HUBUNGAN ANTARA TUMOR ASSOCIATED MACROPHAGES (TAMs) DENGAN STATUS LIMFONODI PADA KARSINOMA PAYUDARA

ERYNA AYU NUGRA DESITA, dr. Irianiwati, Sp.PA(K).

2014 | Skripsi | PENDIDIKAN DOKTER

Latar belakang: Metastasis karsinoma payudara terutama melalui jalur limfogen, diawali dengan invasi tumor ke pembuluh limfe, kemudian ke limfonodi, dan selanjutnya ke organ jauh. Metastasis limfonodi merupakan faktor prognostik kuat pada kanker payudara. Tumor associated macrophages (TAMs) merupakan infiltrat sel radang utama pada karsinoma. Pada karsinoma payudara, peran protumor TAMs lebih dominan daripada antitumor. Peran TAMs pada metastasis limfonodi karsinoma payudara masih belum jelas. Tujuan: Mengetahui hubungan antara jumlah TAMs dengan status limfonodi pada karsinoma payudara. Metode: Diteliti 46 blok parafin karsinoma duktal invasif payudara dari RSUP dr. Sardjito Yogyakarta. Sampel dicat secara imunohistokimiawi menggunakan antibodi monoklonal anti CD68. Ekspresi CD68 dinilai dari jumlah TAMs yang sitoplasmanya mengekspresikan CD68 pada 5 area hot spot. TAMs dikelompokkan menjadi tinggi dan rendah, berdasarkan nilai median sebagai cut-off. Status limfonodi dikelompokkan menjadi positif dan negatif. Hubungan antara jumlah TAMs dengan status limfonodi dianalisis dengan Chi-Square test. Hasil: Nilai cut-off TAMs adalah 48,5. Frekuensi TAMs tinggi: 50%, rendah: 50%. Frekuensi sampel dengan status limfonodi positif: 65,22% dan negatif: 34,78%. Tidak terdapat hubungan yang signifikan antara jumlah TAMs dengan status limfonodi (p=0,063). Meskipun demikian, jumlah TAMs tinggi banyak didapatkan pada karsinoma dengan metastasis limfonodi. Kesimpulan: Pada penelitian ini, jumlah TAMs tidak berhubungan dengan status limfonodi karsinoma payudara.

Background: Metastasis of breast carcinoma, which occurs primarily through the lymphatic pathway, begins with tumor invasion into lymphatic vessels, then toward lymph nodes, and subsequently to distant organs. Lymph node metastasis is a strong prognostic factor in breast cancer. Tumor associated macrophages (TAMs) are the main inflammatory cells in carcinoma. In breast carcinoma, the protumoral characters of TAMs is more dominant than the antitumoral ones. The role of TAMs in lymph node metastasis in breast carcinoma remains unclear. Objective: To study the relationship between amount of TAMs and lymph node status in breast carcinoma. Method: 46 paraffin blocks of invasive ductal carcinoma of the breast from Sardjito Hospital Yogyakarta were observed. Sampels were stained immunohistochemically by CD68 monoclonal antibody. CD68 expression was assessed from amount of TAMs whose cytoplasm expressed CD68 within 5 hot spot areas. TAMs was grouped into high and low, based on median value as cut-off. Lymph node status was grouped into positive and negative. The relationship between TAMs and lymph node status was analyzed by Chi-Square test. Result: TAMs cut-off point was 48,5. Frequency of high TAMs: 50%, low TAMs: 50%. Frequency of samples with positive lymph node: 65% and negative lymph node: 35%. There was no significant relationship between amount of TAMs and lymph node status (p=0,063). Nevertheless, many samples with high amount of TAMs were found in carcinoma with lymph node metastasis. Conclusion: In this study, the amount of TAMs had no relationship with lymph node status in breast carcinoma.

Kata Kunci : TAMs, status limfonodi, karsinoma payudara.