PERBANDINGAN KADAR ESTRADIOL DAN STATUS RESEPTOR ESTROGEN BERDASARKAN STATUS MENOPAUSE PENDERITA KANKER PAYUDARA DI YOGYAKARTA

ANNISA DIAN O, dr. Lina Choridah, Sp. Rad

2013 | Skripsi | PENDIDIKAN DOKTER

Latar belakang: Interaksi estradiol dengan reseptor estrogen (ER) berperan dalam karsinogenesis kanker payudara dengan meningkatkan proliferasi dan menurunkan kemampuan apoptosis. Status ER pada pasien kanker payudara tidak hanya menunjukkan ketergantungan tumor terhadap estrogen tetapi juga menjadi faktor prognostik dan prediktif di mana tumor dengan ER positif dapat merespon terapi anti-estrogen. Membandingkan kadar estradiol dan status ER berdasarkan status menopause diharapkan dapat menambah informasi tentang karakteristik biologis kanker payudara. Tujuan: Penelitian ini bertujuan untuk membandingkan kadar estradiol berdasarkan ekspresi ER pada pasien kanker payudara premenopause maupun postmenopause. Metode: Kadar estradiol total dalam serum pasien kanker payudara diperiksa dengan metode ECLIA dan data status ER diperoleh dari hasil pemeriksaan imunohistokimia bagian Patologi Anatomi di RS Sardjito Yogyakarta. Kadar estradiol dibandingkan berdasarkan status ER dan status menopause penderita. Hasil: Didapatkan 50 penderita kanker payudara yang dikelompokkan berdasar status menopause. Kadar estradiol total serum pada premenopause antara 9,68-233,30 pg/dL sedangkan postmenopause 5,00-176,80 pg/dL (p<0,001). Pada kelompok premenopause terdapat 51,85% kanker payudara ER positif dan 48,15% ER negatif. Pada kelompok postmenopause terdapat 60,87% ER positif dan 39,13% ER negatif. Rerata kadar estradiol kelompok premenopause dengan ER positif 96,30±72,72 pg/dL sedangkan ER negatif 48,49±30,01 pg/dL(p=0,058). Rerata kadar estradiol kelompok postmenopause dengan ER positif 12,24±6,27 pg/dL sedangkan ER negatif 37,38±57,08 pg/dL(p=0,430). Kesimpulan: Pada kelompok premenopause, kadar estradiol yang lebih tinggi ditemukan pada pasien dengan ER positif sedangkan pada kelompok postmenopause kadar estradiol lebih tinggi pada pasien dengan ER negatif namun tidak terdapat perbedaan bermakna baik pada pasien premenopause (p=0,058) maupun postmenopause (p=0,430)

Background: Estradiol-estrogen receptor (ER) signaling plays an important role in breast cancer carcinogenesis by increasing cell proliferation and decreasing apoptosis. Therefore, ER status in breast cancer patients is not only indicate tumor dependency on estrogen but also provide prognostic and predictive value in which ER positive tumor will have benefit from anti-estrogen therapy. Comparing estradiol levels and ER status based on menopausal status could give information on biological characteristics of breast cancer. Objective: The aim of this study is to compare between estradiol levels and ER expression based on menopausal status of breast cancer patient. Methods: In this cross-sectional study, total estradiol levels in breast cancer patient were measured using ECLIA while ER status data were collected from IHC result performed in Department of Anatomical Pathology of Sardjito Hospital. Estradiol levels were further compared to ER status based on menopausal status. Results: Fifty breast cancer patients participated in this study and were grouped based on their menopausal status. In premenopausal subjects, estradiol levels varied between 9,68 to 233,30 pg/dL, while in postmenopausal subjects between 5,00 to 176,80 pg/dL(p<0,0010. In premenopausal group, ER was positive in 51,85% patients and negative in 48,15% patients. In postmenopausal group, ER was positive in 60,87% patients and negative in 39,17% patients. Among premenopausal women, mean of estradiol levels in ER positive subjects was 96,30±72,72 pg/dL while in ER negative was 48,49±30,01 pg/dL (p=0,058). Mean of estradiol in postmenopausal subjects with ER positive was 12,24±6,27 pg/dL while ER negative was 37,38±57,08 pg/dL (p=0,430). Conclusion: In premenopausal women, higher estradiol level is found in ER positive breast cancer patients while in postmenopausal women estradiol level is higher in ER negative. There was neither significant difference of estradiol levels in ER positive nor negative in premenopausal (p=0,058) nor postmenopausal patients (p=0,430).

Kata Kunci : kanker payudara, estradiol, reseptor estrogen, menopause