Perbedaan Tampilan Imunohistokimia p63 antara Neoplasia Intraepitel Prostat dengan Adenokarsinoma Prostat

Abstract

ABSTRAK Latar belakang Kadangkala pada pemeriksaan histopatologi rutin sulit dibedakan antara adenokarsinoma prostat berdifrensiasi baik dan neoplasia intraepitel prostat (PIN). Untuk itu diperlukan pewarnaan lain yang lebih akurat dengan menggunakan petanda sel basal, seperti p63. Tujuan penelitian ini adalah membuktikan adanya perbedaan tampilan imunohistokimia p63 antara PIN dengan adenokarsinoma prostat. Bahan dan cara Penelitian ini merupakan penelitian deskripsi analitik dengan rancangan cross sectional. Sampel penelitian jaringan prostat sebanyak 49 blok paraffin berasal dari transurethral resection of prostate (TURP) atau surgical prostatectomy yang telah didiagnosa dengan pewarnaan HE. Hasil Pemeriksaan imunohistokimia (IHK) menggunakan p63 ini memiliki sensitivitas sebesar 68%, spesifitas sebesar 75%, nilai prediktif positif sebesar 74%, nilai prediktif negatif sebesar 69% dan likelihood ratio + sebesar 2,72. Uji statistik chi-square antara PIN dan adenokarsinoma prostat menunjukkan perbedaan bermakna (p<0.05). Uji korelasi antara ekspresi aberrant p63 dan Gleason score pada adenokarsinoma prostat menjukkan perbedaan bermakna (p<0.001). Kesimpulan Tampilan p63 dapat digunakan untuk membedakan antara PIN dan adenokarsinoma prostat. Semakin kuat tampilan aberrant p63, semakin tinggi Gleason score artinya semakin buruk prognosis adenokarsinoma prostat. Kata kunci : imunohistokimia p63, aberrant p63, neoplasia intraepitel prostat, adenokarsinoma prostat, Gleason score. ABSTRACT Background Sometimes, on routine histologic examination it was very difficult to differentiate between prostate adenocarcinoma well differentiated and prostate intraepithelial neoplasia (PIN). To accurate stain basal cell markers, such as p63. The purpose of this research is to improve distinctive of expression p63 between PIN and prostate adenocarcinoma. Methods This research is an analytic descriptive research with cross sectional approach. Observational sample of prostate tissue contains of 49 paraffin blocks from transurethral resection of prostate (TURP) or surgical prostatectomy have been diagnosed by HE staining. Results Immunohistochemistry assay of p63 has sensitivity 68%, specificity 75%, positive predictive value 74%, negative predictive value 69% and likelihood ratio + 2,72. Statistic analysis of chi-square between PIN and adeno-carcinoma prostate showed significant differences (p<0.05). Correlation test between aberrant p63 expression and Gleason score on adenocarcinoma prostate showed significant differences (p<0.001). Conclusion Expression p63 be could used to differentiated between PIN and adenocarcinoma prostate. The higher expression of aberrant p63, the higher Gleason score means poorly differentiate adenocarcinoma prostat. Key words : p63 immunohistochemistry, aberrant p63, prostate intraepithelial neoplasia, prostate adenocarci-noma, Gleason score.