Hubungan Imunoekspresi Epidermal Growth Factor Receptor (EGFR) dengan Stadium Dukes pada Karsinoma Kolorektal - Fenny Ariyanni; Sri Suryanti; Abdul Hadi Hassan; Bethy S Hernowo (Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA), 2015)
ABSTRAK Latar belakang Epidermal growth factor receptor (EGFR) berperan dalam patogenesis dan progresivitas karsinoma kolorektal. Stadium Dukes menunjukkan luas penyebaran tumor dan digunakan sebagai pedoman terapi. Pada stadium Dukes A tumor masih terbatas pada tunika submukosa, stadium Dukes B tumor sudah menembus tunika muskularis dan stadium Dukes C sudah bermetastasis ke kelenjar getah bening. Penggunaan kemoterapi adjuvan pada stadium Dukes B masih kontroversi sehingga hanya diberikan pada stadium Dukes B yang high risk. Diperlukan penanda molekuler yang dapat menunjukkan tumor yang agresif. Pada penelitian ini akan diteliti hubungan imunoekspresi EGFR dengan stadium Dukes pada karsinoma kolorektal. EGFR diharapkan dapat digunakan menjadi penanda karsinoma kolorektal yang agresif. Metode Pewarnaan imunohistokimia EGFR dilakukan terhadap 45 blok parafin karsinoma kolorektal yang dilakukan kolektomi (masing-masing stadium Dukes A, B, C 15 kasus). Hasilnya dihubungkan dengan stadium Dukes. Hasil Pada stadium Dukes A sebanyak 2 kasus (13%) menunjukkan imunoekspresi positif dan stadium Dukes B sebanyak 8 kasus (53%) menunjukkan imunoekspresi positif dan pada stadium Dukes C sebanyak 11 kasus (73%) menunjukkan imunoekspresi positif. Imunoekspresi EGFR secara statistik (p=0.004, uji Chi-Square) lebih sering ditemukan pada stadium Dukes C. EGFR berperan penting dalam diferensiasi dan proliferasi sel. Pada sel normal pengaktifan sinyal EGFR menyebabkan proliferasi sel, migrasi, metastasis, penghindaran apoptosis dan angiogenesis. Kesimpulan Imunoekspresi EGFR lebih sering ditemukan pada stadium Dukes C dibanding Dukes A dan B. Kata kunci: EGFR, imunoekspresi, karsinoma kolorektal, stadium Dukes. ABSTRACT Background Epidermal growth factor receptor immunoexpression may clarify the effects of the pathogenesis and determine the prognosis of colorectal carcinoma (CRC). Dukes’ stage explained the extension of the tumor. Dukes’ stage A was defined as malignant tumour in which growth extends into the submucosa, but not into the muscle coat; Dukes’ stage B was defined as the tumour growth extends into the muscle coat; and Dukes’ stage C was defined as the presence of lymph node metastases. Adjuvant chemotherapy in Dukes’ stage B is controversial, which only given to high-risk Dukes’ stage B. Hence, we need to identify high-risk Dukes’ stage B. This research will study association EGFR clone H11 and CRC Dukes’ stage. Methods Immunohistochemistry was performed in paraffin-embedded specimens of 45 cases colorectal carcinoma (each Dukes’ stage A, B, C was 15 cases) for the assesment of clone H11 EGFR expression. The results were correlated with colorectal carcinoma Dukes’ stage. Results At Dukes’ stage A there were 2 cases (13%) showed positive immunoexpression and Dukes’ stage B there were 8 cases (53%) showed positive immunoexpression and Dukes’ stage C there were 11 cases (73%) showed positive immunoexpression. clone H11. EGFR clone H11 immunoexpression (p=0.004, Chi-Square test) was significantly more frequent in Dukes’ stage C. EGFR play an important role in cell differentiation and proliferation. The activation of EGFR signaling would lead to cell proliferation, migration, metastasis, evasion of apoptosis or angiogenesis. Conclusion EGFR immunoexpression was more frequent in colorectal carcinoma Dukes’ stage C explain clearly that EGFR play important role in pathogenesis colorectal carcinoma. Key words: colorectal carcinoma, Dukes’ stage, EGFR, immunoexpression.