Hubungan Ekspresi Hypoxia Inducible Factor-1 Alpha dengan Derajat Histopatologi pada Pasien Astrositoma di RSUP H. Adam Malik Medan

Abstract

Latar Belakang : Hipoksia telah diakui sebagai fitur penting terkait mortalitas, metastase dan resistensi terhadap radioterapi sejak 1933. Hipoksia memainkan peran penting dalam angiogenesis dan pertumbuhan tumor ganas otak. Hipoksia dapat dideteksi dengan suatu penanda jaringan hipoksia yaitu Hypoxia Inducible Factor-1 Alpha. Hipoksia dan nekrotik pada GBM mempunyai alasan kuat bahwa hipoksia berperan dalam pertumbuhan GBM dan angiogenesis. Objektif : Tujuan penelitian ini untuk mengetahui hubungan ekspresi HIF-1α dengan derajat grading astrositoma berdasarkan derajat histopatologi WHO dan mortalitas pada penderita astrositoma. Metode : Penelitian ini merupakan penelitian cross sectional yang menggunakan metode penelitian analitik untuk mengukur ekspresi HIF-1α pada penderita astrositoma, dilanjutkan dengan analisa hubungan antara ekspresi HIF-1α dengan derajat histopatologi WHO di RSUP HAM dari Januari 2014 s/d Desember 2017 dengan jumlah sebanyak 37 subjek. Hasil : Dari penelitian didapat ekspresi HIF-1α lemah sebesar 16 (84%) yang hidup dan 3 (16%) yang meninggal, sedangkan ekspresi HIF-1α sedang sebesar 4 (40%) yang hidup dan 6 (60%) yang meninggal. Delapan (100%) dengan ekspresi HIF-1α negatif semuanya hidup. Berdasarkan klasifikasi didapat mayoritas astrositoma grade I memiliki ekspresi lemah sebesar 11 (65%) dan ekspresi sedang sebesar 0 (0%). Mayoritas astrositoma grade II memiliki ekspresi lemah sebesar 5 (72%) dan ekspresi sedang sebesar 1 (14%). Mayoritas astrositoma grade III memiliki ekspresi sedang sebesar 3 (60%) dan ekspresi lemah sebesar 1 (20%). Mayoritas astrositoma grade IV memiliki ekspresi sedang sebesar 5 (63%) dan ekspresi lemah sebesar 3 (37%). Kesimpulan : Pada penelitian ini didapatkan hasil korelasi positif yang signifikan antara ekspresi HIF-1α dengan derajat astrositoma berdasarkan WHO dan mortalitas. Kata Kunci : Ekspresi HIF-1α, grading astrositoma WHO, mortalitas ABSTRACT Background: Hypoxia has been accepted as important fiture associated with mortality, metastasis, and resistence to radiotherapy since 1933. Hypoxia plays an important role in angiogenesis and brain malignant tumor development. Hypoxia can be detected by using a hypoxia tissue marker called Hypoxia Inducible Factor-1 Alpha. Hypoxia and necrotic conditions in glioblastoma (GBM) present as marked reason explained that hypoxia plays a role in GBM development and angiogenesis. Objective: The aim of this study was to investigate the association between HIF1α expression and the grading system of astrocytoma based on WHO histological grading and mortality in astrocytoma patients Method: This was a cross sectional study using analytical method to measure HIF-1α expression in astrocytoma patients, followed by analysis of association between HIF-1α expression and WHO histological grading at Adam Malik General Hospital from January 2014 to December 2017 involved 37 patients. Results: This study found low HIF-1α expression as 16 (84%) in survived patients and 3 (16%) in dead patients, whereas moderate HIF-1α expression as 4 (40%) in survived patients and 6 (60%) in dead patients. All patients with negative HIF-1α 7 Universitas Sumatera Utara expression as 8 (100%) were survived. Based on classification we found that the majority of grade I astrocytoma had low HIF-1α expression as 11 (65%) and moderate HIF-1α expression as 0 (0%). The majority of grade II astrocytoma had low HIF-1α expression as 5 (72%) and moderate HIF-1α expression as 1 (14%). The majority of grade III astrocytoma had moderate HIF1α expression as 3 (60%) and low HIF-1α expression as 1 (20%). The majority of grade IV astrocytoma had moderate HIF-1α expression as 5 (63%) and low HIF1α expression as 3 (37%). Conclusion: This study found significant positive correlation btween HIF-1α expression and WHO histological grading of astrocytoma and mortality. Key Words: HIF-1α expression, WHO histological grading of astrocytoma, mortality.