Perbedaan Kadar Soluble ICAM1 Serum pada Pasien Kanker Payudara Stadium Dini dan Stadium Lanjut

Kanker payudara merupakan salah satu penyumbang terbesar morbiditas dan mortalitas pada wanita di seluruh dunia, khususnya di Indonesia merupakan penyebab kanker kedua setelah kanker serviks. Beberapa biomarker telah ditemukan dan digunakan dalam penegakkan diagnosis dan penentuan terapi kanker payudara, salah satunya adalah intercellular adhesion molecule 1 (ICAM1) yang diekspresikan oleh sel kanker payudara. Pemeriksaan ekspresi ICAM1 dengan berbagai metode misalnya messenger RNA (mRNA), flow-cytometry, western blotting, dan immunohistochemistry (IHC) telah dilakukan dengan sampel cell-lines maupun jaringan kanker payudara, didapatkan bahwa sel kanker dengan daya metastasis tinggi mengekspresikan ICAM1 yang lebih tinggi daripada sel non metastatik. Peningkatan kadar soluble ICAM1 (sICAM1) serum diharapkan sejalan dengan peningkatan stadium dari kanker payudara. Penelitian ini memiliki tujuan untuk melihat adanya perbedaan kadar sICAM1 serum pada pasien stadium dini dan lanjut sebelum pasien mendapatkan kemoterapi maupun radioterapi. Penelitian analitik observasional dengan desain potong lintang pada pasien kanker payudara dilakukan bulan Juli 2017 - Oktober 2017. Kadar sICAM1 serum diperiksa dengan menggunakan metode enzyme linked immunosorbent assay (ELISA). Kadar sICAM1 dianalisis sesuai stadium pasien kanker payudara menggunakan uji beda. Penelitian dengan total 37 subjek penelitian pasien kanker payudara, didapatkan median (min – max) kadar sICAM1 201,65 (44,3 – 534,3) ng/mL. Perbedaan kadar sICAM1 bermakna pada variabel ukuran tumor primer (T) (p = 0,045) dengan perbedaan signifikan pada T2 dengan T4 (p = 0,023). Variabel keterlibatan limfonodi (N), metastasis jauh (M) tidak menimbulkan perbedaan kadar sICAM1. Kadar sICAM1 pasien kanker payudara stadium dini lebih rendah dan berbeda signifikan (p = 0,019) dibandingkan pada pasien stadium lanjut. Pada penelitian ini didapatkan perbedaan yang sICAM1 yang signifikan antara pasien kanker payudara stadium dini dan stadium lanjut, sehingga sICAM1 serum dapat digunakan untuk mengevaluasi perkembangan dari kanker payudara. Kata kunci : kanker payudara, stadium kanker, sICAM1 seru

Detection of Disease-specific Fusion Genes of Soft Tissue Tumors Using Formalin-fixed Paraffin-embedded Tissues; Its Diagnostic Usefulness and Factors Affecting the Detection Rates

[Background] Recent rapid advances in molecular biology have led the discovery of disease-specific novel fusion genes in a variety of soft tissue tumors. In this study, we attempted to detect these fusion genes using formalin-fixed paraffin-embedded (FFPE) tumor tissues and investigated their clinical utility and factors that affect the results of examination. [Methods] Reverse transcription polymerase chain reaction for the detection of tumor-specific fusion genes was performed using 41 FFPE tumor samples obtained from 37 patients representing nine histological types of soft tissue tumors that were diagnosed from 2006 to 2017 in our laboratory. [Results] Fusion genes in 19 (51.3%) out of 37 cases were detected successfully. Relatively high detection rates were observed in synovial sarcomas (100%, 4/4) and alveolar rhabdomyosarcomas (75%, 3/4). The detection rates of fusion genes were inversely correlated with the storage period of FFPE blocks. Decalcification by Plank-Rychlo solution significantly affected detection rates of the internal control gene (P = 0.0038). In contrast, there was no significant difference in detection rates between primary and metastatic lesion, or biopsy and resection material, or presence and absence of treatment history. [Conclusion] In certain histological types, detection of disease-specific fusion genes of soft tissue tumors using FFPE tissues showed high sensitivity and thus had diagnostic utility. However, due to the diversity of fusion patterns and the low-quality of nucleic acid, the detection rate as a whole was sluggish and required further improvement. For factors affecting the detection results, our results suggested that it was impossible to detect fusion genes by decalcified FFPE tissues, but it may be not necessary to consider factors such as the type of specimen (biopsy or resection) and treatment history of the patients when selecting the FFPE tissues