CORRELATION OF ULTRASONOGRAPHIC FINDINGS AND ESTROGEN RECEPTOR mRNA EXPRESSION IN THYROID CARCINOMA

NURHUDA HENDRA S, Dr. dr. Lina Choridah, Sp.Rad (K).; dr. Sudarmanta, SpRad(K).

2017 | Tesis-Spesialis | SP RADIOLOGI

Latar Belakang: Ultrasonografi (USG) adalah alat yang sensitif, tanpa radiasi, dan tersedia luas untuk pemeriksaan tiroid. Morbiditas dan mortalitas karsinoma tiroid rendah namun meningkat seiring usia dan stadium. Hal yang menarik adalah prevalensinya lebih tinggi pada perempuan, sehingga dicurigai adanya peranan estrogen terhadap karsinoma tiroid. Dengan diketahuinya korelasi USG yang menunjukkan morfologi tumor dan ER sebagai penanda biologis diharapkan dapat dimanfaatkan untuk menentukan prognosis dan terapi karsinoma tiroid. Tujuan: Mengetahui gambaran USG dan ekspresi mRNA ER karsinoma tiroid, serta korelasi antara gambaran USG dengan ekspresi mRNA ER. Bahan dan Cara: Ini merupakan studi analitik uji korelasi cross-sectional secara retrospektif. Penelitian dilakukan di RSUP Dr. Sardjito Yogyakarta. Subjek penelitian adalah pasien yang telah diperiksa ultrasonografi tiroid, patologi anatomi serta mRNA ER pada 2015. Dilakukan analisis deskriptif karakteristik subjek dan uji Spearman Correlation Coefficient untuk mengetahui hubungan karakteristik ultrasonografi dengan ekspresi mRNA ER. Hasil: Didapatkan 30 subjek, 60% perempuan dan 40% laki-laki, usia 16-79 tahun. Ekspresi mRNA ER positif pada 28 subjek (93,3%), rata-rata perempuan 24,773 dan laki-laki 28,425. Histopatologi 80% subjek adalah karsinoma papiler. Gambaran ultrasonografi tersering adalah lesi solid-predominan solid (80%), hipoekoik-sangat hipoekoik (80%), taller-than-wide (76,7%), ukuran > 2 cm (90%), batas ireguler-tidak tegas (86,7%) dan mikrokalsifikasi (60%). Korelasi fitur ultrasonografi tiroid dengan ekspresi mRNA ER, p>0,05. Kesimpulan: Sebagian besar penderita kanker tiroid adalah perempuan usia mendekati menopause. Penderita laki-laki rata-rata usia lebih tua dengan ekspresi mRNA lebih tinggi. Didapatkan fitur khas USG keganasan tiroid. Tidak didapatkan korelasi USG dengan ekspresi mRNA ER.

Background: Ultrasound (US) is a sensitive, non-radiation, and widely available tool for thyroid examination. Morbidity and mortality of thyroid carcinoma is low but increases with age and stadium. Interestingly, the prevalence is higher in women, possibly due to estrogen role. The correlation of US could reveal tumor morphology and ER as biologic marker which could be used as prognosis and treatment planning. Objective: To describe the US findings and ER mRNA expression of thyroid carcinoma, and their correlation. Materials and Methods: This is analytical cross-sectional correlation study done retrospectively. It was conducted at RSUP Dr. Sardjito Yogyakarta. The subjects were patients who had undergone thyroid US, pathology and ER mRNA test by 2015. We perform descriptive analysis on subjects and Spearman Correlation Coefficient to determine the correlation of US and ER mRNA expression. Results: We obtained 30 subjects, 60% female and 40% male, 16-79 age range. ER mRNA expression was positive in 28 subjects (93,3%), the average on female and male was 24,773 and 28,425, respectively. Histopathologically, 80% of subjects were papillary carcinomas. The most common US features were solid-predominant solid (80%), hypoechoic-very hypoechoic (80%), taller-than-wide (76,7%), > 2cm size (90%), irregular-indistinct border (86,7%) and microcalcification (60%). Correlation of US features and ER mRNA expression, p> 0,05. Conclusion: Thyroid cancer occured mostly in women approaching menopause. Male patients have higher mRNA expression on average. We found typical US features of thyroid malignancy but no correlation between US findings and ER mRNA expression was found.

Kata Kunci : tiroid, estrogen, reseptor, mRNA, ultrasonografi, thyroid, estrogen, receptor, mRNA, ultrasound