Tesis

Korelasi Ekspresi Androgen Receptor dan Ekspresi Chromogranin A pada Adenokarsinoma Prostat di RSUPN. Dr. Cipto Mangunkusumo = Correlation of Androgen Receptor Expression and Chromogranin A Expression in Prostate Adenocarcinoma at RSUPN. Dr. Cipto Mangunkusumo.

Latar belakang : Insiden Adenokarsinoma di RSCM meningkat pada periode 2001-2006 dibanding periode sebelumnya (1995-2000). Banyak penderita yang resisten terhadap pengobaan hormonal. Resistensi ini diduga akibat sel tumor mengalami transformasi Neuroendokrin. Akan dilakukan penelitian untuk melihat ekspresi Androgen Receptor (AR) dan Chromogranin A (CgA) pada adenokarsinoma prostat di RSCM tahun 2011-2015. Tujuan : Membuktikan korelasi ekspresi AR dan CgA dengan derajat keganasan. Metode : Studi potong lintang analitik terhadap 70 kasus adenokarsinoma prostat di departemen PA FKUI/RSCM tahun 2011-2015. Kasus dipulas imunohistokimia AR dan Cg A serta dilakukan interpretasi hasil. AR dinilai prosentase positivitasnya pada inti epitel dan stromal. CgA dinilai prosentase positivitasnya pada sitoplasma. Uji korelasi dilakukan untuk melihat kemaknaan dan kekuatan korelasi antar variabel terikat. Hasil : Karakteristik sampel usia 47,1% >70 tahun; diferensiasi histopatologik/skor gleason 42,9% buruk/>7, grade group 28,6% grade5 dan PSA 64,3% dalam rentang 11-100ng/ml. Ekspresi CgA berkorelasi negatif lemah dengan ekspresi AR epitel (r=-0,288;p=0,016). Ekspresi CgA tidak berkorelasi dengan ekspresi AR stromal (p=0,886). Terdapat hubungan bermakna ekspresi AR epitel dengan grade group (p=0,003). Tidak terdapat hubungan bermakna ekspresi AR epitel dengan usia, diferensiasi histopatologik/skor gleason dan PSA. Ekspresi CgA berhubungan bermakna dengan diferensiasi histopatologik/skor gleason dan grade group (p=0,018;p=0,038). Tidak terdapat hubungan bermakna ekspresi CgA dengan usia dan PSA. Ekspresi AR stromal tidak berhubungan bermakna dengan usia, diferensiasi histopatologik, grade group, skor gleason, maupun PSA. Kesimpulan : Terdapat korelasi yang lemah antara AR dan CgA sehingga pulasan AR dan CgA dapat dipakai untuk pemilihan terapi.
Kata kunci : Adenokarsinoma prostat, androgen receptor, chromogranin A, diferensiasi histopatologik, grade group, skor gleason



Background: Prevalence of prostate adenocarcinoma doubled in 2001-2006 compared to 1995-2000 in RSCM. Many patients resistant to hormonal treatment. This resistance is thought to be due to tumor cells undergoing neuroendocrine transformation. Study will be conducted to analyze the expression of Androgen Receptor (AR) and Chromogranin A (CgA) in prostate adenocarcinoma at RSCM in 2011-2015. Objective: To prove correlation of expression of AR and CgA with degree of malignancy. Methods: A cross sectional study was carried out on 70 cases of prostate adenocarcinoma in department of Anatomic Pathology FKUI / RSCM from 20112015. AR expressed in stromal and epithelial nuclei, CgA expressed in cytoplasm. Statistical tests used to discover significance and correlation between the dependent variables. Results: Most samples are more than 70 years old (47,1%), has poor histologic/gleason score (42.9%), are in clinical grade 5 (28.6%), and has PSA score range between 11-100 ng/ml. CgA expression negatively correlates to epithelial AR expression (r=-0,288;p=0.016), while no correlation are found between CgA expression and stromal AR expression (p=0.886). There is significant difference between epithelial AR expression with grade group (p=0.003), but not with age, histopathologic differentiation/Gleason score and PSA. There are significant difference between CgA expression and histopathologic differentiation/grade group and Gleason score (p=0.018; p=0.038), but not with age and PSA. No significant difference observed between stromal AR expression with age, histopathologic differentiation/gleason score, grade group or PSA. Conclusion: There’s a weak correlation between AR and CgA so that AR and CgA expression can be used for the selection of therapy.
Keywords: Prostate adenocarcinoma, androgen receptor, chromogranin A, histopathologic differentiation, grade group, gleason score.