Hubungan Ekspresi p38 MAPK (Mitogen Activated Protein Kinase) Terhadap Tipe Histopatologi Pada Penderita Karsinoma Nasofaring

Abstract

Background: Nasopharyngeal carcinoma (NPC) is a squamous cell carcinoma and is one of the most common malignancies in Indonesia with more than 13,000 new patients each year. p38 MAPK is reported to have a role in cellular processes such as proliferation, differentiation, migration and apoptosis which are important for inhibiting tumor growth in NPC. Objective: To identify the relationship between p38 MAPK expression and histopathological type in patients with nasopharyngeal carcinoma. Methods: This is an analytical study with 126 patients diagnosed with NPC based on history, physical examination, and histopathological biopsy in February - December 2019 at Haji Adam Malik General Hospital. The tissue was examined using immunohistochemistry under a fluorescence microscope to evaluate the immunoreactivity of the MAPK p38 antibody. The results were evaluated based on the immunoreactive score (≥4 considered as positive or p38 MAPK overexpression). Results: NPC was found mostly in the age group 41-60 years (57.1%), male (71.4%), non-keratinizing SCC (79.4%), and stage IV group (54.8%). In the immunohistochemical evaluation, most of the p38 MAPK was expressed in non-keratinizing SCC (81.0%), T3-T4 (97.1%), N3 (100%), and clinical stage III-IV (96.8%). Conclusion: There is a significant correlation between p38 MAPK expression and primary tumor size, neck lymph node enlargement and clinical stage, but there is no significant correlation between p38 MAPK expression and the histopathological type of NPC.

Latar belakang : Karsinoma nasofaring (KNF) adalah suatu karsinoma sel skuamosa dan merupakan salah satu keganasan yang paling sering di Indonesia dengan lebih dari 13.000 pasien baru per tahun. p38 MAPK dilaporkan memiliki peran dalam proses seluler seperti proliferasi, diferensiasi, migrasi dan apoptosis yang penting dalam inhibisi pertumbuhan tumor pada KNF. Tujuan : Untuk mengidentifikasi hubungan ekspresi p38 MAPK terhadap tipe histopatologi pada penderita karsinoma nasofaring. Metode : Ini adalah penelitian analitik dengan 126 pasien yang didiagnosis dengan KNF berdasarkan anamnesis, pemeriksaan fisik, dan biopsy histopatologi pada periode Februari - Desember 2019 di Rumah Sakit Umum Haji Adam Malik. Jaringan diperiksa menggunakan imunohistokimia di bawah mikroskop fluoresens mengevaluasi imunoreaksivitas antibodi p38 MAPK. Hasilnya dievaluasi berdasarkan skor imunoreaktif (≥4 dianggap positif atau overekspresi p38 MAPK). Hasil : KNF ditemukan paling banyak pada kelompok usia 41-60 tahun (57,1%), laki-laki (71,4%), non-keratinizing SCC (79,4%), dan kelompok stadium IV (54,8%). Dalam evaluasi imunohistokimia, sebagian besar p38 MAPK diekspresikan dalam non-keratinizing SCC (81,0%), T3-T4 (97,1%), N3 (100%), dan tahap klinis III-IV (96,8%). Kesimpulan : Terdapat korelasi yang signifikan antara ekspresi p38 MAPK dan ukuran tumor primer, ukuran pembesaran kelenjar getah bening leher serta stadium klinis, namun tidak terdapat hubungan yang signifikan antara ekspresi p38 MAPK dengan tipe histopatologi KNF.