KORELASI KARAKTERISTIK ULTRASONOGRAFI DENGAN EKSPRESI mRNA GEN HER2 PADA KANKER PAYUDARA

LESTARI, Dr. dr. Lina Choridah, Sp.Rad (K).; dr. Henry Kusumo Husodoputro, Sp.Rad (K)

2017 | Tesis-Spesialis | SP RADIOLOGI

Latar Belakang. Kanker payudara memiliki mortalitas dan morbiditas yang tinggi. Ultrasonografi (USG) merupakan modalitas diagnostik untuk mengevaluasi abnormalitas payudara. Marker biologi human epidermal growth factor receptor type 2 (HER2) dapat digunakan untuk memprediksi respon terapi dan prognosis. Penggunaan level mRNA dengan metode qRT-PCR merupakan metode pemeriksaan marker biologi terbaru yang bersifat dinamis, sensitif dan mudah diaplikasikan serta bersifat sangat obyektif dan kuantitatif. Tujuan. Untuk mengetahui korelasi antara karakteristik gambaran USG dengan ekspresi HER2 pada kanker payudara. Bahan dan Metode. Penelitian ini merupakan penelitian observasional analitik rancangan cross-sectional, pengambilan sampel dengan cara retrospektif. Penelitian dilakukan di RSUP Dr. Sardjito Yogyakarta pada bulan Desember 2016 -Mei 2017. Subjek penelitian adalah citra USG lesi ganas payudara dan hasil patologi anatomi serta ekspresi mRNA gen HER2. Dilakukan analisis deskriptif karakteristik subjek dan uji Spearman untuk mengetahui hubungan karakteristik USG dengan ekspresi mRNA gen HER2. Hasil. Sampel terdiri dari 30 citra USG yang dilakukan uji korelasi terhadap ekspresi gen HER2 lesi payudara menggunakan uji Spearman. Karakteristik USG gambaran posterior memiliki nilai p = 0,047 dan = - 0,366 terhadap ekspresi mRNA gen HER2. Ekspresi mRNA HER2 positif pada 20 Subjek (66,7%). Gambaran USG tersering pada expresi HER2 positif adalah ireguler ((66,7%), orientasi non paralel (83,3%), tepi indistinct (46,7%), pola ekho hipoekhoik (63,3%), penyangatan posterior (50%), tidak terdapat kalsifikasi (66,7%) dan metastasis limfonodi (63,3%). Kesimpulan. Tidak didapatkan korelasi yang kuat antara karakteristik USG dengan ekspresi mRNA gen HER2. Didapatkan korelasi yang lemah gambaran posterior dengan ekspresi mRNA gen HER2 pada kanker payudara.

Background. Breast cancer has high mortality and morbidity. Ultrasonography is a diagnostic modality for evaluating breast abnormalities. The Human Epidermal Growth Factor Receptor type 2 (HER2) biological marker can be used to predict the treatment response and prognosis. The usage of mRNA with qRT-PCR method is the latest method for examining biological markers which is dynamic, sensitive and easy to apply and is highly objective and quantitative. Purpose. To determine the correlation between sonographic characteristic findings and HER2 mRNA gene expression in breast cancer. Materials and Methods. This is an analytic observational study which was done cross-sectionally with retrospective sampling. The study was conducted at RSUP Dr. Sardjito Yogyakarta in December 2016 - May 2017. Study subjects were sonographic images of malignant breast lesions, pathology results, and HER2 mRNA gene expression. Descriptive analysis of subject characteristics and Spearman test was performed to determine the relationship of sonographic characteristic findings and HER2 mRNA gene expression. Results. The sample consisted of 30 sonographic images which were correlated with HER2 mRNA gene expression using Spearman test. Sonographic characteristic finding of posterior feature showed p value = 0,047 and = - 0,366 with HER2 mRNA gene expression. HER2 mRNA gene expression was positive in 20 subjects (66,7%). The most frequent sonographic characteristic findings of positive HER2 expression were irregular (66,7%), non-paralel orientation (83,3%), indistinct margin (46,7%), hypoechoic echo pattern (63,3%), posterior enhancement (50%), no calcification (66,7%) and lymph node metastasis (63,3%). Conclusion. No evidence of strong correlation between sonographic characteristic findings and HER2 mRNA gene expression in breast cancer. There was a weak correlation between sonographic characteristic finding of posterior feature with HER2 mRNA gene expression in breast cancer.

Kata Kunci : Kanker payudara, USG, HER2, Breast cancer, Sonographic finding