Korean Journal of Nephrology 1998;17(2):291-298.
복막 투석액 내의 cancer antigen 125(CA125)의 농도 복막 중피세포의 용적 표지자로서의 의의
강덕희 , 윤견일
Abstract
The longevity of the peritoneum has been an object of interests and speculation since the ince- ption of CAPD. Peritoneal mesothelial cells(MC) are the mast important intraperitoneal cell quantitatively and have the capability to secret different types of substances including lubricant and various cytokines. It may therefore be essential to have information on the MC mass during peritoneal dialysis. However, there were no specific tools to evaluate the exact status of peritoneal membrane. CA125 is a 22kDa glycoprotein which is a clinically useful tumor mar- ker of non-mucinous epithelial ovarian carcinoma. Recently, other cells including pleural and peritoneal MC have been proved to express CA125. This study was undertaken to determine whether CA125 can be used as a bulk marker of MC mass in clinically stable 23 CAPD patients. We also analyzed whether the observed intraperitoneal production of CA125 can be attributed to MC using the cultured human peri- toneal MC from omentum. The CA125 production by MC in vitro was estimated with cultured MC of va- rious number(10,000-5,000,000/well) for different pe- riod of time. The median concentration of CA125 was significantly higher in 24-hour spent dialysate than in serum(5.5 vs. 17.3U/ml, P<0.05). There was signifcant negative correlation between the dialysate CA125 level and the incidence of peritonitis. In-vitro experiment using cultured MC cell showed an expo- nential increase of CA125 level during confluence(6th day of culture), and persistently increased till 15 days of culture, reaching a plateau. A linear relation between the number of MC and the amount of CA125 in supernatant was also observed. In conc- lusion, CA125 is locally produced in the peritoneal cavity and can be an useful marker of MC mass in stable CAPD patients. Since the clinical significance of the inverse correlation between the CA125 level and peritonitis incidence is uncertain(low CA125 as a second result of repeated peritonitis or the importa- nce of MC mass to regulate the antibacterial defense mechanism?), a prospective follow-up study is nece- ssary to confirm the relation between dialysate CA125 and the incidence of peritonitis.
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