Imunoekspresi ER-α, PR, Wnt5a, dan HMGA2 pada Berbagai Gradasi Tumor Filodes Payudara

Fairuz Quzwain, Yusuf Sulaiman Effendi, Bethy Suryawati Hernowo, Ida Parwati

Abstract


Tumor filodes merupakan tumor fibroepitelial pada payudara yang secara mikroskopis ditandai dengan peningkatan selularitas sel stroma dan membentuk struktur seperti daun (leaf-like). Berbeda dengan tumor dari unsur epitel duktuli dan kelenjar payudara, penelitian peranan hormonal maupun faktor lain pada tumor filodes masih menunjukkan hasil yang inkonsisten sehingga menyebabkan patogenesis dan penatalaksanaan tumor ini dalam jalur hormonal masih kontroversi. Penelitian ini bertujuan menganalisis imunoekspresi faktor hormonal, yaitu estrogen receptor alpha (ER-α), progesteron receptor (PR), serta faktor nonhormonal HMGA2 dan wnt5a pada berbagai gradasi tumor filodes payudara. Dilakukan penilaian histologi dan imunoekspresi pada parafin blok jaringan tumor filodes payudara di Laboratorium Departemen Patologi Anatomi RSUP Dr. Hasan Sadikin Bandung periode tahun 2011 sampai 2014. Subjek penelitian dibagi menjadi 3 kelompok gradasi berdasarkan kriteria WHO tahun 2012, yaitu benign, borderline, dan malignant. Didapatkan 62 kasus tumor filodes yang sebagian besar menunjukkan distribusi imunoekspresi ER-α >50%, yaitu pada kategori benign sebanyak 35 dari 40 pasien. Terdapat korelasi signifikan histoskor ER-α, HMGA2, dan Wnt5a dengan gradasi histopatologis PT (p=0,002; p=0,001; p=0,040) dengan arah negatif untuk ER-α 2 (R=−0,423) serta positif untuk HMGA2 dan Wnt5a (R=0,439 dan R=0,243). Pada penelitian ini dapat disimpulkan semakin besar nilai histoskor ER-α maka semakin banyak diekpresikan pada gradasi benign dan semakin besar nilai histoskor HMGA2 serta Wnt5a semakin banyak ditemukan pada gradasi malignant.


ER-α, PR, HMGA2 AND WNT5A IMMUNOEXPRESSION IN VARIOUS GRADE OF PHYLLODES TUMOR OF THE BREAST

Phyllodes tumors (PTs) of the breast are fibroepithelial neoplasms, histologically characterized by hypercellular stromal, stromal overgrowth and double-layered epithelial component arranged in clefts which in combination elaborate leaf-like structures. Unlike epithelial neoplasm of the duct and gland of the breast, there were inconsitence and controversion in hormonal expression research in PTs. These were make unclear pathogenesis and unestablished hormonal therapy in PTs. The aim of this study was to analysis the immunoexpression estrogen receptor-alpha  (ER-α), progesterone receptor (PR), HMGA and Wnt5a in various grade of phyllodes tumors of the breast. We reviewed histology and performed immunohistochemistry for paraffin block of PTs in Laboratory of Departement Pathological Anatomic at Dr. Hasan Sadikin General Hospital in 2011 until 2014 period. According to WHO classification (2012), PTs were categorized into three groups benign, borderline and malignant. According to 62 cases of PT, mainly showed that distribution of immunoexpresion ER-α >50% in benign category were 35 of 40 patients. A significant correlation was observed between histoscore ER-α, HMGA2 and Wnt5a (p=0.002, p=0.001, p=0.040) and histopathological grading of PT (p=0.001) in negative direction (R=−0.423), HMGA2 and Wnt5a in positive direction (R=0.439 and R=0.243). It indicates that the histoscore ER-a value increases with increasing expressed value in benign grade. On the other side, the histoscore HMGA2 and Wnt5a value increases  with increasing expressed value in malignant grade.


Keywords


ER-α; gradasi; grade; HMGA2; PR; phyllodes tumor; tumor filodes; Wnt5a

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DOI: https://doi.org/10.29313/gmhc.v4i2.1820

pISSN 2301-9123 | eISSN 2460-5441


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