Latar belakang: Karsinoma sel hati (KSH) merupakan jenis keganasan primer hatitersering dengan gambaran histologik menunjukkan diferensiasi sel hepatoselular. Selaininsiden yang tinggi, beban yang berat dari keganasan ini adalah prognosis yang sangatburuk dengan angka rekurensi yang tinggi. Terdapat banyak faktor resiko secaraklinikopatologik yang telah diketahui mempengaruhi prognosis KSH, seperti kadar alfafetoprotein, derajat diferensiasi, dan invasi mikrovaskular. Secara molekular, mutasi p53dan β-catenin merupakan dua mutasi tersering dalam KSH. β-catenin merupakan proteinmultifungsi yang dikode oleh gen CTNNB1 yang dapat ditemukan pada 3 kompartemensel, yaitu di membran sel, sitoplasma dan inti. Jalur Wnt/β-catenin meregulasi prosesseluler yang terkait inisiasi, pertumbuhan, survival, migrasi, diferensiasi, dan apoptosis.Meski sudah banyak diketahui beberapa jalur patofisiologi molekularhepatokarsinogenesis, hubungan dengan aplikasi klinik membutuhkan pemahaman lebihmengenai hubungan sifat molekuler dan sifat fenotip tumor, terutama dalam penentuanfaktor prognosis dan pengembangan terapi target. Penelitian ini bertujuan untuk menilaiekspresi β-catenin pada KSH dan hubungannya dengan berbagai faktor prognosis yaituAFP, derajat diferensiasi dan invasi mikrovaskular.Bahan dan cara: Penelitian ini menggunakan desain potong lintang. Sampel terdiri atas35 kasus KSH yang sudah ditegakkan diagnosisnya berdasarkan pemeriksaanhistopatologik dan/atau imunohistokimia di RSCM dari Januari 2013 sampai September2019. Dilakukan pulasan β-catenin dan analisis statistik dengan uji komparatif terhadapberbagai karakteristik klinikopatologik dan faktor resiko berupa AFP, derajat diferensiasidan invasi mikrovaskular.Hasil: Terdapat perbedaan bermakna ekspresi β-catenin terhadap AFP (p=0,037) danderajat diferensiasi (p=0,043) pada KSH. Ekspresi β-catenin pada inti dengan/tanpasitoplasma lebih sering ditemukan pada kasus KSH dengan kadar AFP rendah dan derajatdiferensiasi baik-sedang. Tidak ditemukan perbedaan bermakna ekspresi β-cateninterhadap invasi mikrovaskular pada KSH (p=1,000).Kesimpulan: Terdapat perbedaan bermakna ekspresi β-catenin terhadap AFP dan derajatdiferensiasi pada KSH.
Background: Hepatocellular carcinoma (HCC) is the most common primary livercancer, displaying histologically hepatocellular differentiation. In addition to its highincidence, the disease burden of HCC is due to its poor prognosis with high recurrencerate. Some of the previously known clinicopathologic prognostic factors of HCC includealpha-fetoprotein (AFP) level, tumor grade and microvascular invasion. At molecularlevel, p53 and β-catenin are the two most common driver mutations in HCC that aremutually exclusive. β-catenin is a multifunction protein that is encoded by CTNNB1 gen.It is found in 3 compartments of cells, which are membrane cell, cytoplasm and nucleus.Wnt/ β-catenin pathway regulates cellular process which is related to initiation, growth,survival, migration, differentiation and apoptosis. Although molecular pathogenesispathways of hepatocarcinogenesis are known, clinical application warrants moreunderstanding in terms of molecular characteristic and tumor phenotype, especially indetermining prognosis and target therapy development. This current study aims to analyzethe expression of β-catenin and its association with prognostic factors, such as AFP,tumor grade and microvascular invasion.Material and method: A cross-sectional study was conducted comprising 35 samples ofsurgically resected HCCs between January 2013 to September 2019 in CiptoMangunkusumo General Hospital. The cases were diagnosed based on histopathologicaland immunohistochemical findings and was then performed β-catenin staining. β-cateninexpression was analyzed with statistical tests to determine expression difference betweenAFP level, tumor grade and microvascular invasion.Result: There were statistically significant difference of β-catenin expression in AFPlevel and tumor grade (p=0.037 and 0.043, respectively). Nuclear with/withoutcytoplasmic expression of β-catenin was more frequently found in HCC with low AFPlevel and well-to-moderately differentiated tumors. No significant difference wasobserved in β-catenin expression between HCC with and without microvascular invasion(p=1.000).Conclusion: β-catenin expression was significantly different in AFP level and tumorgrade. |
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