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Ekspresi Penanda Imunohistokimia MYD88 dan Hubungannya dengan Prognosis pada Limfoma Non-Hodgkin Sel B Adneksa Okular di Rumah Sakit Cipto Mangunkusumo = Immunohistochemistry Expression of MYD88 and its Association with Prognosis in Ocular Adnexal B-Cell Non-Hodgkin Lymphoma at Cipto Mangunkusumo Hospital.

Latar Belakang: Mutasi gen myeloid differentiation primary response 88 (MYD88) di adneksa okular dihubungkan dengan prognosis yang lebih buruk pada Limfoma NonHodgkin tipe DLBCL, walaupun hubungannya dengan LNH sel B adneksa okular tipe lain belum banyak diketahui. Tujuan: Mengetahui hubungan ekspresi penanda IHK MYD88 terhadap prognosis berupa overall survival (OS), event-free survival (EFS), dan progression-free survival (PFS) pasien dengan LNH sel B adneksa okular. Metode: Penelitian ini merupakan studi kohort retrospektif. Dilakukan interpretasi silang data rekam medis pasien dengan LNH sel B adneksa okular dengan blok paraffin yang dilakukan pulasan IHK MYD88. Analisis fisher’s exact test dilakukan untuk menguji hasil ekspresi IHK MYD88. Uji kemaknaan log-rank diterapkan untuk menilai pengaruh ekspresi IHK MYD88 terhadap nilai OS, PFS, dan EFS. Hasil: Total subyek adalah 47 orang dengan laki-laki sebanyak 57.4% dan perempuan 42.6%. Rerata usia subyek penelitian adalah 58.11 ± 14.3 tahun. Jenis histopatologi terbanyak adalah EMZL (83%). Seluruh skor ekspresi MYD88 kuat ditemukan pada DLBCL (p < 0.001). Nilai OS adalah 80%, PFS 55%, dan EFS 82%. Kesimpulan: Tidak terdapat perbedaan bermakna pada ekspresi MYD88 kuat dan lemah di sitoplasma LNH Sel B Adneksa Okular dan hubungannya terhadap prognosis baik OS, EFS, dan PFS. Walaupun demikian, ditemukan kecenderungan hubungan antara ekspresi MYD88 yang kuat terhadap angka OS yang lebih rendah.
Kata Kunci: adneksa okular, limfoma Non-Hodgkin sel B, MYD88, prognosis


Background: Mutations in the myeloid differentiation primary response 88 (MYD88) gene in ocular adnexa have been associated with poorer prognosis in Diffuse Large BCell Lymphoma (DLBCL), although its association with other types of B-cell NonHodgkin Lymphoma (NHL) in the ocular adnexa remains largely unknown. Objective: To investigate the relationship between immunohistochemical marker expression of MYD88 and prognosis, as measured by overall survival (OS), event-free survival (EFS), and progression-free survival (PFS) in patients with B-cell NHL of the ocular adnexa. Methods: This study is a retrospective cohort study. Cross-interpretation of medical record data from patients with B-cell NHL of the ocular adnexa was performed, along with immunohistochemical staining of MYD88. Fisher's exact test was used to assess the expression of MYD88. The log-rank test was applied to evaluate the impact of MYD88 expression on OS, PFS, and EFS values. Results: The total number of subjects was 47, with 57.4% being male and 42.6% female. The mean age of the study subjects was 58.11 ± 14.3 years. The most prevalent histopathological type was Extranodal Marginal Zone Lymphoma (EMZL) at 83%. Strong MYD88 expression was found exclusively in DLBCL (p < 0.001). The OS rate was 80%, PFS rate was 55%, and EFS rate was 82%. Conclusion: There was no significant difference in the expression of strong and weak MYD88 in the cytoplasm of Ocular Adnexal B Cells NHL and their relationship to the prognosis of both OS, EFS, and PFS. However, a tendency was found for a relationship between strong MYD88 expression and lower OS numbers.
Keywords: B-cell Non-Hodgkin Lymphoma, ocular adnexa, MYD88, prognosis