Ekspresi Topoisomerase IIΑ pada Karsinoma Duktal Invasif Payudara, Hubungannya dengan Derajat Histopatologik dan Klasifikasi Subkelas Molekuler Payudara

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. Nila Kurniasari, Imam Susilo

Abstract

ABSTRAK

Latar belakang

Karsinoma duktal invasive payudara merupakan penyebab tersering kematian pada wanita di seluruh dunia. Topoisomerase IIα memiliki peran penting dalam replikasi DNA dan merupakan target spesifik agen kemoterapi berganda.Diduga amplifikasi topoisomerase IIα berkaitan dengan prognosis yang buruk pada karsinoma duktal invasive payudara, namun mempunyai respon yang baik terhadap kemoterapi sitotoksik. Namun, hubungan antara derajat histopatologik dan klasifikasi subkelas molekuler berdasarkan ekspresi ER, PR, HER-2/neu dan Topoisomerase IIα masih belum jelas.

Tujuan

Penelitian ini bertujuan utuk menentukan hubungan antaratopoisomerase IIα pada karsinoma duktal invasif payudara dan derajat histopatologik dan klasifikasi subkelas molekuler payudara.

Bahan dan cara

Sejak Januari-Desember 2009, rekam medik 35pasien karsinoma duktal invasif payudara pada Departemen Patologi Anatomik RSUD Dr. Soetomo Surabaya, dicatat data derajat histopatologik dan hasil pemeriksaan imunohistokimia (ER, PR, HER-2/neu). Pembuatan spesimen dan pulasan imunohistokimia dilakukan untuk melihat ekspresi imunohistokimia topoisomerase IIα.

Hasil
Pemeriksaan Imunohistokimia menunjukkan ekspresi Ekspresi topoisomerase IIα pada 23 (65.7%) kasus. Analisa Chi Squareantara topoisomerase IIα dan derajat histopatologik menunjukkan hubungan yang tidak bermakna (p=0.091). Sedangkan analisa Chi Squareantara ekspresi topoisomerase IIα dan klasifikasi subkelas molekuler payudara menunjukkan hubungan yang tidak bermakna (p= 0.204).
Kesimpulan
Topoisomerase IIαtidak berperan pada diferensiasi, proliferasi sel tumor dan karsinogenesis karsinoma duktal invasif payudara melalui jalur hormonal.
Kata kunci : karsinoma duktal invasif payudara , topoisomerase IIα, ER, PR, HER-2/neu, derajat histopatologik.


ABSTRACT

Background

Invasive ductal carcinoma of the breast was the most common cause of death among women in the world. Topoisomerase IIα plays a key role in DNA replication and is a target for multiple chemotherapeutic agents. Amplification of Topoisomerase IIα is considered to have correlation with poor prognosis in invasive ductal carcinoma of the breast, but have a favourable response to cytotoxic chemotherapy. The correlation between Topoisomerase IIα, histopathology grading and molecular subclass classification based on ER, PR and HER-2/neu expression is still unclear.

Objective

This study was conducted to determine the correlation between topoisomerase IIα in invasive ductal carcinoma of the breast and histopathological grading and molecular subclass classification of the breast.

Methods

Since January-December 2009, medical records of 35 patients invasive ductal carcinoma of the breast of Pathology department of Dr. Soetomo Hospital Surabaya, retrieved histopathological grading and immunohistochemical data (ER, PR, HER-2/neu). Specimen and immunohistochemicalexaminationwere made to study expression of topoisomerase IIα

Results
Immunohistochemical examination topoisomerase IIα expression in 23 cases (65.7%). Chi Square analysis between topoisomerase IIα expression and histopathological grading showed not significant correlation (p=0.091). However, Chi Square analysis between topoisomerase IIα exspresion and molecular subclass classification of the breast showed not significant correlation (p=0.204)
Conclusion
Topoisomerase IIαhave no role in differentiation, tumor cell proliferation and carcinogenesis of invasive ductal carcinoma of the breast via the hormonal pathway.
Keywords: invasive ductal carcinoma of the breast, Topoisomerase IIα, ER, PR, HER-2/neu, histopatho-logical grading.

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