HUBUNGAN ANTARA TUMOR ASSOCIATED MACROPHAGES ( TAMs ) DENGAN KEPADATAN LIMFOVASKULAR PADA KARSINOMA PAYUDARA

FERDINANDUS BAYU SATRIA, dr. Irianiwati,Sp.PA(K),

2014 | Skripsi | PENDIDIKAN DOKTER

Latar Belakang : Kepadatan limfovaskular merupakan indikator signifikan dalam limfangiogenesis dan berperan penting pada metastasis karsinoma. TAMs adalah makrofag teraktivasi berperan pada angiogenesis, invasi serta migrasi tumor. Pada karsinoma payudara peran protumor lebih dominan daripada antitumor. Hubungan jumlah TAMs dengan LVD pada karsinoma payudara belum jelas. Tujuan : Mengetahui hubungan antara jumlah TAMs kepadatan limfovaskular pada karsinoma payudara. Metode : Diteliti 44 sampel dari pasien karsinoma duktal invasif payudara (NOS) RSUP dr. Sardjito 2009. Sampel dicat secara imunohistokimiawi menggunakan antibodi monoklonal anti CD-68 dan anti D2-40. TAMs dihitung dari jumlah makrofag yang mengekspresikan CD-68 pada 5 area hot spot. LVD dihitung dari pembuluh limfa yang sel endotelnya mengekspresikan 40 pada 5 area hot spot. TAMs dan LVD dikelompokkan menjadi tinggi dan rendah, berdasarkan nilai sebagai cut- off. Hubungan antara jumlah TAMs dianalisis dengan korelasi Pearson Chi-Square Test. Hasil : Nilai cut-off TAMs adalah 49. Frekuensi tinggi: 50%, rendah: 50%. Frekuensi sampel dengan tinggi: 54,5%, rendah: 45,5%. Tidak didapatkan positif antara TAMs dengan kepadatan limfovaskular (LVD) pada karsinoma payudara.(p=0,545),CI 95% 4,757). Kesimpulan :Pada penelitian ini TAMs tidak mempunyai pengaruh signifikan terhadap kepadatan limfovaskular pada karsinoma payudara.

Background : Lymphovascular Density (LVD) is a significant indicator of lymphangiogenesis process and it has important role in cancer metastatic. TAMs are activated macrophages which induce angiogenesis,tumor invasion and migration. In breast carcinoma, the protumoral characters of TAMs is more dominant than the antitumoral ones. The correlation between the number of TAMs and LVD in breast carcinoma is still unclear. Aim: To know the correlation between the number of TAMs with LVD in breast carcinoma. Methods : 44 samples of invasive ductal carcinoma of the breast from Sardjito Hospital 2009 were observed in this study. These samples were stained immunohistochemically by anti CD-68 and anti D2-40 monoclonal antibody. Number of TAMs were determined by counting the number of macrophages which expressed CD68 within 5 hot spot areas. Number of LVD was determined by counting the number of lymphatic vessel which it’s endothelial cells expressed D2-40 within 5 hot spot areas. TAMs and LVD were grouped into high and low based on median value as cut-off. Correlation between the number of TAMs and LVD will be analyzed using Pearson Chi-Square Test correlation. Results: cut-off point of TAMs was 49. Frequency of high TAMs: 50%, low: 50%. Frequency of samples with high LVD: 54,5%, low: 45,5%. There was no significant correlation between TAMs and LVD in breast carcinoma.(p=0,545),CI 95% (0,439 – 4,757). Conclusions : In this study TAMs have not play a significant role in lymphovascular density in breast carcinoma.

Kata Kunci : Karsinoma Payudara, Tumor Associated Macrophages (TAMs), Lymphovascular Density (LVD), CD68, D2-40.