PERBEDAAN EKSPRESI KI-67 DAN PCNA PADA STROMA TUMOR OVARIUM EPITELIAL GANAS DAN JINAK

ADELIA NOVI ZULVINA, dr.Nungki Anggorowati,Sp.PA, Ph.D ; dr.Nur Arfian, Ph.D

2016 | Skripsi | S1 PENDIDIKAN DOKTER

Latar Belakang: Kanker ovarium merupakan kanker keenam yang paling umum terdiagnosis pada wanita di seluruh dunia. Telah banyak studi yang membahas tentang hubungan antar sel stroma dengan sel kanker. Awal pemikiran menyebutkan pembentukan stroma baru merupakan penghalang terhadap invasi tumor. Namun, penelitian mulai membuktikan terdapat peran stroma terhadap keagresifan sel tumor. Ki-67 dan PCNA merupakan protein inti sel penanda proliferasi sel yang banyak digunakan sebagai alat diagnostik dan prognostik. Tujuan: Untuk mengetahui perbedaan ekspresi Ki-67 dan PCNA pada stroma tumor ovarium epitelial ganas dan jinak. Metode: 14 jaringan tumor ovarium epitelial ganas dan 12 jaringan tumor ovarium epitelial jinak dicat secara immunohistokimiawi dengan antibodi anti Ki-67 dan PCNA. Diambil 10 lapang pandang stroma menggunakan mikroskop kemudian dihitung fibroblast positif dibanding fibroblast total pada masing-masing lapang pandang. Perbedaan ekspresi Ki-67 dan PCNA pada stroma tumor ovarium epitelial ganas dan jinak dianalisis dengan uji-t tidak berpasangan atau Mann-Whitney dengan p<0,05. Hasil: Rerata ekspresi Ki-67 secara signifikan ditemukan lebih tinggi pada stroma tumor ovarium epitelial ganas (p=0,038) dengan hasil sebesar 6,64% pada ganas dan 3,75% pada jinak. Namun, pada PCNA hal serupa tidak ditemukan (p=0,107) dengan rerata ekspresinya sebesar 17,29% pada ganas dan 27,83% pada jinak. Kesimpulan: Terdapat perbedaan ekspresi Ki-67 antara stroma tumor ovarium epitelial ganas dengan jinak. Namun, tidak terdapat perbedaan ekspresi PCNA antara stroma tumor ovarium epitelial ganas dengan jinak.

Background: ovarian cancer represents the sixth most commonly diagnosed cancer among women in the world, and causes more deaths per year than any other cancer of the female reproductive system. There have been many studies that discuss the relationship between stromal cells with cancer cells. The intial thought said that stroma formation was considered to be a reaction and response of the host tissue against invasive cancer cells. This idea, however, was challenged in the late 1980s and more researches were done to prove its role in progressing the tumor. Ki-67 and PCNA are nuclear proteins that are associated with cellular proliferation and are used widely as diagnostic and prognostic tools. Aim: to study the expression of Ki-67 and PCNA in the stroma of malignant and benign epithelial tumor of the ovary. Method: fourteen malignant and twelve benign epithelial tumor of the ovarian tissues were studied using immunohistochemistry with monoclonal antibody anti Ki-67 and PCNA to detect the expression of them. The expression was shown in the nucleus. Ten views of stroma were randomly taken by microscope. The proliferating index was estimated as the percentage of fibroblasts with positive nuclei: positive fibroblasts/total fibroblasts. Statistical analysis was performed using independent-t test or Mann Whitney with p<0,05. Result: the mean percentage of the expression of Ki-67 in the stroma of malignant epithelial tumor of the ovary (6,64%)was significantly higher than in the stroma of benign epithelial tumor (3,75%; p=0,038). But no significant differences appeared in the expression of PCNA between malignant (17,29%) and benign epithelial tumor of the ovary (27,83%; p=0,107) Conclusion: there was a significantly difference of the expression of Ki-67 in the stroma of malignat and benign epithelial tumor of the ovary. There was, however, no difference of the expression of PCNA.

Kata Kunci : Stroma, fibroblast, tumor ovarium epitelial ganas, tumor ovarium epitelial jinak, Ki-67, PCNA