Tesis

Ekspresi PD-L1 pada Adenokarsinoma Prostat: Korelasi dengan Gambaran Histopatologik dan Profil Klinikopatologik = PD-L1 Expression in Prostate Adenocarcinoma: Correlation with Histopathological and Clinical Profiles.

Latar Belakang: Pasien adenokarsinoma prostat sering kali datang dalam kondisi telah lanjut atau bermetastasis. Terapi yang dapat diberikan pada kasus adenokarsinoma stadium lanjut umumnya pengobatan androgen deprivation therapy (ADT), namun sebagian pasien mengalami castration-resistant prostate cancer (CRPC). Jalur inhibitor immune check point dapat menjadi alternatif pilihan terapi. Tujuan penelitian ini adalah untuk mengetahui korelasi ekspresi PD-L1 dengan gambaran histopatologik dan gejala klinikopatologis adenokarsinoma prostat. Metode: Penelitian ini merupakan penelitian analitik korelasi terhadap kasus-kasus adenokarsinoma prostat retrospektif. Dilakukan pulasan imunohistokimia PD-L1 klon 22C3 terhadap 30 subjek dan dinilai menggunakan combined proportion score (CPS). dilakukan penilaian ulang skor Gleason dan WHO/ISUP grade, serta penilaian tumor infiltrating lymphocytes (TILS). Dilakukan uji korelasi menggunakan SPSS 20.0 untuk melihat korelasi dengan derajat WHO/ISUP, TILS, nilai PSA dan body mass indek (BMI). Hasil: Dari 30 sampel yang dipilih secara acak didapatkan rata-rata usia 63 tahun. Body mass index antara 17,6 hingga 35,2. Nilai PSA antara 4,1 ng/ml hingga 973 ng/ml. Tidak terdapat korelasi antara ekspresi PD-L1 dengan derajat WHO/ISUP, BMI dan nilai PSA. Didapatkan korelasi dengan intratumoral TILS tapi tidak pada Stromal TILS. Diskusi: Pada penelitian ini didapatkan korelasi bermakna dengan intratumoral TILS, namun sebagian besar penelitian lain pada umumnya menggunakan hanya stromal TILS. Dibutuhkan penelitian lebih lanjut untuk diaplikasikan secara klinis
Kata kunci: adenokarsinoma prostat, PD-L1, derajat WHO/ISUP, TILS, BMI, PSA


Background: Prostate adenocarcinoma patients often present in an advanced or metastatic condition. Treatment that can be given in cases of advanced adenocarcinoma is androgen deprivation therapy (ADT), but some patients experience castration-resistant prostate cancer (CRPC). Immune check point inhibitor pathways can be an alternative treatment option. The aim of this study was to determine the correlation of PD-L1 expression with histopathologic features and clinicopathological symptoms of prostate adenocarcinoma. Methods: This study is a retrospective correlation analytic study of cases of prostate adenocarcinoma. 30 subjects were performed with PD-L1 clone 22C3 immunohistochemistry and assessed using a combined proportion score (CPS). a reassessment of the Gleason score and WHO/ISUP grade, as well as an assessment of tumor infiltrating lymphocytes (TILS). Correlation test was performed using SPSS 20.0 to see the correlation with WHO/ISUP degrees, TILS, PSA values and body mass index (BMI). Results: From 30 randomly selected subjects, the mean age was 63 years. Body mass index between 17.6 and 35.2. PSA values are between 4.1 ng/ml to 973 ng/ml. There was no correlation between PD-L1 expression and WHO / ISUP degree, BMI and PSA value. There was a correlation with intratumoral TILS but not Stromal TILS, Discussion: PD-L1 expression with TILS has been shown to be associated with various tumors. In this study, there was a significant correlation with intratumoral TILS, but most other studies generally used only stromal TILS. Further research is needed for its clinical application
Keyword: prostate adenocarcinoma, PD-L1, WHO/ISUP grade, TILS, BMI, PSA