Imunoekspresi Poly (ADP-Ribose) Polymerase sebagai Petanda Kemoresisten pada Karsinoma Ovarium
Abstract
Karsinoma ovarium merupakan keganasan kelima terbanyak dan penyebab kematian ginekologi pertama di dunia. Kemoterapi merupakan modalitas terapi utama karsinoma ovarium dengan stadium lanjut setelah dilakukan pembedahan. Poly (ADP-Ribose) Polymerase (PARP) dan B cell Lymphoma-2 (Bcl-2) merupakan petanda imunohistokimia yang berfungsi dalam proses DNA repair dan anti-apoptosis yang merupakan bagian dari lingkaran mekanisme kerja regimen kemoterapi pada sel tumor. Oleh karena itu dua mekanisme tersebut dianggap memegang peranan penting terhadap terjadinya resisten kemoterapi bahkan rekurensi. Tujuan penelitian ini adalah melihat hubungan imunoekspresi PARP dan Bcl-2 dengan respons kemoterapi pada karsinoma ovarium. Penelitian ini menggunakan desain analisis observasi secara potong lintang dengan menggunakan blok parafin pasien yang didiagnosis sebagai karsinoma ovarium selama periode tahun 2012−2015 di Departemen Patologi Anatomi RSUP Dr Hasan Sadikin Bandung. Jumlah sampel sebanyak 58 kasus yang terdiri atas 30 kasus kemoterapi sensitif dan 28 kasus kemoterapi resisten, keseluruhan sampel dilakukan pulasan imunohistokimia PARP dan Bcl-2. Analisis data menggunakan uji Chi-Square dengan taraf signifikansi 5%. Hasil dari penelitian ini adalah 60% sampel terekspresi PARP kuat dengan proporsi terbesar pada kelompok resisten (p=0,001) dan 74% sampel terekspresi Bcl-2 lemah dengan proporsi sama pada tiap kelompok respon kemoterapi (p=0,45). Respons kemoterapi sangat dipengaruhi oleh proses DNA repair yang dapat dinilai dengan pemeriksaan imunoekspresi PARP. Semakin tinggi imunoekspresi PARP maka semakin tinggi kemampuan DNA repair sehingga semakin tinggi kemungkinan kemoterapi resisten.
Kata kunci: Bcl-2, karsinoma ovarium, kemoterapi, PARP
Poly (ADP-Ribose) Polymerase Immunoexpression as Chemoresistance Marker in Ovarian Carcinoma
Abstract
Epithelial ovarian cancer (EOC) is the fifth most common cancer and the main cause of gynecological cancer death worldwide. Chemotherapy is the main therapy in advanced stage of EOC. Poly (ADP-Ribose) Polymerase (PARP) dan B cell Lymphoma-2 (Bcl-2) are immunohistochemistry markers that represent influential factors in chemotherapy response which have roles in DNA repair and anti-apoptosis. The aim of this study was to review the correlation between PARP and Bcl-2 expression with chemotherapy response in EOC. This research was performed as analytic-observational with cross-sectional design using paraffin block of patients diagnosed as EOC in 2012–2015 at Anatomical Pathology Department, Hasan Sadikin Hospital Bandung. Total sample was 58 cases which were divided into chemotherapy sensitive and resistant. All samples were stained by immunohistochemistry PARP and Bcl-2 and analysed using Chi-Square test with significant level of 5%. The results of this study showed that 60% of all samples have strong PARP expression whereas the largest proportion is in chemotherapy resistant group (p=0.001) and 74% of all samples have weak Bcl-2 expression in each group (p=0.45). The conclusion of this study in chemotherapy response was influenced by PARP. Higher PARP immunoexpression showed higher tumour cell ability to repair DNA and higher chemotherapy resistance.
Keywords: Bcl-2, chemotherapy, EOC, PARP
Keywords
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DOI: https://doi.org/10.15416/ijcp.2018.7.2.115
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