전립선암에서 Claudin-1과 5의 발현 정도와 Gleason Score 및 PSA의 관계

Other Titles
Correlation among Claudin-1,-5 Expression and Gleason Score and PSA in Prostate Cancer
Authors
서경원
Issue Date
2009-12
Awarded Date
2010
Abstract
Claudin은 상피세포와 내피세포에서 표현되는 단단접합단백질로서 다양한 아형 (1, 2, 3, 4, 5, 7)을 가지고 있다. 전립선암으로 수술 받았던 환자들에서 Claudin-1과 Claudin-5의 발현정도와 전립선암과의 관계를 알아 보았다. 1998년부터 2007년까지 전립선암으로 수술을 받은 환자 58례를 대상으로 하였다. 평균 추적관찰기간은 38개월(12-126개월)이었다. 면역조직화학 염색을 시행하여 Claudin-1과 Claudin-5의 발현정도에 따라 중등도 미만 발현을 저발현군, 중등도 이상발현을 고발현군으로 분류하였다. 각 군의 Gleasone 점수 (6점이하, 7점이상), PSA, T병기, 재발, 원격전이를 비교하였다. Claudin-1 저발현군은 31례 (53.5%), 고발현군은 27례 (46.5%)였다. Claudin-1 저발현군에서 Gleason 7점 이상은 27례 (87.1%), 6점 이하는 4례 (12.9%)였고, 고발현군에서는 각각 13례 (48.1%), 14례 (51.9%)로 저발현군에서 Gleason 7점 이상이 많았다 (p=0.003). Claudin-5 저발현군은 23례 (39.7%), 고발현군은 35례 (60.3%)였다. Claudin-5 저발현군에서 Gleason 7점 이상은 21례 (91.3%), 6점 이하는 2례 (8.7%)였고, 고발현군에서는 각각 20례 (57.1%), 15례 (42.9%)로 저발현군에서 Gleason 7점 이상이 많았다 (p=0.005). 평균 PSA는 Claudin-5의 저발현군과 고발현군에서 각각 31.6 ng/ml, 14.4 ng/ml으로 저발현군에서 유의하게 높았다 (p=0.028). T병기, 재발, 원격전이 등은 Claudin-1과 5의 발현 정도에 따른 통계적인 유의한 차이가 없었다 (p>0.05). Claudin-1의 저발현은 7점 이상의 높은 Gleason 점수와 연관이 있었고, Claudin-5의 저발현은 7점 이상의 높은 Gleason 점수 및 높은 PSA 수치와 연관이 있었다. 전립선암의 예후 인자인 T병기, 재발, 생화학적 재발, 원격전이와 claudin-1과 5의 발현 정도는 유의한 차이점을 보이지 않았다. The claudin is a tight junctional protein expressed from epithelium and endothelium and has various subtype 1, 2, 3, 4, 5, and 7 ect. The purpose of this study was to evaluate the correlation between expression of claudin-1 and claudin-5 and patients with prostate cancer who underwent operation. The object of this study was 58 cases of patients who had underwent operation with prostate cancer during the period from 1998 to 2007. The mean follow-up duration was 38 months (12-126 months). The average expression was categorized as below the average expression to low expression group and above the average expression to high expression group by implementing immunochemical stain and in accordance with the expression of claudin-1 and claudin-5. The below Gleason score 6, above Gleason score 7, PSA, T stage, biochemical recurrence, local recurrence, and distant metastasis of each group were compared. There were 31 patients (53.5%) with claudin-1 low expression group and 27 patients (46.5%) with high expression group. Of the claudin-1 low expression group was 27 (87.1%) with above Gleason score 7 and 4 (12.9%) with below Gleason score 6, in high expression group, it showed 14 (51.9%) and 13 (48.1%) respectively, indicating the above Gleason score 7 was higher in low expression group (p=0.003). There were 23 patients (39.7%) in claudin-5 low expression group and 35 patients (60.3%) with high expression group. Of the claudin-5 low expression group was 21 (91.3%) above Gleason score 7 and 2 (8.7%) below Gleason score 6, in high expression group, it showed 20 (57.1%) and 15 (42.9%) respectively, indicating above Gleason score 7 was higher in low expression group (p=0.005). The mean PSA showed 31.6ng/ml and 14.4ng/ml in claudin-5 low expression group and high expression group respectively, indicating significantly high PSA level in low expression group (p=0.028). There was no statisfical difference in accordance with the expression of claudin-1 and claudin-5 in T stage, biochemical recurrence, local recurrence and distant metastasis. Claudin-1 low expression was correlated with high Gleason score of above score 7 and claudin-5 low expression was correlated with high Gleason score of above score 7 and high PSA level. There was no statistical difference between prognostic factors of prostate cancer such as T stage, biochemical recurrence, local recurrence, distant metastasis, and claudin-1 and -5 expression.
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/11674
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3. 학위논문 > 1. School of Medicine (의과대학) > 석사
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