up of 3 years and 10 months, there was still no evidence of cancer. It is believed that the elevated serum CA19-9 level was due to bronchiectasis. An elevated serum CA19-9 level should be interpreted carefully with the patients' clinical condition.

키워드

참고문헌

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