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HUBUNGAN ANTARA EKSPRESI CDK4 DENGAN PROFIL DEMOGRAFIS DAN TEMUAN HISTOPATOLOGI PASIEN OSTEOSARKOMA DI RSUP DR. SARDJITO

FAIZAH DWI TIRTASARI, dr. Ery Kus Dwianingsih, Sp.PA (K)., PhD.; Dr. dr. Ahmad Ghozali, Sp.PA (K)

2020 | Tesis-Spesialis | PATOLOGI ANATOMI

Pendahuluan: Osteosarkoma adalah keganasan tumor primer tulang yang paling umum menyumbang 30% -80% dari seluruh tumor primer tulang dengan distribusi bimodal yaitu usia 10-20 tahun dan usia lebih dari 60 tahun. Prognosis penderita dipengaruhi oleh berbagai faktor, salah satunya ekspresi Cyclin- dependent kinase 4 (CDK4). Cyclin-dependent kinase 4 sebagai salah satu jalur patogenesis osteosarkoma lewat inaktivasi gen Rb, dari penelitian sebelumnya dinilai berhubungan dengan prognosis osteosarkoma yang baik. Objektif: Penelitian ini bertujuan untuk mengetahui profil mutasi CDK4 pada kasus osteosarkoma dan hubungannya dengan jenis kelamin, usia, lokasi tumor, metastasis, grading histologis, dan pathologic staging di RSUP Dr. Sardjito. Metode: Penelitian ini merupakan penelitian analitik observasional dengan metode kohort retrospektif. Pengumpulan data dilakukan dengan pengukuran ekspresi CDK4 (BioCare Medical, USA, 1:100) pada jaringan blok parafin yang dinilai dengan teknik imunohistokimia. Sampel yang diambil yaitu 50 orang pasien osteosarkoma di RSUP Dr. Sardjito. Data yang telah dikumpulkan kemudian dianalisis dengan uji statistik Chi-Square, Fishers exact test, dan Mann Whitney. Hasil: Dari 50 subjek penelitian, 38 sampel (76%) menunjukkan overekspresi CDK4, dengan 24 sampel (63,2%) berjenis kelamin laki-laki, 24 sampel (63,2%) memiliki usia < 25 tahun, 31 sampel (81,6%) tumor berlokasi di ekstremitas, 17 sampel (44,7%) dengan metastasis, 35 sampel (92,1%) merupakan osteosarkoma derajat tinggi, dan 21 sampel (91,3%) tumor terlokalisasi. Mutasi CDK4 tidak berhubungan signifikan dengan jenis kelamin (p=1,000), usia (p=0,729), lokasi tumor (p=0,424), metastasis (p=0,750), grading histologis (p=1,000), dan pathologic staging (p=0,309). Kesimpulan: Overekspresi CDK4 terdapat pada 76% pasien osteosarkoma, namun tidak memiliki hubungan yang signifikan dengan jenis kelamin, usia, lokasi tumor, metastasis, grading histologis, dan pathologic staging.

Introduction: Osteosarcoma is the most common primary bone tumor malignancy that accounts for 30% -80% of all primary bone tumors with a bimodal distribution, namely 10-20 years of age and over 60 years of age. The patients prognosis is influenced by various factors, one of which is the expression of Cyclin-dependent kinase 4 (CDK4). Cyclin-dependent kinase 4 as a pathogenesis pathogenesis of osteosarcoma through inactivation of the Rb gene, from previous studies was considered to be associated with a good prognosis of osteosarcoma. Objective: This study aims to determine the profile of CDK4 mutations in osteosarcoma cases and their relationship with gender, age, tumor location, metastases, histological grading, and pathologic staging in Dr. Sardjito. Methods: This study was an observational analytic study using a retrospective cohort method. Data collection was performed by measuring CDK4 expression (BioCare Medical, USA, 1: 100) in paraffin block tissue assessed by immunohistochemical techniques. Samples taken were 50 osteosarcoma patients at RSUP Dr. Sardjito. The data that had been collected was then analyzed by using the Chi-Square statistical test, Fishers exact test, and Mann Whitney. Results: Of the 50 study subjects, 38 samples (76%) showed CDK4 overexpression, with 24 samples (63.2%) male, 24 samples (63.2%) having age <25 years, 31 samples (81.6%) tumors were located in the extremities, 17 samples (44.7%) with metastatic, 35 samples (92.1%) were high-grade osteosarcomas, and 21 samples (91.3%) were localized tumors. CDK4 mutation was not significantly related to sex (p = 1,000), age (p = 0.729), tumor location (p= 0.424), metastasis (p = 0.750), histological grading (p = 1,000), and pathologic staging (p = 0.309). Conclusion: CDK4 overexpression was found in 76% of osteosarcoma patients, but it have no a significant association with gender, age, tumor location, metastasis, histological grading, and pathologic staging.

Kata Kunci : ekspresi CDK4, osteosarkoma, metastasis, grading histologis, dan pathologic staging, CDK4 expression, osteosarcoma, metastasis, histological grading, and pathologic staging

  1. S2-2020-420568-abstract.pdf  
  2. S2-2020-420568-bibliography.pdf  
  3. S2-2020-420568-tableofcontent.pdf  
  4. S2-2020-420568-title.pdf