Ekspresi Protein Cyclooxygenase-2 (COX-2)Pada Karsinoma Sel Skuamosa Sinonasal Dan Laring

Muhammad Dzulfikar Lingga Qamal Mozhaf , dr. Agus Surono, Ph.D., M.Sc., Sp.THT-KL, dr. Irianiwati, Sp.PA(K)

2012 | Skripsi | S1 PENDIDIKAN DOKTER

Latar Belakang: COX-2 berperan dalam mempengaruhi tingkah laku biologis tumor-tumor pada manusia, meliputi karsinogenesis, progresi tumor, apoptosis, dan diferensiasi. Penelitian mengenai hubungan COX-2 dengan parameter klinikopatologis pada karsinoma sel skuamosa kepala dan leher masih jarang di Indonesia, dan hasilnya pun berbeda satu dengan yang lain. Tujuan: Mengetahui perbedaan frekuensi ekspresi protein COX-2 antara karsinoma sel skuamosa sinonasal dan karsinoma sel skuamosa laring, serta mengetahui perbedaan antara ekspresi COX-2 dengan derajat diferensiasi dan usia. Metode: Diteliti 39 sampel karsinoma sel skuamosa kepala dan leher (KSSKL), terdiri dari 22 sampel karsinoma sel skuamosa laring dan 17 sampel karsinoma sel skuamosa sinonasal dari bagian THT-KL RSUP Dr. Sardjito tahun 2008-2011. Sampel dicat dengan metode immunohistokimia menggunakan antibodi monoklonal anti COX-2. Ekspresi COX-2 positif tampak berwarna coklat pada membran nukleus atau sitoplasma sel tumor. Perbedaan ekspresi COX-2 berdasarkan usia, derajat diferensiasi, dan lokasi tumor dianalisis dengan uj statistik Fisher Exact Test. Hasil: Sebelas sampel Karsinoma Sel Skuamosa Kepala dan Leher (28,2%)menunjukkan ekspresi COX-2 positif pada karsinoma sel skuamosa kepala dan leher (KSSKL. Ekspresi COX-2 lebih banyak ditemukan di karsinoma sel skuamosa sinonasal (35%) dibandingkan karsinoma sel skuamosa laring (23%) (p=0,482), pada derajat diferensiasi buruk dibandingakan derajat diferensiasi baik (p=0,719), dan usia ?65 tahun (p=1,000) namun secara statistik tidak bermakna. Kesimpulan: Frekuensi karsinoma sel skuamosa sinonasal dan laring, yang menunjukkan ekspresi COX-2 positif adalah 28,2%. Ekspresi COX-2 lebih banyak dijumpai pada derajat diferensiasi buruk, usia ?65 tahun, dan pada sinonasal.

Background: COX-2 plays a role in influencing the biological behavior of human tumors, including carcinogenesis, tumor progression, apoptosis, and differentiation. Study on the relationship of COX-2 with the parameters klinikopatologis squamous cell carcinoma of the head and neck are still rare in Indonesia, and the results were different from one another. Objective: To determine the difference frequency of COX-2 protein expression between sinonasal squamous cell carcinomas and laryngeal squamous cell carcinoma, as well as knowing the difference between the expression of COX-2 with degrees of differentiation and age. Method: 39 samples of head and neck squamous cell carcinoma of the head and neck (HNSCC) were examined, consisting of 22 samples of laryngeal squamous cell carcinoma and 17 samples of sinonasal squamous cell carcinoma from the THT-KL department of Dr Sardjito years 2008-2011. Samples were stained by immunohistochemical methods using monoclonal antibodies anti-COX-2. Expression of COX-2 positive look brown on the cytoplasm or nucleic membrane of tumor cells. COX-2 expression differences based on age, degree of differentiation, and tumor location were analyzed by statistical tests Fisher Exact Test. Results: Eleven samples of Squamous Cell Carcinoma of the Head and Neck (28.2%) showed positive COX-2 expression in squamous cell carcinoma of the head and neck. COX-2 expression were more common in sinonasal squamous cell carcinoma (35%) than in squamous cell carcinoma of the larynx (23%) (p = 0.482), the degree of differentiation worse (p = 0.719), and age ? 65 years (p = 1.000 ) but not statistically significant. Conclusions: The frequency of squamous cell carcinoma of sinonasal and larynx, which showed positive expression of COX2 was 28.2%. COX-2 expression more common in poor differentiation degrees, age ? 65 years, and in the sinonasal.

Kata Kunci : Ekspresi COX-2, karsinoma sel skuamosa sinonasal, karsinoma sel skuamosa laring, usia, derajat diferensiasi, Expression of COX-2, sinonasal squamous cell carcinoma, laryngeal squamous cell carcinoma, age, differentiation.