Hubungan Ekspresi Ki-67 dan E-Cadherin dengan Kedalaman Invasi Melanoma Malignum Berdasarkan Clark Level

Abstract

Background
Malignant melanoma (MM) is a neoplasia derived from melanocytes. This is the most aggressive cancer of
skin. Even small tumors may have a tendency to metastasize and thus lead to a relatively unfavorable
prognosis. Malignant melanoma depth of invasion based on Clark level is one of the important prognostic
factors to determine survival rate of MM patient. Determination of invasion based on this Clark level is
subjective, more objective checks such as Ki-67 and E-Cadherin are required. This examination is
expected to see the risk of metastasis in MM. Cell proliferation is the main key for tumor progression and it
can be measured with Ki-67 expression. E-cadherin is one of transmembrane protein that plays important
role in metastasis. The purpose of this study is to determine correlation between Ki-67 and E-Cadherin
expression with depth of invasion of malignant melanoma based on Clark level.
Methods
This is cross sectional study in Padang and Jakarta, with 42 cases of malignant melanoma which have
been diagnosed in Pathology Anatomic Laboratory in West Sumatera. Samples were obtained from
paraffin block of or tissue from surgery and have been reviewed depth of invasion based on the Clark level.
These samples were divided into I-V Clark level group. Ki-67 expression of cells nuclei and expression of
E-Cadherin of cells membrane were analyzed using immunohistochemistry assay. One Way Annova
bivariate statistical analysis were used and value p<0.05 were considered significant.
Results
Positive Ki-67 expression were found in 42 cases, 6 samples with II Clark level, 8 samples with III Clark
level, 19 samples with IV Clark level, 9 samples with V Clark level. Malignant melanomas were mostly
found in male 60-79 age group and depth of invasion in IV Clark level. Positive E-Cadherin expression in II
Clark level. There was significant correlation between Ki-67 and E-Cadherin