PROFIL EKSPRESI MikroRNA-214 CAIRAN PLEURA PADA PASIEN ADENOKARSINOMA PARU BERDASARKAN STATUS MUTASI EGFR

M. RIDOTU SOLICHIN, dr. Didik Setyo Heriyanto, Sp.PA(K)., PhD; dr. Ery Kus Dwianingsih, Sp.PA(K)., PhD

2021 | Tesis-Spesialis | PATOLOGI ANATOMI

Pendahuluan. Kanker paru merupakan penyebab utama mortalitas terkait kanker dengan adenokarsinoma menjadi jenis tersering dan ditemukan pada hampir setengah jumlah kasus kanker paru. Di Indonesia penegakan diagnosis adenokarsinoma paru hingga penentuan terapi target seperti pemeriksaan mutasi EGFR sampai saat ini mengandalkan pemeriksaan sitologi, salah satunya menggunakan cairan pleura. Terdapat studi yang menunjukkan adanya deregulasi ekspresi miRNA-214 pada adenokarsinoma paru. Belum adanya studi miR-214 cairan pleura mendorong peneliti untuk mengeksplorasi ekspresi miR-214 cairan pleura pasien adenokarsinoma paru berdasarkan status mutasi EGFR. Tujuan. Penelitian ini bertujuan mengidentifikasi profil ekspresi miR-214 cairan pleura pasien adenokarsinoma paru berdasarkan status mutasi EGFR. Metode. Penelitian ini adalah penelitian potong lintang terhadap pasien adenokarsinoma paru dengan status mutasi EGFR diketahui dan mengalami efusi pleura di RSUP dr Sardjito pada 2018-2019. Sampel penelitian diambil secara purposive. Cairan efusi pleura selanjutnya disentrifugasi dan disimpan pada suhu -80oC hingga proses ekstraksi RNA. Pemeriksaan reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) dilakukan untuk menilai ekspresi miR-214 cairan efusi pleura. Ekspresi relatif miRNA dihitung dengan menggunakan metode delta-delta CT Hasil dan diskusi. Pada penelitian ini, dilakukan analisis terhadap 23 sampel cairan efusi pleura pasien adenokarsinoma paru yang diperiksa terdiri atas 4 (17,3%) adenokarsinoma EGFR positif dan 19 (82,7%) adenokarsinoma EGFR negatif. Didapatkan rerata hasil ekspresi miR-214 cairan pleura yang lebih tinggi pada adenokarsinoma paru EGFR positif dibandingkan pada adenokarsinoma EGFR negatif, meskipun secara statistik perbedaan ini tidak bermakna (p=0.95). Ekspresi miR-214 yang lebih tinggi pada kelompok adenokarsinoma EGFR positif ini dapat menguatkan kemungkinan peran miR-214 sebagai miRNA onkogenik (onkomir) pada karsinogenesis adenokarsinoma paru. Kesimpulan. Tidak terdapat perbedaan ekspresi miR-214 cairan pleura pada pasien adenokarsinoma paru dengan mutasi EGFR dibandingkan tanpa mutasi, meskipun ada kecenderungan ekspresi miR-214 yang lebih tinggi pada adenokarsinoma paru dengan mutasi EGFR positif.

Introduction. Lung cancer is a major cause of cancer-related mortality, with adenocarcinoma being the most common type and is found in almost half of all lung cancer cases. In Indonesia, diagnosis of lung adenocarcinoma, as well as EGFR examination, relies on cytology examination, one of which is using pleural fluid. Studies are showing the deregulation of miRNA-214 expression in lung adenocarcinoma. The absence of studies of miR-214 in pleural fluid prompted researchers to explore the expression of miR-214 in pleural fluid in lung adenocarcinoma patients based on EGFR mutational status. Objective. This study aims to identify the expression of miR-214 pleural effusion based on EGFR mutation status. Method. This study was a cross-sectional study of known EGFR status of lung adenocarcinoma patients with pleural effusions at RSUP Dr. Sardjito in 2018-2019. The samples were taken purposively. Pleural effusion fluid was obtained then centrifuged and stored at -80oC until the RNA extraction process. Examination of quantitative polymerase chain reaction reverse transcriptase (RT-qPCR) was carried out to assess the expression of miR-214 pleural effusion. The relative expression of miRNA is calculated using the Delta-Delta CT method. Results and discussion. In this study, 23 samples of lung adenocarcinoma pleural effusion fluid were examined, consisting of 19 (782.7%) samples from EGFR-negative adenocarcinoma patients and 4 (17.3%) EGFR-positive adenocarcinomas. There was an increase in miR-214 expression in EGFR-positive adenocarcinomas compared to EGFR-negative adenocarcinomas, but no statistically significant (p=0.95). The higher expression of miR-214 in the EGFR-positive adenocarcinoma group may strengthen the possible role of miR-214 as an oncogenic miRNA (oncomir) in lung adenocarcinoma carcinogenesis. Conclusion. There was no difference in the expression of pleural fluid miR-214 in lung adenocarcinoma patients with EGFR mutations compared to those without mutations, although there was a tendency for higher miR-214 expression in lung adenocarcinomas with positive EGFR mutations.

Kata Kunci : Adenokarsinoma paru, miR-214, EGFR, cairan pleura