Gambaran Klinikopatologis dan Ekspresi p16INK4a pada Kutil Anogenital Pria di Yogyakarta

Cindy Rizqita Putri, dr. Hanggoro Tri Rinonce, Ph.D., Sp.P.A., Subsp. URL (K), Subsp. KA (K); dr. Indrawarman, Sp.U(K); dr. Mardiah Suci Hardianti, Ph.D, Sp.PD-KHOM

2025 | Skripsi | PENDIDIKAN DOKTER

Latar Belakang: Kutil anogenital merupakan salah satu manifestasi infeksi human papillomavirus (HPV) yang umum pada pria dan masuk dalam tiga besar penyakit menular seksual di Indonesia. HPV risiko rendah (HPV 6, 11) umumnya jinak, sedangkan HPV risiko tinggi (HPV 16, 18) dapat menimbulkan lesi prakanker hingga kanker. Ekspresi p16INK4a diketahui sebagai biomarker yang mencerminkan potensi onkogenik HPV, namun penelitian terkait di Indonesia masih terbatas.

Tujuan: Penelitian ini bertujuan untuk mengetahui gambaran karakteristik klinikopatologis, menilai frekuensi ekspresi p16INK4a, serta menganalisis hubungan keduanya pada pasien kutil anogenital pria di Yogyakarta

Metode: Penelitian ini merupakan studi observasional-analitis retrospektif dengan desain potong lintang pada pasien kutil anogenital pria di RSUP Dr. Sardjito Yogyakarta tahun 2017–2024. Data klinikopatologis diperoleh dari instalasi catatan medis, sedangkan penilaian ekspresi p16INK4a dilakukan melalui pewarnaan imunohistokimia pada jaringan formalin fixed paraffin-embedded (FFPE). Analisis data dilakukan menggunakan uji Chi-Square, Fisher’s Exact Test, dan Monte Carlo.

Hasil: Hasil penelitian ini menunjukkan bahwa sebagian besar pasien KA berusia 25-34 tahun (40,4%), dengan lesi terbanyak pada area anal (80,9%). Mayoritas pasien terinfeksi HIV (78,7%), memiliki multiple sexual partners (61,7%), berorientasi heterosexual (31,9%), melakukan aktivitas seksual secara genital-oral-anal (23,4%), serta menggunakan kondom secara inkosisten (42,6%). Mayoritas memulai hubungan seksual di usia dewasa muda (34%) dan sirkumsisi pada usia anak (46,8%). Ekspresi p16INK4a didominasi hasil negatif (72,3%). Analisis menunjukkan hubungan signifikan antara ekspresi p16INK4a dengan jenis aktivitas seksual (genital-oral) (p<0>

Kesimpulan: Terdapat 13 pasien (27,7%) dengan ekspresi p16INK4a positif. Ekspresi p16INK4a positif mengindikasikan adanya potensi lesi berkembang menjadi keganasan.

Background: Anogenital warts are a common manifestation of human papillomavirus (HPV) infection in men and rank among the top three sexually transmitted infections in Indonesia. Low-risk HPV types (HPV 6, 11) are generally benign, whereas high-risk HPV types (HPV 16, 18) can cause precancerous lesions and progress to cancer. The expression of p16INK4a is recognized as a biomarker reflecting the oncogenic potential of HPV; however, related studies in Indonesia remain limited.

Objective: This study aimed to describe the clinicopathological characteristics, assess the frequency of p16INK4a expression, and analyze their association in male patients with anogenital warts in Yogyakarta.

Methods: This was a retrospective observational-analytical cross-sectional study on male patients with anogenital warts treated at Dr. Sardjito General Hospital, Yogyakarta, from 2017 to 2024. Clinicopathological data were obtained from medical records, while p16INK4a expression was evaluated through immunohistochemical staining on formalin-fixed paraffin-embedded (FFPE) tissues. Data analysis was performed using Chi-Square, Fisher’s Exact Test, and Monte Carlo methods.

Results: Most patients were 25–34 years old (40.4%), with the anal region being the most frequent lesion site (80.9%). The majority were HIV-positive (78.7%), had multiple sexual partners (61.7%), identified as heterosexual (31.9%), engaged in genital-oral-anal  sexual activity (23.4%), and reported inconsistent condom use (42.6%). Most initiated sexual activity in early adulthood (34%) and underwent circumcision during childhood (46.8%). Negative p16INK4a expression predominated (72.3%). A significant association was found between p16INK4a expression and type of sexual activity (genital-oral) (p < 0>

Conclusion: Thirteen patients (27.7%) demonstrated positive p16INK4a expression, indicating the potential for lesions to progress toward malignancy.

Kata Kunci : p16INK4a, Genotipe HPV, Blok Parafin, Infeksi Virus, Condyloma Acuminata