HUBUNGAN MORFOLOGI VARIAN SENTROBLASTIK DAN IMUNOBLASTIK DENGAN SUBTIPE ACTIVATED B CELL-LIKE DAN GERMINAL CENTER B CELL-LIKE PADA DIFFUSE LARGE B CELL LYMPHOMA DI RSUP SARDJITO TAHUN 2012-2014

FRANSISKUS RGUKGUK, dr.Nungki Anggorowati, Ph.D,Sp.PA;.dr.Indrawati, Sp.PA (K)

2016 | Skripsi | S1 PENDIDIKAN DOKTER

INTISARI Latar belakang: Limfoma merupakan tumor limfoid yang sering terjadi. WHO mengklasifikasikan tumor limfoid berdasarkan morfologi, imunofenotip, genetik, molekular dan sifat klinisnya. Limfoma dibagi menjadi Non Hodgkin Lymphoma (NHL) dan Hodgkin Lymphoma (HL). Diffuse large B-cell lymphoma merupakan subtipe NHL yang sering terjadi. Berdasarkan morfologi, DLBCL yang sering terjadi adalah sentroblastik, imunoblastik, dan anaplastik. Berdasarkan profil ekpresi Gen, terdapat dua subtipe DLBCL meliputi Germinal center B cell-like (GCB) dan Activated B cell-like (ABC). Tujuan: Mengetahui hubungan morfologi varian sentroblastik dan imunoblastik dengan subtipe ABC dan GCB DLBCL di RSUP Sardjito tahun 2012-2014. Metode: Penelitian ini menggunakan metode potong lintang. Blok parafin yang terdiagnosis DLBCL dibuat sediaan histopatologis selanjutnya diwarnai menggunakan HE untuk mengetahui morfologi DLBCL dan menggunakan pewarnaan IHC CD10, BCL6, dan MUM1 lalu dinilai secara kualitatif oleh peneliti selanjutnya dikelompokkan menjadi subtipe ABC dan GCB berdasarkan algoritme Hans. Penelitian ini dianalisis menggunakan chi-square test dengan interval kepercayaan 95% dan P<0.05 Hasil: Terdapat 57 preparat Histopatologis, 10 (17,54%) varian imunoblastik dan 47 (82,46%) varian sentroblastik. Terdapat 47 varian sentroblastik, 28 varian ini menunjukkan subtipe ABC dan 19 sisanya subtipe GCB pada pewarnaan imunohistokimia menggunakan algoritme Hans (59,57% VS 40,43%). Sepuluh preparat varian imunoblastik, 5 diantaranya menunjukkan subtipe ABC dan 5 sisanya merupakan GCB (50% vs 50%). Selanjutnya dilakukan uji statistik chi-square untuk mengetahui signifikansi hubungan antara morfologi dengan subtipe DLBCL. Berdasarkan uji statistik menggunakan chi-square didapatkan nilai signifikansi p=0,727. Kesimpulan: Tidak terdapat hubungan antara morfologi varian sentroblastik dan imunoblastik dengan subtipe ABC dan GCB DLBCL. Kata kunci: DLBCL, sentroblastik, imunoblastik, Activated B cell-like (ABC), Germinal center B cell-like (GCB).

Background: Lymphoma is the most common lymphoid tumors. WHO classify lymphoid tumors based on morphology, immunophenotype, genetic, molecular and clinical characteristic. Lymphoma can be divided into Non Hodgkin Lymphoma (NHL) and Hodgkin Lymphoma (HL). Diffuse Large B-Cell Lymphoma (DLBCL) is the most frequent Non Hodgkin Lymphoma subtype. Based on morphology, the most common Diffuse Large B-Cell Lymphoma subtypes are centroblastic, immunoblastic, and anaplastic. Based on gene expression profile, are exist two molecular subtypes of DLBCL, namely Germinal center B cell-like (GCB) and Activated B cell-like (ABC). Objective: To know the relationship between sentroblastic/immunoblastic variant and Activated B cell-like/Germinal center B cell-like subtype of diffuse large B-cell lymphoma in Sardjito hospital from the year 2012-2014. Methods: This research used a cross sectional method. Paraffin block specimens diagnosed with diffuse large B-cell lymphoma were made into histopathological slides which is then stained using Hematoxilin-Eosin to discover the morphology of the specimens; and stained with CD10, BCL6 & MUM1 to discover the molecular subtype of the specimens. The relationship between sentroblastic/immunoblastic variants and Activated B cell-like/Germinal center B cell-like subtype of diffuse large B-cell lymphoma based on Hans algorytm in Sardjito hospital from the year 2012-2014 is analized using Chi-square test with and CI of 95% and p<0.05. Result: There were 57 histopathological slides, 10 (17,54%) immunoblastic variant and 47 (82,46%) centroblastic variant. There are 47 centroblastic variant, 28 variants showed ABC subtype and 19 GCB subtype remaining (59,57% vs 40,43%). Ten Immunoblastic variant, 5 of them showed the ABC subtype and 5 GCB. Based on statistical test chi-square p value=0,727. Conclusion: There was no relationship between centroblastic/immunoblastic variant and ABC/GCB subtype DLBCL. Keyword: DLBCL, Centroblastic, immunoblastic, Activated B cell-like (ABC), Germinal center B cell-like (GCB).

Kata Kunci : Keyword: DLBCL, Centroblastic, immunoblastic, Activated B cell-like (ABC), Germinal center B cell-like (GCB).