Latar Belakang : Melanoma malignum (MM) merupakan tumor ganas yang berasaldari proliferasi sel melanosit dan dapat ditemukan pada kulit, mukosa dan okular. Angka mortalitas MM cukup tinggi, terutama pada stadium lanjut yang ditandai dengan metastasis. Metastasis MM dipengaruhi berbagai faktor risiko yang dapat berbeda pada MM kulit, mukosa dan okular, salah satunya yaitu proses imunologi tumor yang dapat dinilai dari Tumor Infiltrating Lymphocyte (TIL). Komponen TIL yang berperan dalam proses penghindaran sistem imun pada MM adalah sel T regulator dengan penanda yang paling spesifik sampai saat ini adalah Foxp3. Hubungan Foxp3 dengan stadium MM masih kontroversial dan sampai saat ini belum ada penelitian mengenai hubungan Foxp3 pada TIL dengan stadium MM di Indonesia. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan karakteristik klinikopatologik dan ekspresi Foxp3 pada TIL dengan stadium MM. Metode: Penelitian analitik pada sediaan MM di Departemen Patologi Anatomik FKUI/RSCM selama periode Januari 2010 hingga Desember 2021. Pengambilan sampel penelitian dilakukan secara total sampling dari kasus yang memenuhi kriteria inklusi sesuai perhitungan besar sampel untuk masing-masing kelompok. Pemeriksaan imunohistokimia menggunakan antibodi primer monoklonal Foxp3. Data imunoekspresi dianalisis untuk mengetahui hubungannya dengan stadium MM. Hasil: Didapatkan 54 kasus MM, 19 kasus diantaranya merupakan MM kulit, 29 kasus MM okular, dan 6 kasus MM mukosa. Mayoritas kasus (63%) merupakan stadium lanjut.Tebal tumor dan mitosis berhubungan dengan stadium klinis MM kulit dan keseluruhan.Jenis kelamin perempuan, tebal tumor >2 mm, mitosis >16/10 LPB, adanya invasi limfovaskular dan invasi perineural umumnya mempunyai ekspresi Foxp3 yang rendah.Pada MM kulit dan MM keseluruhan, ekspresi Foxp3 yang rendah ditemukan padastadium klinis lanjut meskipun tidak didapatkan hubungan yang signifikan.Kesimpulan: Tebal tumor dan mitosis berhubungan dengan stadium klinis MM kulit dan keseluruhan. Karakteristik klinikopatologik tidak berhubungan signifikan dengan ekspresi Foxp3
Background: Malignant melanoma (MM) is a malignant tumor originating fromproliferation of melanocyte cells and can be found in skin, mucosa and ocular. Themortality rate for malignant melanoma is quite high, especially at advanced stagecharacterized by metastases. Various risk factors can predispose MM into metastases,which can be different in cutaneous, mucosal and ocular MM, one of which is theimmunological process of the tumor which can be assessed from Tumor InfiltratingLymphocyte (TIL). TIL components that play a role in the process of avoiding the immunesystem in malignant melanoma are regulatory T cells, whose the most specific marker sofar is Foxp3. The association of Foxp3 with clinical stage of malignant melanoma is stillcontroversial and until now there has been no research on the association of Foxp3 inTIL with clinical stage of MM in Indonesia.Aims: This study aims to determine the association between clinicopathologicalcharacteristics and Foxp3 expression in TIL with MM clinical stage.Methods: Analytic study on malignant melanoma diagnosed at Anatomical PathologyDepartment FKUI/RSCM during January 2010 until December 2021. Sampling wascarried out by total sampling from cases that met the inclusion criteria according to thecalculation of the sample size for each group. Immunohistochemical examination usingFoxp3 monoclonal primary antibody. Immunoexpression data were analyzed todetermine its relationship with clinical stage of malignant melanoma.Result: There were 54 cases of MM: 19 cases were skin MM, 29 cases of ocular MM, and6 cases of mucosal MM. Majority of cases (63%) were in advanced stages. Tumorthickness and mitosis associated with clinical stage of cutaneous and overall MM. Femalegender, tumor thickness >2 mm, mitoses >16/10 HPF, presence of lymphovascularinvasion and perineural invasion generally had low Foxp3 expression. In cutaneous MMand overall MM, low Foxp3 expression was found at advanced clinical stage althoughno significant association was found.Conclusion: Tumor thickness and mitosis associated with clinical stage of cutaneous andoverall MM. Clinicopathological characteristic was not statistically significant withFoxp3 expression. Low Foxp3 expression was associated with advanced clinical stagealthough no statistically significant association was found. |
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