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"ABSTRAKLatar belakang : Insiden Adenokarsinoma di RSCM meningkat pada periode 2001-2006 dibanding periode sebelumnya 1995-2000 . Banyak penderita yang resisten terhadap pengobaan hormonal. Resistensi ini diduga akibat sel tumor mengalami transformasi Neuroendokrin. Akan dilakukan penelitian untuk melihat ekspresi Androgen Receptor AR dan Chromogranin A CgA pada adenokarsinoma prostat di RSCM tahun 2011-2015.Tujuan : Membuktikan korelasi ekspresi AR dan CgA dengan derajat keganasan.Metode : Studi potong lintang analitik terhadap 70 kasus adenokarsinoma prostat di departemen PA FKUI/RSCM tahun 2011-2015. Kasus dipulas imunohistokimia AR dan Cg A serta dilakukan interpretasi hasil. AR dinilai prosentase positivitasnya pada inti epitel dan stromal. CgA dinilai prosentase positivitasnya pada sitoplasma. Uji korelasi dilakukan untuk melihat kemaknaan dan kekuatan korelasi antar variabel terikat.Hasil : Karakteristik sampel usia 47,1 >70 tahun; diferensiasi histopatologik/skor gleason 42,9 buruk/>7, grade group 28,6 grade5 dan PSA 64,3 dalam rentang 11-100ng/ml. Ekspresi CgA berkorelasi negatif lemah dengan ekspresi AR epitel r=-0,288;p=0,016 . Ekspresi CgA tidak berkorelasi dengan ekspresi AR stromal p=0,886 . Terdapat hubungan bermakna ekspresi AR epitel dengan grade group p=0,003 . Tidak terdapat hubungan bermakna ekspresi AR epitel dengan usia, diferensiasi histopatologik/skor gleason dan PSA. Ekspresi CgA berhubungan bermakna dengan diferensiasi histopatologik/skor gleason dan grade group p=0,018;p=0,038 . Tidak terdapat hubungan bermakna ekspresi CgA dengan usia dan PSA. Ekspresi AR stromal tidak berhubungan bermakna dengan usia, diferensiasi histopatologik, grade group, skor gleason, maupun PSA.Kesimpulan : Terdapat korelasi yang lemah antara AR dan CgA sehingga pulasan AR dan CgA dapat dipakai untuk pemilihan terapi.

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ABSTRACT Background Prevalence of prostate adenocarcinoma doubled in 2001 2006 compared to 1995 2000 in RSCM. Many patients resistant to hormonal treatment. This resistance is thought to be due to tumor cells undergoing neuroendocrine transformation. Study will be conducted to analyze the expression of Androgen Receptor AR and Chromogranin A CgA in prostate adenocarcinoma at RSCM in 2011 2015. Objective To prove correlation of expression of AR and CgA with degree of malignancy. Methods A cross sectional study was carried out on 70 cases of prostate adenocarcinoma in department of Anatomic Pathology FKUI RSCM from 2011 2015. AR expressed in stromal and epithelial nuclei, CgA expressed in cytoplasm. Statistical tests used to discover significance and correlation between the dependent variables. Results Most samples are more than 70 years old 47,1 , has poor histologic gleason score 42.9 , are in clinical grade 5 28.6 , and has PSA score range between 11 100 ng ml. CgA expression negatively correlates to epithelial AR expression r 0,288 p 0.016 , while no correlation are found between CgA expression and stromal AR expression p 0.886 . There is significant difference between epithelial AR expression with grade group p 0.003 , but not with age, histopathologic differentiation Gleason score and PSA. There are significant difference between CgA expression and histopathologic differentiation grade group and Gleason score p 0.018 p 0.038 , but not with age and PSA. No significant difference observed between stromal AR expression with age, histopathologic differentiation gleason score, grade group or PSA. Conclusion There rsquo s a weak correlation between AR and CgA so that AR and CgA expression can be used for the selection of therapy. "

"Latar belakang: Kanker prostat merupakan tumor ganas terbanyak ketiga pria di dunia. Penyebabnya dipengaruhi faktor usia, genetik, ras, hormonal, diet dan lingkungan. Kanker prostat dapat mengalami Neuroendocrine Differentiation NED , meningkat pada kanker prostat berdiferensiasi buruk terutama yang tidak merespon baik terhadap terapi hormonal. NED akan menentukan prognosis dan pemilihan alternatif terapi.Tujuan: Mengetahui perbedaan ekspresi Chromogranin A CgA pada adenokarsinoma prostat berdiferensiasi baik, sedang dan buruk serta kaitannya dengan derajat keganasan berdasarkan grading tumor yang diharapkan dapat menentukan prognosis dan pemilihan alternatif terapi.Metode: Studi potong lintang terhadap jaringan biopsi yang difiksasi formalin, diletakkan dalam parafin dari pasien dengan adenokarsinoma prostat berdiferensiasi baik, sedang dan buruk. Sampel penelitian dipulas dengan pewarnaan imunohistokimia CgA, diidentifikasi dan dianalisa hubungan ekspresi CgA berdasarkan usia, diagnosis histopatologik, grade groups, skor Gleason dan kadar PSA.Hasil: Ekspresi CgA positif dengan median 40 0,4-100 banyak terjadi pada kelompok usia 7. Ekspresi CgA positif dengan median 35,4 0,4-88,6 banyak terjadi dengan kadar PSA > 52,4 ?g/ml. Didapatkan hubungan bermakna antara ekspresi CgA dengan diagnosis histopatologik, grade groups dan skor Gleason p = 0, 006;p = 0,021;p = 0,006 . Tidak didapatkan hubungan bermakna antara ekspresi CgA dengan usia dan kadar PSA p = 0,412;p = 0.969 . Kesimpulan: Terdapat kecenderungan positivitas ekspresi CgA lebih banyak terjadi pada kasus adenokarsinoma prostat berdiferensiasi buruk dengan grade tinggi, yang dapat mempengaruhi prognosis dan pemilihan alternatif terapi.Kata kunci: Ekspresi Chromogranin A, adenokarsinoma prostat, grade groups, skor Gleason.

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Background Prostate cancer is the third most common malignant tumor in men worldwide. Predisposing factors of prostate cancer are influenced by age, genetics, race, hormonal, diet and environment. Prostate cancer may undergo Neuroendocrine Differentiation NED , and it found to be increase in poorly differentiated type of prostate cancer, especially who do not respond well to hormonal therapy. NED will determine the prognosis and selection of therapeutic alternatives.Objective To determine differences in expression of Chromogranin A CgA in prostate adenocarcinoma well, moderately and poor differentiated and its relationship to the tumour grading, and its effect on determining prognosis and selecting therapeutic alternatives.Methods A cross sectional study conducted to formalin fixed paraffin embedded biopsy tissue that are taken from a patient with prostate adenocarcinoma well, moderately and poor differentiated. The sample are immunohistochemical stained with CgA, identified and analyzed. The reviewed and analized it rsquo s relationship to the parameter on age, histopathological diagnosis, grade groups, Gleason score and PSA level.Results Chromogranin A positive expression with median 40 0.4 100 was found in the age 7 of prostate adenocarcinoma. CgA positive expression with median 35.4 0.4 88, 6 was found with PSA level 52.4 g ml. There were a significant difference between CgA expression with histopathological diagnosis, grade groups and Gleason score p 0, 006 p 0.021 p 0.006 . There were no significant difference between CgA expression with age and PSA level p 0.412 p 0969 .Conclusion There is a statistically significant difference of CgA expression with histopathologycal diagnosis and grade groups of prostate adenocarcinoma that reflect a worse prognosis in CgA positive group among prostate adenocarcinoma, which will need alternative therapies beside widely used hormonal therapy.Keywords Expression Chromogranin A, prostate adenocarcinoma, grade groups, Gleason score."

"Pendahuluan: Penurunan kadar Zink (Zn) pada prostat berkorelasi dengan peningkatan skor Gleason adenokarsinoma prostat dan menyebabkan rendahnya Caspase-3 sebagai eksekutor apoptosis. Tingkat ekspresi transporter Zn pada sel tumor prostat berhubungan dengan tingkat keganasannya. ZnT-1 merupakan transporter Zn ke luar sel prostat, sedangkan ZIP-1 merupakan transporter Zn ke dalam sel prostat. Ekspresi ZIP-1 turun pada adenokarsinoma prostat. Korelasi ZnT-1, ZIP-1 dan Caspase-3 diduga berpengaruh dalam karsinogenesis prostat, sehingga berpotensi untuk menjadi faktor prognosis adenokarsinoma prostat. Tujuan: Mempelajari korelasi ekspresi ZnT-1 dan aktivasi Caspase-3 terhadap skor Gleason, menganalisis korelasi ekspresi ZIP-1, ZnT-1 dan aktivasi Caspase- 3, serta mengetahui profil ekspresi ZnT-1 pada jaringan adenokarsinoma prostat yang berbeda skor Gleason, dibandingkan dengan jaringan Benign Prostatic Hyperplasia (BPH). Desain: Studi retrospektif analitik potong lintang. Metode: Sampel penelitian ini adalah 31 blok parafin prostat yang dikelompokkan menjadi BPH, adenokarsinoma prostat skor Gleason ≤ 7 dan skor Gleason > 7. Ekspresi ZnT-1 dinilai dengan pulasan imunohistokimia. Data ekspresi ZIP-1 dan Caspase-3 merupakan data sekunder dari penelitian Septiawan et al. Hasil: Ekspresi ZnT-1 berkorelasi dengan skor Gleason adenokarsinoma prostat. Ekspresi ZIP-1 berkorelasi dengan aktivasi Caspase-3 pada adenokarsinoma prostat dan adenokarsinoma prostat skor Gleason ≤ 7. Ekspresi ZnT-1 berkorelasi dengan ekspresi ZIP-1 pada adenokarsinoma prostat skor Gleason > 7. Ekspresi ZIP-1 berkorelasi kuat dengan aktivasi Caspase-3 pada adenokarsinoma prostat skor Gleason 8. Ekspresi ZnT-1 pada adenokarsinoma prostat skor Gleason > 7 lebih rendah dibandingkan pada skor Gleason ≤ 7, tetapi tidak dapat dianalisis kemaknaan perbedaannya dengan BPH karena hanya diperoleh 1 sampel BPH pada penelitian ini. Kesimpulan: Transporter Zn berpotensi untuk menjadi faktor prognosis adenokarsinoma prostat.

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Background: Decreased levels of Zinc ( Zn ) in the prostate correlates with an increase in the grade Gleason score of prostate adenocarcinoma and decrease in Caspase-3 as apoptosis executor. Zn transporter expression levels in prostate tumor cells associates with the level of malignancy. The ZnT-1 is Zn exporter, while the ZIP-1 is Zn importer of prostate cells. ZIP-1 expression drops on adenocarcinoma prostate. Correlation ZnT-1, ZIP-1 and Caspase-3 allegedly influential in prostate carcinogenesis and potential to be prognostic factor of prostate adenocarcinoma.

Objective: To analyze the correlation ZnT-1 and Caspase-3 activation of the gleason score, to analyze the correlation of the expression of ZIP-1, ZnT-1 and Caspase-3 activation in adenocarcinoma prostate, and to study the profile expression of ZnT-1 in prostate adenocarcinoma with different grading of Gleason scores, compared with benign prostatic hyperplasia (BPH).

Design: A cross-sectional retrospective study analytic . Methodology: The sample is 31 paraffin blocks were grouped into BPH, prostate adenocarcinoma Gleason scored ≤ 7 and prostate adenocarcinoma Gleason scored > 7. Samples are analyzed expression of ZnT-1 by immunohistochemical staining. ZIP-1 and Caspase-3 expression is secondary data of Septiawan et al?s immunohistochemical staining.

Results: ZnT-1 expression correlated with gleason score. ZIP-1 correlated with the activation of Caspase-3 in prostate adenocarcinoma and prostate adenocarcinoma Gleason score ≤ 7. ZnT-1 correlated with ZIP-1 in prostate adenocarcinoma Gleason score > 7. ZnT-1 expression in prostate adenocarcinoma Gleason scored > 7 was lower than prostate adenocarcinoma Gleason score ≤ 7, but could not be analyzed the difference significance with BPH because there was only 1 BPH sample in this research.

Conclusion: Zn transporters have the potential to be a prognostic factor of prostate adenocarcinoma."