Tesis

Peran Ekspresi p53 Pada KSSRM Stadium Lanjut sebagai Penanda Prognosis = Rule of p53 Expression in Advanced Stage Oral Squamous Cell Carcinoma as a Prognosis Marker.

Latar Belakang: Menurut GLOBOCAN 2020 terdapat 5780 kasus baru Karsinoma Sel Skuamosa Rongga Mulut (KSSRM) di Indonesia. Overall sruvival (OS) 5 tahun hanya 47 % dengan disease free survival (DFS) 74%. Faktor utama terkait kesintasan diantaranya stadium penyakit, metastasis, invasi tumor dan ketebalan tumor. Faktor klinis diantaranya umur, jenis kelamin, ukuran tumor, dan lokasi tumor. Penelitian mengenai kesintasan terutama pada KSSRM di Indonesia masih terbatas. Marker p53 dianggap sebagai penanda prognosis yang buruk untuk KSSRM. Tujuan: Mengetahui hubungan ekspresi p53 pada sel tumor sebagai penanda prognosis pada KSSRM stadium lanjut. Metode: Penelitian kohort retrospektif dengan desain penelitian studi analitik kesintasan. Sampel diambil dari populasi terjangkau yang memenuhi kriteria inklusi dan eksklusi dari tahun 2014-2018 dengan metode consecutive sampling. Pemeriksaan imunohistokimia menggunakan antibodi primer p53. Data imunoekspresi dianalisis untuk mengetahui hubungannya sebagai penanda prognosis pada KSSRM. Hasil: Ekspresi p53 ditemukan pada 37 kasus (68,5%). Ekspresi p53 ditemukan terbanyak pada derajat diferensiasi sedang-buruk, yaitu pada 10 kasus (50%). Ekspresi p53 berdasarkan derajat keganasan skor Bryne ditemukan paling banyak pada derajat keganasan baik dan sedang yaitu 6 dan 7 kasus (80,6% dan 58,8%). Ekspresi p53 pada KSSRM yang tidak ditemukan invasi limfovaskular sebanyak 50 kasus (92,6%). Tidak terdapat hubungan yang bermakna antara ekspresi p53 dan kesintasan 2 tahun (p=0,211). Terdapat hubungan yang bermakna antara ekspresi p53 dengan diferensiasi sel tumor (p=0,026), dan pada derajat keganasan skor Bryne (0,043). Tidak terdapat hubungan yang bermakna antara ekspresi p53 dan invasi limfovaskular (p=0,087). Kesimpulan: Tidak terdapat hubungan yang bermakna antara ekspresi p53 pada KSSRM dengan kesintasan.
Kata kunci: Karsinoma sel skuamosa rongga mulut, angka kesintasan, ekspresi p53.


Background: According to GLOBOCAN 2020, there were 5780 new cases of Oral Cavity Squamous Cell Carcinoma (OSSC) in Indonesia. Overall survival (OS) 5 years was only 47% with disease free survival (DFS) 74%. The main factors related to survival include disease stage, metastasis, tumor invasion and tumor thickness. Clinical factors include age, gender, tumor size, and tumor location. Research on survival, especially in OSSC in Indonesia, is limited. The p53 marker is considered a poor prognostic marker for OSSC. Objective: To determine the relationship between p53 expression in tumor cells as a prognostic marker in advanced stage OSSC. Methods: Retrospective cohort study with a survival analytic study design. Samples were taken from an affordable population that met the inclusion and exclusion criteria from 20142018 with the consecutive sampling method. Immunohistochemistry examination using p53 primary antibody. Immunoexpression data were analyzed to determine its relationship as a prognostic marker in OSSC . Results: Expression of p53 was found in 37 cases (68.5%). The highest p53 expression was found in the moderate to poor degree of differentiation, totally in 10 cases (50%). The p53 expression based on the degree of malignancy Bryne score was found and the highest in good and moderate malignancy, totally 6 and 7 cases (80.6% and 58.8%). The expression of p53 in OSSC without lymphovascular invasion was found in 50 cases (92.6%). There was no significant relationship between p53 expression and 2-year survival rate (p=0.211). There was a significant relationship between p53 expression with tumor cell differentiation (p=0.026), and the degree of malignancy Bryne score (0.043). There was no significant relationship between p53 expression and lymphovascular invasion (p=0.087). Conclusion: There was no significant relationship between p53 expression in OSSC and survival.
Keywords: Oral squamous cell carcinoma, survival rate, p53 expression.