Human papillomavirus pada pterigium progresif dan pterigium stasioner

SIDHARTA, Bragastio, Prof. dr. Suhardjo, SU., Sp.M(K)

2010 | Tesis | S2 MSPPDS-Ilmu Penyakit Mata

Pterigium secara klinis dibedakan menjadi pterigium progresif dan stasioner. Pterigium progresif ditandai korpus yang sangat tebal dan banyak vaskularisasi, pterigium stasioner mempunyai korpus tipis dan pucat dengan sedikit vaskularisasi. Banyak teori dikemukakan dalam patogenesis pterigium. Dengan adanya penemuan p53, patogenesis pterigium yang dulu dipercaya sebagai lesi degeneratif, sekarang berubah ke arah karakteristik tumor, karena sifat-sifat histologisnya, yaitu adanya displasia ringan, invasi lokal dan angka kekambuhan yang tinggi. Human Papilloma Virus (HPV) merupakan virus DNA yang dapat bersifat memicu terjadinya perubahan genetik. Mekanisme utama dari protein E6 HPV adalah melakukan interaksi dengan protein p53 dari sel target sehingga memicu terjadinya proses perkembangan kanker. Penelitian ini bertujuan untuk membandingkan proporsi HPV pada pterigium progresif dan pterigium stasioner. Hipotesis yang diajukan adalah: proporsi HPV positif pada pterigium progresif lebih besar daripada proporsi HPV positif pada pterigium stasioner. Pemeriksaan dilakukan terhadap 62 jaringan pterigium yaitu 31 jaringan pterigium progresif dan 31 jaringan pterigium stasioner. Semua jaringan pterigium diperiksa menggunakan teknik PCR (Polymerase Chain Reaction) dengan primer DNA single strand HPV Hela. Pada penelitian ini didapatkan hasil positif adanya HPV pada kelompok pterigium progresif sebesar 67,7%. Pada kelompok pterigium stasioner didapatkan hasil positif HPV sebesar 22,6% dengan nilai p<0,05 (p=0,001). Hasil penelitian ini menunjukkan proporsi HPV positif pada pterigium progresif lebih besar dibanding proporsi HPV positif pada pterigium stasioner dan secara statistik bermakna.

Clinically, pterygium is classified into progressive and stationary pterygium. A progressive pterygium is characterized by a very thick body and abundant vascularization, meanwhile a stationary pterigium has a thin and pale body with scanty vascularization. There have been many theories proposed in the pathogenesis of pterygium. With the discovery of p53, the pathogenesis of pterygium which was previously believed to be a degenerative lesion has changed nowadays into tumor characteristics, due to its histological properties, in which there are mild dysplasia, local invasion and a high recurrence rate. Human Papilloma Virus (HPV) is a viral DNA that has the ability to trigger genetic mutations. The main mechanism of E6 HPV protein is to engage in some reactions with p53 protein from the target cell leading to the trigger of a cancer development process. The aim of this study is to compare the HPV proportion between progressive and stationary pterygium. The proposed hypothesis: the proportion of HPV-positive in progressive pterygium is greater than that of stationary pterygium. Examination was performed to 62 pterygium tissues, 31 of which were progressive pterygia and the other 31 were of stationary pterygia. All pterygia tissues were examined using a PCR technique (Polymerase Chain Reaction) with a primer DNA of a single strand Hela HPV. The result obtained from this study showed that HPV was present in 66.7% of cases of progressive pterygium and only 22.6% of cases of stationary pterygium with p<0,05 (p=0,001). The study showed that the proportion of HPV-positive in progressive pterygium was greater that that of stationary pterygium and was statistically significant.

Kata Kunci : Pterigium progresif,Pterigium stasioner,Human papillomavirus, Progressive pterygium, stationary pterygium, Human papillomavirus, Polymerase Chain Reaction.