Hubungan Imunoekspresi E-cadherin dan C-erbB2 dengan Derajat Keganasan Histopatologik Karsinoma Kistik Adenoid Kelenjar Liur

Abstract

Karsinoma kistik adenoid (KKA) merupakan keganasan kelenjar liur terbanyak, prognosisnya sukar diprediksi dengan tingkat kekambuhan yang tinggi. Berdasarkan beberapa penelitian, prognosis KKA kelenjar liur yang berhubungan dengan tingkat ketahanan hidup sangat terkait dengan derajat keganasan histopatologik berdasarkan tipe pola pertumbuhannya. Penelitian ini dilaksanakan di Departemen Patologi Anatomi Fakultas Kedokteran Universitas Padjadjaran Bandung tahun 2009. Tujuan penelitian untuk mengetahui perubahan imunoekspresi protein adhesi E-cadherin (molekul adhesi antar sel epitel) dan proto-onkogen C-erbB2 (keluarga C-erbB/reseptor faktor pertumbuhan epidermal) pada KKA kelenjar liur dikorelasikan dengan derajat keganasan histopatologik. Desain penelitian studi potong lintang tanpa acak secara retrospektif pada 51 blok parafin penderita karsinoma kistik adenoid kelenjar liur. Sampel didiagnosis ulang, serta ditentukan derajat keganasan histopatologiknya (menurut modifikasi Szantos dan Batsakis) dilanjutkan dengan pemeriksaan imunohistokimia terhadap E-cadherin dan C-erbB2. Hasil menunjukkan korelasi sangat bermakna (p<0,01) perubahan imunoekspresi E-cadherin yang negatif (82%) dengan derajat keganasan histopatologik 1, 2, dan 3 (4%, 33%, dan 46%). Perubahan imunoekspresi C-erbB2 tidak berkorelasi dengan meningkatnya derajat keganasan (p=0,11). Terjadi perubahan peningkatan imunoekspresi dari derajat 1 (5%) ke derajat 2 (11%), namun kembali menurun pada derajat 3 (8%). Simpulan, imunoekspresi E-cadherin dapat digunakan sebagai petanda tumor untuk memprediksi prognosis keganasan KKA kelenjar liur. Perubahan imunoekspresi C-erbB2 pada KKA kelenjar liur menunjukkan perilaku biologinya dan peran utama C-erbB2 pada KKA kelenjar liur terutama pada fase inisiasi dan promosi karsinogenesis. [MKB.2012;44(2):70–6].

Correlation of E-cadherin and C-erbB2 Immunoexpression with the Degree of Histopathological Malignancy on Salivary Gland Adenoid Cystic Carcinoma

Adenoid cystic carcinoma (ACC) is the most common salivary gland malignancies, with high rate of local recurrence and unpredictable prognosis. Based on previous research, prognosis of ACC in salivary gland which is correlated with survival rates, is related with histopathological malignancy degree based on its growth pattern type. This study was conducted in Pathology Anatomy Department of Medical Faculty, Padjadjaran University Bandung in 2009. The aim of this study was to analyze the alteration of immunoexpression of E-cadherin (adhesion molecule of epithelial cells) and C-erbB2 proto-oncogen (the family of C-erbB/epidermal growth factor receptor) in salivary gland. Adenoid cystic carcinoma correlated with cross-sectional non-random study on 51 paraffin blocks, from patients with salivary gland ACC retrospectively. The repeated histopatologic examination was to diagnose ACC and to get data of the histopathological malignancy degree (according to Szantos and Batsakis modification), and it was continued with immunohistochemistry examination of E-cadherin and C-erbB2. The alteration of negative immunoexpression of E-cadherin (82%) had correlation significantly (p<0.001) with the histological malignancy degrees 1, 2, and 3 (4%, 33% and 46%). The C-erbB2 immunoexpression change had no correlation with the increasing histopatologic malignancy degree (p=0.11). The alteration of C-erbB2 immunoexpression, increased from first (5%) to second degree (11%) but decreased on the third degree (8%). In conclusions, the immunoexpression of E-cadherin can be used as tumor marker to predict malignancy prognosis of salivary gland ACC. The expression changes of C-erbB2 in ACC indicate its biological behavior and the main role of C-erbB2 on salivary gland ACC is in the initiation and promotion phase of carcinogenesis. [MKB. 2012;44(2):70–6].

DOI:  http://dx.doi.org/10.15395/mkb.v44n2.126