Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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The Role and Significance of Biomarker for Plasma G-CSF in Patients with Primary Lung Cancer

원발성 폐암에서 혈장 과립구 자극인자의 암표지자로서의 역할과 의의

  • Song, Jung Sub (Department of Internal Medicine, Wonkwang University College of Medicine) ;
  • Kim, So Young (Department of Internal Medicine, Wonkwang University College of Medicine) ;
  • Jo, Hyang Jeong (Department of Pathology, Wonkwang University College of Medicine) ;
  • Lee, Kang Kyoo (Department of Therapeutic Radiology & Oncology, Wonkwang University College of Medicine) ;
  • Shin, Jeong Hyun (Department of Internal Medicine, Wonkwang University College of Medicine) ;
  • Shin, Seong Nam (Department of Internal Medicine, Wonkwang University College of Medicine) ;
  • Kim, Dong (Department of Internal Medicine, Wonkwang University College of Medicine) ;
  • Park, Seong Hoon (Department of Radiology, Wonkwang University College of Medicine) ;
  • Lee, Young Jin (Department of Clinical Pathology, Wonkwang University College of Medicine) ;
  • Ko, Chang Bo (Good Cell Life, Inc.) ;
  • Lee, Mi Kung (Department of Thoracic Surgery, Wonkwang University College of Medicine) ;
  • Choi, Soon Ho (Department of Thoracic Surgery, Wonkwang University College of Medicine) ;
  • Jeong, Jong Hoon (Department of Internal Medicine, Wonkwang University College of Medicine) ;
  • Park, Jung Hyun (Department of Internal Medicine, Wonkwang University College of Medicine) ;
  • Kim, Hui Jung (Department of Internal Medicine, Wonkwang University College of Medicine) ;
  • Kim, Hak Ryul (Department of Internal Medicine, Wonkwang University College of Medicine) ;
  • Jeong, Eun Taik (Department of Internal Medicine, Wonkwang University College of Medicine) ;
  • Yang, Sei Hoon (Department of Internal Medicine, Wonkwang University College of Medicine)
  • 송정섭 (원광대학교 의과대학 내과학교실) ;
  • 김소영 (원광대학교 의과대학 내과학교실) ;
  • 조향정 (원광대학교 의과대학 병리학교실) ;
  • 이강규 (원광대학교 의과대학 방사선종양학교실) ;
  • 신정현 (원광대학교 의과대학 내과학교실) ;
  • 신성남 (원광대학교 의과대학 내과학교실) ;
  • 김동 (원광대학교 의과대학 내과학교실) ;
  • 박성훈 (원광대학교 의과대학 영상의학교실) ;
  • 이영진 (원광대학교 의과대학 임상병리학교실) ;
  • 고창보 (굿셀라이프) ;
  • 이미경 (원광대학교 의과대학 흉부외과학교실) ;
  • 최순호 (원광대학교 의과대학 흉부외과학교실) ;
  • 정종훈 (원광대학교 의과대학 내과학교실) ;
  • 박정현 (원광대학교 의과대학 내과학교실) ;
  • 김휘정 (원광대학교 의과대학 내과학교실) ;
  • 김학렬 (원광대학교 의과대학 내과학교실) ;
  • 정은택 (원광대학교 의과대학 내과학교실) ;
  • 양세훈 (원광대학교 의과대학 내과학교실)
  • Received : 2009.06.21
  • Accepted : 2009.06.22
  • Published : 2009.06.30
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Abstract

Background: Biomarkers for cancer have several potential clinical uses, including the following: early cancer detection, monitoring for recurrence prognostication, and risk stratification. However, no biomarker has been shown to have adequate sensitivity and specificity. Many investigators have tried to validate biomarkers for the early detection and recurrence of lung cancer. To evaluate plasma G-CSF as such a biomarker, protein levels were measured and were found to correlate with the clinicopathological features of primary lung tumors. Methods: Between December 2006 and May 2008, 100 patients with histologically-validated primary lung cancer were enrolled into this study. To serve as controls, 127 healthy volunteers were enrolled into this study. Plasma G-CSF levels were measured in lung cancer patients using the sandwich ELISA system (R & D inc.) prior to treatment. Results: The mean plasma G-CSF levels were 12.2$\pm$0.3 pg/mL and 46.0$\pm$3.8 pg/mL (mean$\pm$SE) in the normal and in the cancer groups, respectively. In addition, plasma G-CSF levels were higher in patients with early lung cancer than in healthy volunteers (p<.001). Plasma G-CSF levels were higher in patients who were under 65 years old or smokers. Within the cancer group, plasma G-CSF levels were higher in patients with non small cell lung cancer than in patients with small cell lung cancer (p<.05). Overall, plasma G-CSF levels were shown to increase dependent upon the type of lung cancer diagnsosed. In the order from highest to lowest, the levels of plasma G-CSF tended to decrease in the following order: large cell carcinoma, squamous cell carcinoma, adenocarcinoma, and bronchioloalveolar carcinoma. Plasma G-CSF levels tended to be higher in patients with advanced TNM stage than in localized TNM stage (I, II

연구배경: 폐암은 진단 당시에 완치할 수 있는 확률이 적어 예후가 불량한 종양으로 알려져 있어, 폐암 진행을 예측할 수 있는 암 표지자(tumor marker)의 발굴이 필요한 실정이다. 그러나 폐암에서 아직까지 특이적인 항원이 없고 현재까지 알려진 많은 종양관련 항원들의 민감도가 떨어지기 때문에 보편화되지 못하고 있다. 본 연구에서는 원발성 폐암 환자에서 혈장 G-CSF를 측정하고 암의 진행 및 예후와 관련이 있는지 알아보고자 하였다. 방 법: 원발성 폐암으로 진단된 100명 환자와 건강 검진에서 이상 소견이 없는 127명 정상인을 대상으로 하였다. 결 과: 정상인에서 혈장 G-CSF 농도는 12.2$\pm$3.6 pg/mL (mean$\pm$SD), 폐암환자에서는 46.0$\pm$38.0 pg/mL였다(p<0.001). 비소세포폐암에서 G-CSF 농도는 유의하게 소세포폐암보다 높았으며(p<0.05), 비소세포 폐암중 대세포 폐암이 가장 높았고, 편평세포암, 선암, 세기관지폐포암 순이었다. G-CSF 농도는 국소형보다는 진행형 비소 세포폐암에서 증가하는 경향을 보였다. 또한 타 장기로의 전이가 있을 때 유의하게 증가하였으며(p<0.05), 다발성 전이에서는 뇌, 부신, 골 전이 순으로 혈청 G-CSF 농도가 증가하는 경향이었다. 결 론: 혈장 G-CSF 농도는 폐암이 진행한 경우, 특히 타 장기로의 전이가 있을 때 유의하게 증가하였다. 그러므로 진행형 폐암의 추적관찰에 이용할 수 있으리라 사료된다.

Keywords

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