Hubungan antara Kadar C-Reactive Protein dan Interleukin-6 terhadap Disease-Free Survival dan Progression-Free Survival Kanker Payudara

Meita Ucche, dr. Johan Kurnianda, Sp.PD-KHOM.; dr. Susanna Hilda Hutajulu, Ph.D, Sp.PD-KHOM

2024 | Tesis-Subspesialis | SUBSPESIALIS ILMU PENYAKIT DALAM

Latar Belakang: Beberapa studi telah menunjukkan peran inflamasi pada proses inisiasi, perkembangan, dan tingkah laku kanker payudara. C-reactive protein (CRP) dan Interleukin-6 (IL-6) merupakan mediator dan indikator respon inflamasi pada kanker payudara namun peran sitokin tersebut sebagai faktor prognostik kanker payudara masih belum konsisten.

Metode: Sebanyak 122 pasien yang baru terdiagnosis kanker payudara sejak Juli 2018 hingga Juni 2020 diikutkan dalam penelitian ini. Sebanyak 69 sampel dapat masuk dalam kelompok analisis DFS sedangkan 43 sampel masuk dalam kelompok analisis PFS. Kadar hsCRP dan IL-6 sebelum terapi diperiksa dengan menggunakan metode ELISA. Nilai ambang keduanya ditentukan dengan analisis receiver operating characteristic (ROC). Hubungan antara hsCRP dan IL-6 dengan disease-free survival (DFS) dan progression-free survival (PFS) dinilai dengan metode Kaplan-Meier.

Hasil: Pada penelitian ini subjek dengan kadar CRP ³0.965 mg/L memiliki prognosis DFS yang lebih buruk (p= 0.022) namun tidak menunjukkan hubungan yang signifikan terhadap PFS. Sementara itu, kadar IL-6 tidak memiliki nilai prognostik baik terhadap DFS maupun PFS.

Simpulan: Tingginya kadar CRP berhubungan DFS yang lebih buruk pada kanker payudara sedangkan kadar IL-6 tidak menunjukkan hubungan yang signifikan baik terhadap DFS maupun PFS.

Background: Some studies have shown the role of inflammation in initiation, development, and behaviour of breast cancer. C-reactive protein (CRP) and Interleukin-6 (IL-6) are the mediator and the indicator of inflammatory response in breast cancer. However, the role of those cytokines as the prognostic factor in breast cancer is still inconsistent. 

Methods: A total of 122 newly diagnosed breast cancer patients from July 2018 to June 2020 were enrolled in this study. Sixty nine samples were analyzed for  DFS while 43 samples were included in PFS analysis. The levels of hsCRP and IL-6 before chemotherapy was examined using ELISA method. The threshold of the cytokines were determined with receiver operating characteristic (ROC) analysis. The correlation of hsCRP and IL-6 to disease-free survival (DFS) and progression-free survival (PFS) was analyzed with Kaplan-Meier method.

Results: In this study, subjects with CRP level ³0.965 mg/L had worse DFS (p= 0.022). However, the results did not show significant correlation with PFS. On the other hand, the IL-6 level did not have prognostic value either for DFS or PFS.

Conclusion: Higher level of CRP was associated with worse DFS in breast cancer while the IL-6 level did not show the significant result for both DFS and PFS.

Kata Kunci : kanker payudara, hsCRP, IL-6, inflamasi, kesintasan, breast cancer, inflammation, survival