HUBUNGAN ANTARA EKSPRESI mRNA HER2 DAN mRNA CXCR4 PADA KARSINOMA PAYUDARA DENGAN DAN TANPA METASTASIS LIMFONODI

JAYATUN PURWANI, dr. FX .Ediati Triningsih, MSc , Sp.PA (K).; dr. Didik SetyoHeriyanto, Sp.PA, PhD.

2017 | Tesis-Spesialis | SP ILMU PATOLOGI ANATOMI

Latar belakang: Status limfonodi aksila adalah faktor prognosis yang paling penting untuk semua karsinoma payudara. Overekspresi HER2 meningkatkan potensi metastatik dan prognosis yang buruk. Peningkatan ekspresi mRNA CXCR4 berkaitan dengan pertumbuhan dan metastasis tumor serta mempengaruhi efek kemoterapi dan memperburuk prognosis. Penelitian tentang ekspresi mRNA HER2 dan CXCR4 pada pasien karsinoma duktal invasif di Indonesia sangat terbatas. Tujuan : Meneliti hubungan antara ekspresi mRNA HER2 dan mRNA CXCR4 dengan status metastasis limfonodi karsinoma duktal invasif. Metode: Sampel jaringan karsinoma duktal invasif tipe non spesifik sejumlah 60. Sampel terdiri dari dua kelompok yaitu 30 dengan metastasis limfonodi dan 30 tanpa metastasis limfonodi. Ekspresi gen mRNA CXCR4 dan HER2 diperiksa dengan metode RT-PCR dan nilainya dibandingkan dengan kontrol positif pada payudara normal. Hasil : Dari 60 sampel, 23 sampel (38,3%) mRNA HER2 terekspresi negatif; 11 sampel (18,3%) dari kelompok metastasis limfonodi dan 12 sampel (20%) dari kelompok tanpa metastasis limfonodi, dan 37 sampel (61,66%) terekspresi positif. Seluruh sampel, gen mRNA CXCR4 terekspresi positif. Rerata ekspresi gen mRNA HER2 pada kelompok tanpa metastasis (8,56)lebih tinggi dibandingkan kelompok metastasis (2,64), p= 0,076. Ekspresi gen mRNA CXCR4 pada kelompok tanpa metastasis (6,76)lebih tinggi dibandingkan kelompok metastasis (1,07), p= 0,358. Terdapat hubungan antara tingkat ekspresi gen mRNA HER2 CXCR4 pada kelompok tanpa metastasis limfonodi p=0,011 sedangkan pada kelompok metastasis limfonodi p=0,126. Kesimpulan : Tidak ada perbedaan tingkat ekspresi gen mRNA HER2 maupun CXCR4 pada karsinoma duktal invasif dengan dan tanpa metastasis limfonodi. Didapatkan adanya hubungan yang signifikan antara tingkat ekspresi gen mRNA HER2 dengan ekspresi CXCR4 pada karsinoma payudara tanpa metastasis limfonodi, namun tidak ada hubungan yang signifikan antara tingkat ekspresi gen mRNA HER2 dengan ekspresi CXCR4 pada karsinoma payudara dengan metastasis limfonodi.

Background: Lymph node metastasis has important role to determine breast carcinoma prognosis. HER2 overexpression increases metastasis potential and indicates poor prognosis. Meanwhile, CXCR4 gene expression associated with growth, metastasis and influences chemotherapy effects, which can worsen the prognosis. Study that emphasize mRNA expression levels of HER2 and CXCR4 in breast invasive ductal carcinoma in Indonesia is limited. Objective: The aim of this study is to investigate association between mRNA HER2, CXCR4 expression and lymph node metastasis in invasive ductal carcinoma patients. Methods: Sixty breast invasive ductal carcinoma of non-specific type tissue were divided into two groups: 30 cases with lymph node metastasis and 30 cases without lymph node metastasis. Expression of HER2 gen mRNA and CXCR4 gen mRNA were analyzed using quantitative-Real Time PCR then compared to positive control of the normal breast. Results: Among sixty samples, 23 samples (38.3%)were HER2 mRNA negatively expressed. Among them, 11 samples (18.3%) were lymph node metastasis group and 12 samples (20%)were without lymph node metastasis group. Thirty seven samples (61.66%)expressed HER 2mRNA positively. All of samples expressed CXCR4 mRNA positively. Mean of HER2 mRNA gene expression in non metastasis group (8:56) was higher than in metastasis group (2.64), p = 0.076. Mean of CXCR4 mRNA gene expression in nonmetastasis group (6.76) was higher than metastasis group (1:07), p = 0358. There was significant correlation between HER2 mRNA and CXCR4 mRNA gene expression level in group without lymph node metastasis (p = 0.011), whereas there was nonsignificant correlation in group with lymph node metastasis group (p = 0.126). Conclusion: There was no difference in the mRNA HER2 and mRNA CXCR4 gene expression level in invasive ductal carcinoma with and without lymph node metastasis. There was a significant positive correlation between mRNA HER2 gene expression level with mRNA CXCR4 expression level in breast carcinoma without lymph node metastasis, but there was no significant relationship between the mRNA HER2 gen expression level with mRnA CXCR4 gene expression level in breast carcinoma with lymph node metastasis.

Kata Kunci : Karsinoma Payudara ; mRNA HER2 ; mRNA CXCR4; metastasis limfonodi, Breast Carcinoma; HER2 mRNA; CXCR4 mRNA; Lymphnode metastasis.