HUBUNGAN UKURAN TUMOR PRIMER DENGAN EKSPRESI INTERLEUKIN-6 JARINGAN KANKER ADENOKARSINOMA KOLOREKTAL

YANIKA HELENA SITANGGANG, dr. Neneng Ratnasari, Sp.PD, KGEH; Prof dr. Siti Nurdjanah, M.Kes, Sp.PD, KGEH

2015 | Tesis | SP Ilmu Penyakit Dalam

Latar belakang Interleukin-6 (IL-6) adalah pleiotropic cytokine yang diketahui memiliki banyak peran dalam fungsi fisiologis dan patofisiologis. Beberapa p enelitian menyatakan kanker kolorektal memproduksi IL-6 sehingga peningkatan Il-6 di mukosa kolon merupakan suatu tanda pertumbuhan sel yang berlebihan. Kadar sitokin ini lebih tinggi pada pasien kanker kolorektal yang dengan metastasis ke hepar dan kadarnya juga berhubungan positif dengan ukuran tumor, sehingga bisa menggambarkan progresivitas kanker. Tujuan penelitian ini untuk menguji hipotesis bahwa terdapat hubungan positif ukuran tumor primer dengan ekspresi IL-6 jaringan pada pasien adenokarsinoma kolorektal. Metode penelitian adalah cross sectional. Pengambilan sampel dilakukan secara random sampling. Subyek penelitian ini adalah preparat biopsi reseksi jaringan kolorektal dari semua pasien dengan kanker kolorektal tipe adenokarsinoma yang dilakukan reseksi jaringan kolorektal dengan sampel jaringan dikirim ke bagian Patologi Anatomi RSUP Dr. Sardjito antara bulan Maret 2010 hingga Mei 201 4 yang memenuhi kriteria inklusi dan eksklusi. Analisa statistik untuk mencari korelasi ukuran tumor primer dengan ekspresi IL6 pada jaringan kolorektal dengan kanker pasien penderita adenokarsinoma kolorektal dinilai dengan uji korelasi Pearson atau uji korelasi Spearman, apabila syarat uji korelasi Pearson tidak terpenuhi. Batas kemaknaan yang diterima bila p< 0,05. Hasil penelitian dari 57 subyek penelitian didapatkan rerata usia adalah 56,51 ± 12,58 tahun, subyek laki-laki 27 (47,4 %) orang dan perempuan 30 (52,6 %) orang, dan yang disertai metastase sebanyak 9 pasien (15,8%), median ukuran tumor 5,075 (2-11) cm, dan median ekspresi IL-6 0,75 (0,26-0,99). Didapatkan hubungan positif lemah antara ukuran tumor primer dengan ekspresi IL-6 jaringan adenokarsinoma kolorektal dan bermakna secara statistik, dan ukuran tumor mempengaruhi ekspresi IL-6 sebesar 15,8% (r = 0,380; R 2 linear = 0,158; p = 0,004) Kesimpulan Peningkatan ukuran tumor primer berkorelasi dengan peningkatan ekspresi Interleukin-6 jaringan adenokarsinoma kolorektal.

Background Interleukin-6 (IL-6) is a pleiotropic cytokine that is known to have a role in many physiological and pathophysiological functions. Some studies suggest that IL-6 is produced by tumor cells that function as a growth factor, it is also reported that colorectal cancers produce IL-6, resulting in increased IL-6 in the colonic mucosa is a sign of excessive cell growth. This cytokine level is higher in adenocarcinoma colorectal patients with liver metastatic dan the level also has positive correlation with the tumor size, so it can figure out the cancer progressivity. Objectives This study is being held to test the hypothesis that there is a positive correlation between primary tumor size with tissue IL-6 expression in adenocarcinoma colorectal. Methods We performed a cross sectional study. Sampling was done by random sampling. The subject of this study is the resection preparation of colorectal tissue biopsies from all patients with adenocarcinoma colorectal with tissue samples are sent to the department of Pathology Anatomy Dr. Sardjito between March 2010 to Mei 2014 who met the inclusion and exclusion criteria. Statistical analysis to look for correlations between primary tumor size with tissue expression IL-6 in adenocarcinoma colorectal was assessed by Pearson correlation test or Spearman correlation test, if Pearson correlation test’s terms are not met. Limitation of significance accepted when p<0.05. Results study of 57 subjects found the mean age was 56,51 ± 12,58 years, with 27 male subjects (47,4%) and 30 female subjects (52,6%), and 9 subjects found to have metastase (15,8%). The median tumor size was 5,075 (2-11) cm and the median IL-6 expression was IL-6 0,90 (0,26-0,99). We found a weak positive correlation b etween primary tumor size with tissue IL-6 expression of colorectal adenocarcinoma and it was significant statistically, and tumor size will effect the tissue IL -6 expression as 15,8% (r = 0,380; R 2 linier = 0,158; p = 0,004). Conclusion. Increase in tumor size has been correlate with increase of tissue Interleukin-6 expression of adenocarcinoma colorectal.

Kata Kunci : adenokarsinoma kolorektal, ekspresi IL-6 jaringan, ukuran tumor primer, adenocarcinoma colorectal, tissue expression of IL-6, primary tumor size