Hubungan Ekspresi p53 dan hMLH1 dengan Karakteristik Kliniko-patologik Kanker Kolorektal - . Pieri Kumaladewi, Indrawati, FX Ediati Triningsih, Soeripto (Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI), 2015)
ABSTRAK Latar belakang Ekspresi protein p53 sudah banyak dibahas dalam proses keganasan dan menunjukkan prognosis yang buruk. Gen hMLH1 adalah suatu gen repair yang salah berpasangan/mismatch-repair (MMR) dan hipermetilasi hMLH1 diikuti mikrosatelit yang tidak stabil dan sering ditemukan pada kanker kolon nonpoliposis herediter. Namun, hubungan dengan karakteristik klinikopatologik masih sangat kontroversial. Tujuan Penelitian ini dilakukan untuk mempelajari hubungan ekspresi p53, dan hMLH1 dengan karakteristik klinikopatologik (umur, jenis kelamin, lokasi tumor, grading dan staging) pada kanker kolorektal. Metode Sampel blok parafin yang berasal dari 45 kasus adenokarsinoma kolorektal yang mengalami pengangkatan tumor dikumpulkan sejak Januari 2007 sampai Desember 2008 di RS Sardjito, RS Bethesda dan RS Panti Rapih, Yogyakarta, Indonesia. Ekspresi protein p53 diteliti menggunakan antibodi monoklonal (clone DO-7; Novocastra) dan ekspresi hMLH1 diteliti menggunakan antibodi monoklonal (Biocare Medical; USA). Kriteria pewarnaan sel diklasifikasikan sbb: negatif, bila 10 sel positif. Data-data kliniko-patologik yang dikumpulkan meliputi usia, jenis kelamin, lokasi tumor, tipe histologik dan stadium penyakit. Uji Chi-square dan Fisher test digunakan untuk melakukan evaluasi antara ekspresi p53 dan hMLH1. Hasil Pewarnaan p53 menunjukkan hasil positif (53.3%); pewarnaan hMLH1 menunjukkan hasil negatif (33.3%). Uji statistik antara p53 dan usia (p:0.459); jenis kelamin (p:0.764); lokasi tumor (p: 0.769); grading (p: 0.664) menunjukkan hasil yang tidak berbeda bermakna. Uji statistik antara hMLH1 dan usia (p:1); jenis kelamin (p:0.352); lokasi tumor (p: 352); grading (p: 0.280) menunjukkan hasil yang tidak berbeda bermakna. Kesimpulan Tidak ditemukan perbedaan bermakna antara ekspresi p53 dan hMLH1 dengan karakteristik klinikopatologik (usia, jenis kelamin, lokasi, grading dan staging) pada kanker kolorektal. Kata kunci: kanker kolorektal, p53, hMLH1, karakteristik klinokopatologik. ABSTRACT Background Over expression of p53 protein has been documented in a number of human malignancies and shown to be associated with poor prognosis. hMLH1 is a mismatch repair gene and hypermethylation of hMLH1 follows microsatelite instability that usually found in hereditary nonpolyposis colon cancer in colorectal cancer. The relation with clinicopathologic characteristic is still controversial. Aim To study relationship p53 and hMLH1 with clinicopathologic characteristics (age, gender, site of tumor, grading and staging) of cancer colorectal. Method Paraffin-preserved adenocarcinoma colorectal samples of 45 cases were collected from patients undergoing tumor resection from January 2007 through December 2008 in Sardjito Hospital, Bethesda Hospital and Panti Rapih Hospital, Yogyakarta, Indonesia. Expression of p53 protein using monoclonal antibody (clone DO-7; Novocastra) and expression of hMLH1 were studied using monoclonal antibody (Biocare Medical:USA). The number of cells stained were classified as negative: 10% positive cells. Clinicopathologic data including gender, age, tumor location, histologic type and stage of disease were collected. Statistic analysis of Chi-square and Fisher’s Exact Test is used to differentiated between p53 and hMLH1 expression. Result p53 staining was positive (53.3%) and hMLH1 was negative (33.3%). Statistic test between between p53 and age (p:0.459); gender (p:0.764); site of tumor (p:0.769); and grading (p:0.664) showed no significant correlation. Statistic test between of hMLH1 and age (p:1), gender (p:0.352), site of tumor(p:0.352) and grading( p:0.280) showed no significant correlation. Conclusion There is no significant differences between expression of p53 and hMLH1 with clinicopathologic characteristics (age, gender, site of tumor, grading and staging) of cancer colorectal. Key words : colorectal cancer, p53, hMLH1, clinicopathologic characteristics