Hubungan Ekspresi Anaplastic Lymphoma Kinase (ALK) dengan Kekambuhan pada Adenokarsinoma Ovarium

Abstract

Introduction: Ovarian cancer is the 8th most common cause of death in women. Ovarian cancer often recurs and is rarely cured. Anaplastic lymphoma kinase (ALK) is a receptor tyrosine kinase whose function is to control cell proliferation and survival. As many as 2–4% of high-grade ovarian cancer patients show abnormal anaplastic lymphoma kinase (ALK) expression. If ALK+ inhibition is associated with improved clinical expression, The purpose of this study was to determine the relationship between ALK+ immunohistochemistry and recurrence in ovarian adenocarcinoma. Method: An observational study with a case control design was used. The study was conducted at H. Adam Malik General Hospital, Medan, in April 2022–May 2022. About 58 patients with inclusion and exclusion criteria were analyzed. The data was analyzed both univariate and bivariately using the chi square or Fischer exact test. P < 0.05 was deemed significant. Results: In 58 patients analyzed, 28 patients with relapsed ovarian adenocarcinoma and 28 patients with ovarian adenocarcinoma without recurrence were found with the most parity being multiparous (25%), and more menopausal status had experienced menopause (51.8%). In relapsed ovarian adenocarcinoma, 83.3% positive ALK expression was found. The results of the analysis using the Fisher Exact test showed a significant relationship between ALK expression and recurrence in ovarian adenocarcinoma (p<0.001). Conclusion: Relapsed ovarian adenocarcinoma found positive ALK expression and had a significant relationship between ALK + expression and relapsed.

Pendahuluan: Kanker ovarium merupakan penyebab kematian ke 8 dan terbanyak pada wanita Kanker ovarium sering mengalami kekambuhan dan jarang disembuhkan. Anaplastic lymphoma kinase (ALK) adalah reseptor tirosin kinase fungsinya dalah untuk mengontrol proliferasi dan ketahanan hidup sel. Sebanyak 2–4% pasien kanker ovarium derajat tinggi menunjukkan kelainan ekspresi Anaplastic Lymphoma Kinase (ALK) Jika inihbisi ALK+ dikaitkan dengan perbaikan ekspresi klinis. Adapun tujuan penelitian ini adalah untuk mengetahui hubungan imunohistokimia ALK+ dengan kekambungan pada adenokarsinoma ovarium. Metode: Studi observational dengan design case control. Penelitian dilakukan di RSUP H. Adam Malik Medan pada bulan April 2022 – Mei 2022. Sekitar 58 pasien dengan kriteria inklusi dan eksklusi yang dianalisis. Analisis data dilakukan secara univariat dan bivariat dengan menggunakan uji chi square atau fischer exact. P < 0.05 dianggap signifikan. Hasil: 58 pasien dianalisis didapati 28 pasien kelompok adenokarsinoma ovarium kambuh dan 28 pasien adenokarsinoma ovarium tanpa kambuh dengan paritas terbanyak multipara (25%), dan status menopause lebih banyak yang telah mengalami menopause (51.8%). Pada adenokarsinoma ovarium kambuh, ditemukan ekspresi ALK positif sebanyak 83.3%. Hasil analisis menggunakan uji Fisher Exact menunjukkan adanya hubungan yang bermakna antara ekspresi ALK dengan kekambuhan pada adenokarsinoma ovarium (p<0.001). Kesimpulan: Pada adenokarsinoma ovarium kambuh dijumpai ekspresi ALK positif dan memiliki hubungan signifkan antara ekspresi ALK + dengan adenokarsinoma kambuh.