Tesis

Hubungan Densitas Tumor Infiltrating Lymphocyte CD3+ dan CD8+ pada Invasive Margin dengan Stadium Tumor, Metastasis Kelenjar Getah Bening dan Status Tumor Budding sebagai Faktor Prognosis Adenokarsinoma Kolorektal = Association between Density of CD3+ and CD8+ Tumor Infiltrating Lymphocytes at the Invasive Margin with Tumor Stage, Lymph Node Metastasis and Tumor Budding Status as a Prognosis Factor Colorectal Adenocarcinoma.

Latar Belakang: Stadium tumor TNM, status nodal dan tumor budding digunakan sebagai panduan penentuan protokol terapi dan prediksi prognosis yang dapat bervariasi pada tiap pasien adenokarsinoma kolorektal (AKR) dengan stadium yang sama. Parameter tambahan yang sudah diteliti adalah respon imun yang menunjukkan hubungan faktor prognosis yang baik dengan sifat antitumor pada sistem imun adaptif tumorinfiltrating lymphocytes (TIL) CD3+ dan CD8+. Tujuan: Penelitian ini bertujuan untuk menilai hubungan densitas CD3+ dan CD8+ tumor infiltrating lymphocyte (TIL) dengan faktor-faktor prognosis berupa stadium tumor, status nodal dan tumor budding di invasive margin pada kasus adenokarsinoma kolorektal. Metode: Penelitian ini menggunakan desain potong lintang. Populasi penelitian adalah pasien operasi yang didiagnosis sebagai AKR dengan pemeriksaan histopatologik di Departemen Patologi Anatomik FKUI/RSCM dari tanggal 1 Januari 201 9 hingga 31 Desember 2021. Pengambilan sampel dilakukan secara simple random sampling. Data dianalisis secara statistik untuk menilai densitas TIL CD3+ dan CD8+ pada kelompok stadium dini dan lanjut, tidak metastasis kelenjar getah bening (KGB) dan metastasis KGB, serta tumor budding derajat rendah dan tinggi. Hasil: Didapatkan 60 kasus AKR. Pada kelompok stadium, terdiri dari 27 kasus stadium dini dan 33 stadium lanjut, kelompok tidak metastasis KGB 28 kasus dan 32 metastasis KGB, kelompok tumor budding derajat rendah 25 kasus dan 35 kasus derajat tinggi. Densitas TIL CD3+ dan CD8+ lebih tinggi pada stadium dini, tidak metastasis KGB dan tumor budding derajat rendah dengan keseluruhan nilai p < 0,001. Kesimpulan: Terdapat perbedaan bermakna antara densitas TIL CD3+ maupun CD8+ pada tiap kelompok stadium tumor, metastasis KGB dan status tumor budding.
Kata kunci: Adenokarsinoma kolorektal, metastasis kelenjar getah bening, stadium tumor, TIL CD3+, TIL CD8+, tumor budding.



Background: The TNM tumor stage, nodal status and tumor budding is used as a guide for determining treatment protocols and predicting prognosis, which can vary among patients with the same stage. Parameter that has been studied is the immune responewhich shows the relationship of favourable prognostic factors with antitumor properties in the adaptive immune system tumor-infiltrating lymphocytes (TIL) CD3+ and CD8+. Objectives: This study aims to evaluate the relationship between the density of CD3+ and CD8+ tumor infiltrating lymphocyte (TIL) expression and prognostic factors such as tumor stage, nodal status, and tumor budding at the invasive margin in cases of colorectal adenocarcinoma. Methods: This study uses a cross-sectional design. The study population is resection patients diagnosed with colorectal adenocarcinoma through histopathological examination in the Department of Anatomical Pathology of FKUI/RSCM from January 1, 2019 to December 31, 2021. Samples were collected using simple random sampling. Data were analyzed statistically to evaluate the density of CD3+ and CD8+ TILs in the early and advanced stage groups, non-metastatic lymph nodes and metastatic lymph nodes, and low and high degree of tumor budding. Results: In this study, a total of 60 cases of colorectal adenocarcinoma were identified. The staging group consisted of 27 cases of early stage and 33 cases of advanced stage, the non-metastatic lymph node group had 28 cases and the metastatic lymph node group had 32 cases, the low grade tumor budding group had 25 cases and the high grade tumor budding group had 35 cases. The density of CD3+ and CD8+ were higher in early stages, no lymph node metastases and low grade budding tumors (p < 0.001 for all). Conclusion: There was a significant difference between the density of TIL CD3+ and CD8+ TILs in the tumor stage, lymph node metastasis, and tumor budding groups.
Keyword: Colorectal adenocarcinoma, CD3+ and CD8+ TIL, lymph node metastases, tumor budding, tumor stage.