Tesis

Ekspresi Programmed Death Ligand-1 (PD-L1) pada Seminoma Testis sebagai Potensi Faktor Prognostik = The Expression of Programmed Death Ligand-1 (PD-L1) in Testicular Seminoma as Potential Prognostic Factor.

Latar belakang: Seminoma testis yang gagal sembuh dengan penatalaksanaan konvensional memiliki prognosis buruk. Beberapa kejadian rekuren setelah dilakukan kemoterapi juga ditemukan. Programmed Death Ligand-1 (PD-L1) terekspresi pada berbagai keganasan dan tumor infiltrating lymphocytes (TILs) serta telah diketahui perannya sebagai faktor prognostik. Penelitian ini dilakukan untuk mengetahui peran ekspresi PD-L1 pada seminoma testis dalam menentukan overall survival (OS) dan progression free survival (PFS). Bahan dan cara: Penelitian ini merupakan penelitian kohort retrospektif dengan desain analisis kesintasan. Data klinis diambil dari rekam medis RSUPN Cipto Mangunkusumo sejak Januari 2011-Desember 2016 yang diobservasi selama 2 tahun. Data histopatologik diambil dari Departemen Patologi Anatomik RSUPN Cipto Mangunkusumo yang kemudian dilakukan pulasan imunohistokimia PD-L1. Hasil: Terdapat hubungan yang bermakna antara ekspresi PD-L1 pada sel tumor dengan 2-year OS (p=0,023) dan PFS (p=0,002) pada seminoma testis. Tidak terdapat hubungan yang bermakna antara ekspresi PD-L1 pada TILs dengan 2-year OS (p=0,235) dan PFS (p=0,111). Terdapat hubungan bermakna antara ekspresi PD-L1 pada sel tumor dan ekspresi PD-L1 pada TILs dengan PFS (p=0,019). Terdapat hubungan yang bermakna antara stadium dengan 2-year OS (p=0,010) dan PFS (p=0,000) serta metastasis kelenjar getah bening pada 2-year OS (p=0,010) dan PFS (p=0,000). Kesimpulan: Ekspresi PD-L1 pada sel tumor seminoma testis berhubungan dengan OS dan PFS, tetapi hubungan tersebut tidak ditemukan pada TILs.
Kata kunci: Seminoma, TILs, PD-L1, OS, PFS


Background: The prognosis of testicular seminoma who failed to be cured with conventional therapy is poor. Several recurrent events after chemotherapy were also found. PD-L1 is expressed in various types of malignancy and tumor infiltrating lymphocytes (TILs) and its role is known as a prognostic factor. This study was conducted to determine the role of PD-L1 expression seminoma in determining overall survival (OS) and progression free survival (PFS). Materials and Methods: This is a retrospective cohort study with survival analysis. Clinical data were obtained from medical record in RSUPN Cipto Mangunkusumo since January 2011-December 2016 and observed for 2 years. Histopathological data were obtained from Anatomical Pathology Department and PD-L1 immunohistochemistry staining were performed. Results: A significant correlation between PD-L1 expression in tumor cells with 2-year OS (p=0,023) and PFS (p=0,002) in testicular seminoma was found. No significant correlation between PD-L1 expression in TILs with 2-year OS (p=0,235) and PFS (p=0,111). We also found significant correlations between PD-L1 expression in tumor cells and TILs with PFS (p=0,019). A significant correlation between stage with 2-year OS (p=0,010) and PFS (p=0,000) and lymph node metastases with 2-year OS (p=0,010) and PFS (p=0,000) Conclusion: PD-L1 expression in tumor cells testicular seminoma were significantly correlated with OS and PFS. There were no statistically significant associations between PD-L1 expression in TILs with OS and PFS.
Keywords: Seminoma, TILs, PD-L1, OS, PFS