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Penilaian ekspresi Mucin-6 (MUC6) aberrant pada serrated adenoma dan adenoma konvensional displasia keras sebagai lesi prekursor kanker kolorektal = Expression aberrant of Mucin-6 (MUC6) assessment in serrated adenoma and conventional adenoma with severe dysplasia as precursor lesions of colorectal cancer.

Latar belakang. Berdasarkan WHO, lesi-lesi prekursor dapat berkembang menjadi karsinoma kolorektal melalui 2 jalur yaitu adenoma - carcinoma sequence dan serrated pathways. Adenoma carcinoma sequence diawali sel atipik - adenoma displasia ringan - adenoma displasia keras -karsinoma kolorektal, sedangkan serrated pathways dimulai dari aberrant crypt foci (ACF) - polip hiperplastik - serrated adenoma (SA) - karsinoma kolorektal. Salah satu komponen penting pada lesi tersebut adalah musin yang berfungsi untuk melindungi lapisan mukosa saluran pencernaan. Musin dapat mengalami perubahan pada tumor ganas yang berperan dalam proses diferensiasi, proliferasi dan invasi sel tumor. Kepustakaan mengatakan bahwa pulasan IHK Mucin-6 (MUC6) dapat digunakan sebagai penanda bagi serrated adenoma dan adenoma konvensional displasia keras. Tujuan. Untuk mengetahui ekspresi MUC6 aberrant di sitoplasma sel epitel kripta mukosa kolorektal pada serrated adenoma (SA) dan adenoma konvensional displasia keras. Bahan dan cara. Penelitian ini dilakukan secara retrospektif, menggunakan studi analitik deskriptif potong lintang, dengan mengumpulkan kasus serrated adenoma (SA) dan pembanding menggunakan kasus adenoma konvensional displasia keras masing-masing 20 kasus. Dilakukan pulasan immunohistokimia (IHK) Mucin-6 (MUC6) terhadap semua kasus. Hasil. Indeks ekspresi MUC6 aberrant kelompok serrated adenoma menunjukkan hasil sedang-kuat pada sebagian besar kasus, sedangkan kelompok adenoma konvensional displasia keras menunjukkan hasil negatif dan positif lemah pada sebagian besar kasus. Maka dapat disimpulkan terdapat hubungan bermakna antara ekspresi MUC6 aberrant pada kelompok serrated adenoma (SA) dan adenoma konvensional displasia keras, dengan nilai p=0,005. Kesimpulan. Terdapat hubungan bermakna antara ekspresi MUC6 aberrant kelompok kasus serrated adenoma (SA) dan adenoma konvensional displasia keras.
Kata kunci : serrated adenoma, adenoma konvensional displasia keras, serrated pathways, adenoma carcinoma sequence, ekspresi Mucin-6.


Background. Based on WHO, precursor lesions can develop into colorectal carcinoma through two pathways, namely adenoma - carcinoma sequence pathways and serrated pathways. Adenoma carcinoma sequence begins atypical cells - adenoma with mild dysplasia - adenoma with severe dysplasia - colorectal carcinoma, whereas serrated pathways begins aberrant crypt foci (ACF) - hyperplastic polyps - serrated adenoma (SA) - colorectal carcinoma. One of the important components of the lesion is the mucin layer which serves to protect the gastrointestinal mucosa. Mucin may experience changes in malignant tumors which play a role in the differentiation, proliferation and invasion of tumor cells. The literature says that the outward appearance of IHC Mucin-6 (MUC6) can be used as a marker for serrated adenoma and conventional adenoma with severe dysplasia. Objective: To find expression aberrant of MUC6 in the cytoplasm of epithelial cells in the colorectal mucosal crypts serrated adenoma (SA) and conventional adenoma with severe dysplasia. Materials and method. This study was conducted retrospectively, using a crosssectional descriptive analytic study, by collecting case serrated adenoma (SA) and a comparison using conventional adenoma with severe dysplasia case each of the 20 cases. Do outward MUC6 immunohistochemistry staining in all cases. Results. Index aberrant expression of Mucin-6 (MUC6) serrated adenoma group showed moderate to strong results in most cases, while the conventional adenoma with severe dysplasia was negative and weakly positive in most cases. So we can conclude there is a relationship between the aberrant expression of Mucin-6 (MUC6) in the serrated adenoma (SA) group and conventional adenoma with severe dysplasia, with p= 0.005. Conclusion. There is a relationship between the aberrant expression of Mucin-6 (MUC6) serrated adenoma (SA) group and conventional adenoma with severe dysplasia.
Keywords: serrated adenoma, conventional adenoma with severe dysplasia, serrated pathways, adenoma carcinoma sequence, the aberrant expression of Mucin-6 (MUC6).