PERBEDAAN KADAR INTERLEUKIN-6 PADA BERBAGAI STADIUM KLINIS KANKER PAYUDARA

ANI USWATUN CHASANAH, Dr. Andaru Dahesihdewi, M.Kes, SpPK(K)

2013 | Tesis | S2 Ilmu Patologi Klinik

Kanker payudara merupakan salah satu penyakit yang banyak menimbulkan morbiditas dan mortalitas. Prevalensi kanker payudara semakin meningkat di seluruh dunia termasuk di Indonesia seiring dengan peningkatan angka harapan hidup, sosial ekonomi, serta perubahan pola penyakit. Lebih dari separuh penderita kanker payudara terdiagnosis pada stadium lanjut saat tumor telah mengalami metastasis sehingga penanganannya cenderung terlambat dan hanya bersifat paliatif. Selama ini IL-6 lebih dikenal sebagai sitokin inflamasi yang memediasi hematopoesis dan aktivasi limfosit, tetapi beberapa penelitian terbaru melaporkan IL-6 memiliki peran sebagai mediator progresivitas tumor. Ekspresi IL-6 dihipotesiskan berkorelasi dengan derajat tumor dan survival yang buruk. Penelitian ini merupakan penelitian observasional analitik dengan desain potong lintang. Subyek penelitian adalah pasien suspek kanker payudara RSUP Dr. Sardjito Yogyakarta yang dipilih secara berurutan dan memenuhi kriteria inklusi maupun eksklusi. Pemeriksaan IL-6 menggunakan metode quantitative sandwich electrochemilumescence. Semua subyek diperiksa kadar IL-6 kemudian dianalisis secara deskriptif dan dilakukan uji Kruskal Wallis dan Mann Whitney untuk mengetahui perbedaan kadar IL-6 pada berbagai stadium klinis kanker payudara. Subyek yang berpartisipasi pada penelitian ini sejumlah 56 orang dengan rerata umur 47±10 tahun. Stadium klinis yang paling banyak ditemukan adalah stadium IIIB sebanyak 18 subyek (32,1%) dan yang mengalami metastasis sebanyak 37 orang (66%). Median kadar IL-6 pada stadium I 1,64 pg/ml , stadium IIA 1,87 pg/ml, stadium IIB 2,47 pg/ml, stadium IIIA 4,09 pg/ml, stadium IIIB 6,09 pg/ml, stadium IIIC 6,2 pg/ml dan stadium IV 34,5 pg/ml. Median kadar IL-6 pada kelompok metastasis signifikan lebih tinggi dibanding non metastasis (6,2 vs 1,99 pg/ml), p=0,001. Median kadar IL-6 pada stadium lanjut signifikan lebih tinggi dibanding stadium lanjut lokal maupun stadium awal (34,52 vs 4,82 vs 1,93 pg/ml). Terdapat perbedaan bermakna median kadar IL-6 pada berbagai stadium klinis kanker payudara. Pada stadium klinis yang lebih tinggi, didapatkan median kadar IL-6 yang lebih tinggi.

Breast cancer is one of diseases that cause morbidity and mortality. The prevalence of breast cancer is increasing worldwide including in Indonesia along with increased life expectancy, socioeconomic, and changes in disease patterns. More than half of patients with breast cancer is diagnosed in an advanced stage when the tumor has had metastasis to the handling tends to be late and only palliative. So far, interleukin-6, better known as cytokines that mediate inflammation and activation of lymphocytes hematopoesis, but recent studies reported IL-6 has a role as a mediator of tumor progression and correlated with the degree of tumor, and poor survival. This study was an observational analytic study with a cross-sectional design. The subjects in this study were patients with suspected breast cancer that visited Dr. Sardjito hospital in Yogyakarta who fullfilled the inclusion and exclusion criteria and collected consecutively. The level of IL-6 serum was determining using a quantitative sandwich electrochemiluminescence immunoassay method. Kruskal Wallis test and Mann Whitney test were used analyze the differences of IL-6 level between various clinical stage of the breast cancer. Fifty six breast cancer female patients, with an age mean of 47±10 years were eligible for this study. Most of breast cancer patients was stage IIIB 18 subjects (32,1%) and metastatic 37 people (66%). The results showed serum concentrations of IL-6 statistically higher in comparison with metastasis and non metastasis (622 vs. 1,99 pg / ml), p=0,001 which also correlated with clinical stage of breast cancer. The median level of IL-6 statistically higher in advanced stage compared with locally advanced and early stage (34,52 vs 4,82 vs 1,93 pg/ml). The median level of IL-6 increased proportionally with the stage of the cancer (the median level of IL-6 in stage I 1,64 pg/ml, stage IIA 1,87 pg/ml, stage IIB 2,47 pg/ml, stage IIIA 4,09 pg/ml, stage IIIB 6,09 pg/ml, stage IIIC 6,2 pg/ml dan stage IV 34,5 pg/ml). We observed that higher level concentration of serum IL-6 in advanced stage of breast cancer.

Kata Kunci : Kanker payudara, interleukin-6, stadium klinis