EKSPRESI BETA-CATENIN (CTNNB1) PADA SITOPLASMA DAN INTI SEL ANTARA AMELOBLASTOMA UNIKISTIK DENGAN ODONTOGENIC KERATOCYST (Penelitian Restropektif Analitik di RSUP DR. Sardjito tahun 2010-2015)
RESTA DINAMIKA CHANDRA BIMANTARA, drg. Bambang Dwirahardjo., SpBM(K); drg. Poerwati Soetji Rahajoe, SpBM(K)
2017 | Tesis-Spesialis | SP ILMU BEDAH MULUTAmeloblastoma unikistik dan odontogenic keratocyst memiliki gambaran klinis dan radiografi yang hampir sama. Ameloblastoma unikistik juga memiliki gambaran histologi yang dapat disalahartikan sebagai odontogenic keratocyst. Beberapa peneliti percaya bahwa ameloblastoma unikistik memiliki kesamaan faktor pembentukannya dengan odontogenic keratocyst. Beta-Catenin adalah protein yang di dalam inti sel akan berinteraksi dengan faktor-faktor transkripsi dan meningkatkan jumlah sel serta merupakan produk onkogenik. Penelitian ini bertujuan untuk mengkaji dan melihat ekspresi Beta-catenin pada sitoplasma dan inti sel ameloblastoma unikistik dan odontogenik keratocyst. Rancangan penelitian restropektif analitik dengan consecutive sampling, menggunakan 18 sampel blok parafin ameloblastoma unikistik dan 13 sampel blok parafin odontogenic keratocyst yang tersimpan di bagian Patologi Anatomi RSUP DR. Sardjito periode 2010-2015, sesuai dengan kriteria inklusi dan eksklusi yang telah ditetapkan, tiap-tiap sampel dilakukan pengecatan imunohistokimiawi Beta-catenin. Pengamatan ekspresi, letak, intensitas dan distribusi Beta-catenin dilakukan dengan menggunakan mikroskop cahaya. Uji statistik menggunakan Chi Square dan Mann Whitney, menunjukkan hasil ekpresi positif Beta-catenin pada ameloblastoma unikistik lebih banyak daripada odontogenic keratocyst (P = 0,002), jumlah Beta-cetanin di sitoplasma ameloblastoma unikistik lebih banyak daripada odontogenic keratocyst (P = 0,004), sedangkan jumlah Beta-catenin di inti sel pada ameloblastoma unikistik lebih sedikit dibandingkan odontogenic keratocyst (P = 0,014), intensitas pewarnaan Beta-catenin (+3) hanya dijumpai pada ameloblastoma unikistik (22,2%), dan distribusi imunopositif Beta-catenin difuse banyak dijumpai pada ameloblastoma unikistik (66,7%). Kesimpulan, ekspresi Beta-catenin pada sitoplasma ameloblastoma unikstik lebih banyak dibandingkan odontogenic keratocyst. Ekspresi Beta-catenin pada sitoplasma dapat dijadikan pertimbangan dalam mendiagnosa ameloblastoma unikistik dengan lesi kistik lainnya.
Unicystic ameloblastoma and odontogenic keratocyst share almost the same clinical and radiographic features. Unicystic ameloblastoma also has histologic features that could be mistaken for odontogenic keratocyst. Some researchers believe that a unicystic ameloblastoma has similarities to its formation factor with odontogenic keratocyst. Beta-Catenin is a protein that found in the nucleus which will interact with transcription factors and increase cell count and is also an oncogenic product. The aim of this study was to examine and to observe Beta-catenin expression in the cytoplasma and nucleus of unicystic ameloblastoma and odontogenic keratocyst. The retrospective analytic study design was conducted with consecutive sampling, using 18 samples of unicystic ameloblastoma paraffin blocks and 13 samples of odontogenic keratocyst paraffin blocks which was stored in the Anatomical Pathology section of RSUP DR. Sardjito during the 2010-2015 period. A diagnosis was then made based on the inclusion and exclusion criteria set, followed by immunohistochemical staining of Beta-catenin. The observations for expression, location, intensity and distribution of Beta-catenin were performed using a light microscope. The statistical tests were carried out using Chi Square and Mann Whitney which showed the positive expression of Beta-catenin on more the unicystic ameloblastoma than the odontogenic keratocyst (P = 0.002), whereas Beta-cetanin in the cytoplasma of unicystic ameloblastoma is more than the odontogenic keratocyst (P = 0.004). The Beta-catenin position in the cell nucleus in unicystic ameloblastoma is slightly more than the odontogenic keratocyst (P = 0.014), the intensity of Beta-catenin staining (+3) in the unicystic ameloblastoma (22,2%) is more positive than the odontogenic keratocyst (P = 0.001), and the more difused Beta-catenin immunopositive distribution (66,7%) in unicystic ameloblastoma was found than in the odontogenic keratocyst (P = 0.047). In conclusion, Beta-catenin expression in the cytoplasma of unicystic ameloblastoma was higher than that of odontogenic keratocyst. The presence of Beta-catenin expression in the cytoplasma may serve as a consideration that can be used in diagnosing unicystic ameloblastoma with other cystic lesions.
Kata Kunci : Ameloblastoma unikistik, odontogenic keratocyst, Beta-Catenin.
