Korean Journal of Clinical Laboratory Science (대한임상검사과학회지)

Korean Society for Clinical Laboratory Science (대한임상검사과학회)
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Diagnostic Availability of Estrogen Receptor Alpha mRNA on Cervical Cancer Tissue

자궁경부암 조직에서 에스트로겐 수용체 알파 mRNA의 진단적 유용성

  • Kim, Geehyuk (Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University) ;
  • Yu, Kwangmin (Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University) ;
  • Kim, Jungho (Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University) ;
  • Kim, Seoyong (Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University) ;
  • Park, Sunyoung (Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University) ;
  • Ahn, Sungwoo (Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University) ;
  • Lee, Ji-Young (Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University) ;
  • Kim, Sunghyun (Department of Clinical Laboratory Science, College of Health Sciences, Catholic University of Pusan) ;
  • Park, Ho-Hyun (Department of Biomedical Laboratory Science, Mokpo Science University) ;
  • Lee, Dongsup (Department of Clinical Laboratory Science, Hyejeon College)
  • 김지혁 (연세대학교 임상병리학과) ;
  • 유광민 (연세대학교 임상병리학과) ;
  • 김정호 (연세대학교 임상병리학과) ;
  • 김서용 (연세대학교 임상병리학과) ;
  • 박선영 (연세대학교 임상병리학과) ;
  • 안성우 (연세대학교 임상병리학과) ;
  • 이지영 (연세대학교 임상병리학과) ;
  • 김성현 (부산가톨릭대학교 임상병리학과) ;
  • 박호현 (목포과학대학교 임상병리과) ;
  • 이동섭 (혜전대학교 임상병리과)
  • Received : 2018.10.11
  • Accepted : 2018.11.14
  • Published : 2018.12.31
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Abstract

Cervical cancer is the fourth most frequently diagnosed cancer in women worldwide. In lower Human Development Index countries, it has the second highest incidence and mortality among cancer in women. Therefore, better diagnosis and treatment systems are needed. Among them, estrogen receptor alpha ($ER-{\alpha}$) mRNA expression has been analyzed with RT-qPCR since several studies reported that $ER-{\alpha}$ is necessary in the maturation of the uterus and is related to cervical cancer. In this study, $ER-{\alpha}$ quantitative analysis was performed on various lesions and normal tissue samples. Based on the receiver operating characteristic (ROC) curve, its sensitivity and specificity were 85% and 75%, respectively, showing higher or similar results to those of conventional HPV tests. In addition, its expression level was analyzed with clinical information. With regression analysis, the R square value between the $ER-{\alpha}$ mRNA expression level and menopause status was 0.5041, indicating a strong correlation. This study was performed as part of a pilot study and suggests that $ER-{\alpha}$ is related to carcinogenesis. Future studies will examine other hormones and menopausal factors with a larger sample size.

자궁경부암은 세계적으로 여성에서 네번째로 많이 진단되는 암이다. 개발 지수가 낮은 개발도상국이나 후진국에서는 자궁경부암의 발생률과 사망률이 훨씬 심각하다. 따라서 더 나은 진단법과 치료법이 시급하다. 인유두종바이러스가 자궁경부암 발생의 주요 원인으로 알려진 이후로 바이러스에 대한 검사가 세포검사 조직검사와 함께 자궁경부암을 진단하는데 일상적으로 쓰이고 있다. 하지만, HPV 검사에서 음성을 보이는 환자가 자궁경부암으로 발전하는 사례가 계속해서 발견되고 있다. 본 연구에서는 HPV 외에 자궁경부암의 원인으로 생각되는 인자들에 대해 분석하였다. 그 중에서도 에스트로겐 수용체 알파의 mRNA 발현양을 실시간 역전사 중합효소 연쇄반응을 통해 분석하였다. 에스트로겐 수용체 알파에 대해서는 예전부터 자궁내막을 성숙시키면서 동시에 자궁경부암의 발암 기전에 연관이 있을 것이라는 추측이 있었는데, 본 연구에서는 이에 대해 임상검체를 통해 양적 분석을 진행하였다. ROC 곡선을 바탕으로, 85%의 민감도와 75%의 특이도를 확인할 수 있었는데, 이 값은 기존의 HPV 검사법보다 유사하거나 더 높은 값이었다. 나이, 병변의 심한 정도 등을 포함한 임상 정보를 바탕으로 회귀 분석한 결과 폐경 여부와 에스트로겐 수용체 알파의 발현양이 높은 연관성을 확인하였다. 본 연구는 예비 연구의 일종으로, 추후 연구에서 가능성이 확인된 호르몬과 폐경에 관련된 유전자를 대상으로 더 많은 검체로 분석해야 할 것이다.

Keywords

References

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