Hubungan Ekspresi Protein NM23-H1, Densitas Limfovaskuler Peri-tumoral dan Invasi Limfovaskuler dengan Stadium dan Diferensiasi Histopatologi Adenokarsinoma Kolorektal - Tejo Jayadi; Harijadi -; Prijono Tirtoprod (Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI), 2013)
ABSTRAK Latar belakang Salah satu penyebab kekambuhan karsinoma kolorektal adalah metastasis locoregional atau metastasis jauh. NM23-H1 salah satu gen penghambat metastasis yang berperan dalam menurunkan potensi metastasis. Hasil penelitian-penelitian tentang peran NM23-H1 dan invasi limfovaskuler terhadap peningkatan derajat histopatologi dan stadium adenokarsinoma hasilnya masih kontroversial. Penelitian ini bertujuan mengetahui hubungan ekspresi protein NM23-H1 dan invasi limfovaskuler dengan derajat histopatologi dan stadium karsinoma kolorektal. Metode Rancangan Penelitian adalah potong lintang dengan menggunakan 50blok parafin dari pasien karsinoma kolorektal yang diagnosisnya ditegakkan secara histopatologis sebagai adenokarsinoma kolorektal stadium Duke B dan C di RSUP. Dr. Sardjito mulai tanggal 1 Januari 2007. Blok parafin dipotong 4 Î¼m diwarnai dengan antibodi poliklonal anti NM23-H1 dan antibodi monoklonal anti D2-40. Korelasi NM23-H1 dengan invasi limfovaskuler dianalisa dengan uji korelasi Spearman; asosiasi NM23-H1 dan invasi limfovaskuler dengan diferensiasi histopatologi dan stadium dianalisa menggunakan uji Chi-square. Hasil Penelitian ini menunjukkan terdapat korelasi antara ekspresi NM23-H1 dan invasi limfovaskuler dengan stadium adenokarsinoma kolorektal Duke B dan C (p= 0,006 dan 0,013). Ekspresi NM23-H1 tidak berhubungan dengan diferensiasi histopatologi (p=0,644). Invasi limfovaskuler berhubungan dengan diferensiasi histopatologi (p=0,018). Densitas limfovaskuler peritumoral tidak berhubungan dengan diferensiasi histopatologi dan stadium (p=0,556 dan p=0,768). Penelitian ini juga menunjukkan tidak adanya akorelasi antara NM23-H1 dengan densitas limfovaskuler peritumoral dan invasi limfovaskuler (p=0,996 dan p=0,176), dengan rasio odds 1,071 dan 2,1. Kesimpulan Ekspresi NM23-H1 dan invasi limfovaskuler berperan dalam perluasan dan metastasis adenokarsinoma kolorektal, sedangkan derajat diferensiasi sel tumor berhubungan dengan invasi limfovaskuler. Kata kunci : adenokarsinoma kolorektal, diferensiasi histopatologi, invasi limfovaskuler, NM23-H1, stadium. ABSTRACT Background One of the causes of colorectal carcinoma recurrence due to locoregional or distant metastasis. NM23-H1 is one of metastasis suppressor gene, and many studies showed that the influence of NM23-H1 expression and lymphovascular invasion to the grading and staging of colorectal carcinoma still controversial. The aim of this study is to determine the correlation of NM23-H1 expression and lymphovascular invasion with the grading and staging of colorectal carcinoma. Methods The study was retrospective cross sectional using 50 paraffin embedded tissue of patients with adenocarcinoma colorectal Duke B and C paraffin block, which diagnosed as adenocarcinoma colorectal Duke B and C by histopathological examination in Dr. Sardjito Central General Hospital since 1 January 2007. Those embeded tissues were cut 4Î¼m and stained by NM23-H1 polyclonal antibody and D2-40 monoclonal antibodi. t. Correlation NM23-H1 with lymphovascular invasion were analyzed using Spearman test. Chi Square test was performed to analyzed the association of NM23-H1 and lymphovascular invasion with grading and staging of the tumor. Results There were correlations between NM23-H1 expression, lymphovascular invasion with adenocarcinoma colorectal stage B and C (p=0.006 and 0.013). There was no correlation between NM23-H1 expression with the grading of tumor (p=0.644). There was correlation between lymphovascular invasion and grading of the tumor (p=0.018). There was no correlation between peripheral lymphovessel density with grading dan staging of the tumor (p=0,556 and p=0,768). This study showed no correlation between NM23-H1 with peripheral lymphovessel density and lymphovascular invasion (p=0.996 and p=0.176), with odds ratio 1.071 and 2.1. Conclusion NM23-H1 expression and lymphovascular invasion may have a role in the adenocarcinoma colorectal expansion and metastasis, while moderate and high grade have relationship with lymphovascular invasion. Key words: adenocarcinoma colorectal, histopathology differentiation, lymphovascular invasion, Nm23-H1, stage.