THE CHANGE OF SALIVARY FLOW RATE, AND CONCENTRATION OF TOTAL PROTEIN AND IGA AFTER RADIATION THERAPY OF ORAL CANCER

구강암 환자에서 방사선 조사에 따른 타액량, 총 단백 및 IgA 농도의 변화

This study was performed to investigate the changes in flow and composition of saliva in oral cancer patients after radiation therapy. Stimulated whole saliva was collected from 7 patients who were scheduled for over 6,000cGy irradiation (180 - 225cGy fraction $Co^{60}$ therapy, 5 times a week). The flow rate of saliva, and concentration of total protein and IgA were measured before irradiation and 1, 2, 3, 4, 5 days and 1, 2, 3, 4, 6 weeks and 3, 6, 12 months after. The followings are results we obtained: 1. The salivary flow rate before irradiation was $0.8671{\pm}0.4057ml/min$. Significant decrease started 3 days after irradiation and reached a minimum at 4 weeks ($0.2621{\pm}0.2858ml/min$). Afterwards, flow rate started to increase and was on the way to recover at 1 year. 2. The concentration of total protein and IgA before irradiation were $137.2000{\pm}16.9912mg%$ and $3.4200{\pm}1.4114mg%$, respectively. After irradiation, these figures increased significantly and reached a maximum of $366.4000{\pm}174.0583mg%$ and $43.4800{\pm}29.1207mg/ml$, respectively at 6 weeks. Recovery towards normal values started following the end of irradiation and figures at 12 months had lowered to $165.400{\pm}21.1495mg%$ and $4.6200{\pm}2.1580mg/ml$ each. 3. The ratio of IgA to the amount of total protein was 2.5% before irradiation. This began to increase from 1 week following irradiation as the total dose of radiation received was increased (11.9% at 6 weeks). After 1 year from the start of radiation therapy, the ratio was reduced to such level that was before irradiation.

구강암 환자에서 방사선 조사를 받은 경우에 있어 타액의 성분 및 성질 변화를 알아내는 기초적 조사로 주 5회 180-225cGy fraction의 $Co^{60}$ 치료 예정자 중 총 6,000cGy 이 상자 7명에서 자극전타액 채취를 통해 타액분비량, 총단백 및 IgA의 농도를 방사선치료 직전, 방사선 조사 후 1일, 2일, 3일, 4일, 5일, 1주, 2주, 4주, 6주, 3개월, 6개월, 12개월째에 측정하여 다음과 같은 결과를 얻었다. 1. 타액분비량은 방사선조사 전에는 $0.8671{\pm}0.4057ml/min$이었으며, 방사선조사 후 3일째부터 유의하게 감소하기 시작하여 4주째에 최소치를 나타냈다($0.2621{\pm}0.2858Ml/min$). 이후 타액분비량이 증가하기 시작하여 일년째에는 타액분비량이 회복되는 추세였다. 2. 총 단백 및 IgA 농도는 방사선 조사 전에는 각각 $137.2000{\pm}16.9912mg%$, $3.4200{\pm}1.4114mg%$였으나, 방사선조사와 함께 유의하게 증가하기 시작하여 6주째에 각각 $366.4000{\pm}174.0583mg%$, $43.4800{\pm}29.1207mg/ml$으로 최고점에 도달하였고, 방사선조사 완료와 함께 회복 되기 시작하여 12개월째에는 $165.4000{\pm}21.1495mg%$와 $4.6200{\pm}2.1580mg/ml$으로 그 농도가 낮아졌다. 3. 타액 총단백에 대한 IgA의 비율은 방사선조사 전에는 2.5%에서 방사선 조사 1주 이후부터는 조사량이 증가됨에 따라 계속 증가하다가(방사선 조사 6주 때 11.9%), 일년째에는 방사선 조사전의 비율로 회복되었다.