Subtipe Molekuler Kanker Payudara di RSUD Madiun dan Hubungannya dengan Grading Histopatologi
Molecular Subtypes on Breast Cancer in Madiun Regional General Hospital and its Relevance to Histopathological Grading
Abstract
Breast cancer is a complex disease with variable molecular characteristics and shows different tumor behavior, therapeutic response, and prognosis. The regional general hospital Madiun has begun to improve services for breast cancer patients since 2015 with the availability of immunohistochemical examinations. This effort was made because breast cancer therapy is currently guided by these examinations. This study aimed to determine the distribution of various molecular subtypes of breast cancer in Madiun Hospital and also the relationship between molecular subtypes and histopathological grading. This study was a retrospective study with a cross-sectional design taken from the Anatomical Pathology Laboratory of Madiun Hospital data from 2015 to 2018. A total of 281 breast cancer cases were examined for immunohistochemical of estrogen receptor (ER), progesterone receptor (PR), and human epidermal receptor 2 (HER2), and a total of 91 breast cancer patients plus Ki-67 examination were then classified into luminal A, luminal B, HER2 and triple-negative (TN). The statistical test used was the Chi-Square test with a 95% confidence level. The most common molecular subtypes of breast cancer in Madiun Hospital were luminal B (28,5%) followed by TN (27,5%), luminal A (22%), and HER2 (22%). The mean age of breast cancer patients was 52.8 ± 10.57. The most common histological types and grades of breast cancer were invasive ductal carcinoma (85.1%) and tumor grade 1 (58.71%). There was a correlation between the immunohistochemical features of ER, PR, HER2, and Ki67 with
histopathological grading. Positive ER and PR were more well differentiated but e HER2 positive and
Ki67 were more poorly differented.
Abstrak
Kanker payudara merupakan penyakit kompleks dengan gambaran molekuler bervariasi dan menunjukkan perilaku tumor, respon terapi, dan prognosis yang berbeda. Rumah Sakit Umum Daerah (RSUD) Madiun mulai meningkatkan layanan untuk pasien kanker payudara sejak tahun 2015 dengan tersedianya pemeriksaan imunohistokimia. Upaya ini dilakukan karena terapi kanker payudara saat ini berpedoman atas pemeriksaan tersebut. Penelitian ini bertujuan untuk mengetahui distribusi berbagai subtipe molekuler kanker payudara di RSUD Madiun dan juga hubungan antar subtipe molekuler dengan grading histopatologi. Penelitian ini adalah studi retrospektif dengan desain cross sectional yang diambil dari data Laboratorium Patologi Anatomi RS Madiun selama tahun 2015 sampai 2018. Total 281 kasus kanker payudara dilakukan pemeriksaan imunohistokimia estrogen receptor (ER), progesteron receptor (PR) dan human epidermal epidermal receptor 2 (HER2) dan total 91 pasien kanker payudara ditambah pemeriksaan Ki-67 kemudian diklasifikasikan menjadi luminal A, luminal B, HER2, dan triple negative (TN). Uji statistik yang digunakan adalah uji Chi Square dengan taraf kepercayaan 95%. Subtipe molekuler kanker payudara di RS Madiun yang paling banyak adalah luminal B (28,5%) diikuti TN (27,5%), luminal A (22%), dan HER2 (22%). Rata-rata umur pasien kanker payudara adalah 52,8 ±10,57. Tipe histologi dan grade kanker payudara terbanyak adalah karsinoma duktal invasif (85,1%) dan grade tumor 1 (58,71%). Terdapat hubungan gambaran imunohistokimia baik ER, PR, HER2 dan Ki67 dengan grading histopatologi. ER dan PR positif lebih banyak mengalami diferensiasi baik namun HER2 positif dan KI67 positif lebih banyak mengalami diferensiasi buruk.
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