Ekspresi Reseptor-Estrogen pada Adenoma Pleomorfik Parotis - Yazid, Achmad Syawqie (Faculty of Medicine, Universitas Padjadjaran)
Adenoma pleomorfik parotis (APP) merupakan tumor jinak yang umum terjadi pada kelenjar liur parotis, memiliki perilaku biologi beragam, yaitu sering rekurens setelah dioperasi, dapat berubah menjadi ganas, juga kadang bermetastasis ke kelenjar getah bening atau ke organ lain. Selayaknya untuk tumor APP ini dilakukan pencarian bentuk terapi alternatif lain selain terapi bedah yang diduga penyebab tingginya rekurensi tumor. Terapi alternatif lain dapat berupa hormonal yang memerlukan data dasar ekspresi reseptor estrogen oleh sel tumor APP. Untuk mengungkapkan ekspresi reseptor estrogen oleh sel tumor APP, dilakukan penelitian retrospektif eksperimental laboratoris pemeriksaan imunohistokimia teknik LsAB/labelled strepavidine-biotine terhadap ekspresi estrogen receptor (ER) pada 50 sampel tumor APP di Bagian Patologi Anatomi FKUP/RSHS pada tahun 1998–1999. Pengamatan ditujukan pada kelompok penyebaran tingkat imunoekspresi ER oleh sel tumor APP: 0=negatif; +1=fokal (>20%); +2=heterogen (20–50%); dan +3=difus (>50% sel tumor imunoreaktif). Hasil menunjukkan 40/50 sampel tumor APP (80%) imunoreaktif terhadap ER dengan komposisi imunoekspresi: 67,5% heterogen (27/40) dan 32,5% difus (13/40). Pola pulasan homogen teramati pada inti sel tumor. Sepuluh kasus memperlihatkan hasil negatif (negatif 8 kasus dan fokal 2 kasus). Komponen jaringan tumor APP yang positif meliputi sel epitel duktal/tubuloduktal, area miksomatosa, dan hiperselular. Simpulan, tumor APP berperan sebagai target hormon estrogen dan besar kemungkinannya responsif terhadap terapi hormonal. [MKB. 2010;42(4):181–6].Kata kunci: Adenoma pleomorfik, estrogen receptor, tumor parotisEstrogen-Receptor Expression in Parotid Pleomorphic AdenomaParotid pleomorphic adenoma (PPA) is a benign tumor frequently found in parotid salivary gland. This tumor has various biological behaviors including recurrence after surgery, ability to transform into the malignant form, and occasionally, metastasizes to lymph nodes or other organs. For this PPA tumor, it is appropriate to look for alternative therapy forms other than surgery which is assumed to be the cause of the high tumor recurrence. Other alternatives may include hormonal therapy that needs baseline data on estrogen-receptor expression by PPA tumor cells. To collect the baseline data, a laboratory experimental retrospective study on immunohistochemical study using LsAB/labelled strepavidine-biotine technique of estrogen receptor (ER) receptor on 50 PPA tumor samples at the Anatomic Pathology Department of the Faculty of Medicine, Padjadjaran University/Hasan Sadikin General Hospital during 1998–1999 has been conducted. The observation is focused on the grouping of ER immunoexpression level spread by PPA tumor cells: 0=negative; +1=focal (>20%); +2=heterogeneous (20–50%); and +3=diffuse (>50% immunoreactive tumor cells). The results showed that 40/50 PPA tumor samples (80%) were immunoreactive towards ER with an immunoexpression composition of: 67.5% heterogeneous (27/40) and 32.5% diffuse (13/40). A homogenous smear pattern was observed in tumor cell nucleus. Ten cases showed negative results (8 cases negative and 2 cases focal). The positive PPA tumor tissue components included ductal /tubuloductal epithels, mixomatose and hypercellullar areas. In conclusion, PPA tumor plays the role as target of estrogen hormone and there is a high possibility that it is responsive to hormonal therapy. [MKB. 2010;42(4):181–6].Key words: Estrogen receptor, parotid tumors, pleomorphic adenoma DOI: http://dx.doi.org/10.15395/mkb.v42n4.34