Ekspresi Tinggi Androgen Receptor Sebagai Penentu Prognosis Adenokarsinoma Prostat di Sumatera Barat
Authors: Putriyuni Anandia , Nurwiyeni Nurwiyeni 
Published: December 2022

Abstrak Pendahuluan: Adenokarsinoma adalah jenis kanker prostat terbanyak didiagnosis sampai saat ini. Androgen receptor (AR) berperan penting dalam inisiasi, pertumbuhan dan progresifitas adenokarsinoma prostat, tetapi mekanisme AR masih belum jelas. Analisa ekspresi AR sebagai biomarker prognosis adenokarsinoma prostat belum pernah dilakukan di Sumatera Barat.  Tujuan penelitian: Untuk menganalisa ekspresi tinggi AR dalam penentuan prognosis adenokarsinoma prostat di Sumatera Barat. Metode: Rancangan penelitian analitik observasional dengan desain cross sectional. Penelitian dilakukan bulan November 2019 sampai Oktober 2020. Sampel digunakan sebanyak 56 kasus adenokarsinoma prostat secara consecutive sampling yang tersimpan di laboratorium Patologi Anatomik di Sumatera Barat. Slaid yang telah terwarnai hematoxyline dan eosin (HE) dan blok parafin dikumpulkan. Selanjutnya dilakukan review slaid untuk menentukan Gleason score berdasarkan International Society of Urological Pathology (ISUP) 2014/WHO edisi 2016. Metode pewarnaan imunohistokimia (IHK) pada AR untuk menganalisis ekspresi protein secara semikuantitatif. Ekspresi tinggi AR jika interpretasi yang ditemukan strong. Analisis data secara statistik menggunakan uji Chi-square. Hasil: Hasil penelitian mendapatkan kasus adenokarsinoma prostat terbanyak adalah high grade Gleason score (Gleason score 8-10) yaitu 43 (76,79%) kasus dan ekspresi tinggi AR 29 (51,80%) kasus. Adenokarsinoma prostat dengan high grade Gleason score ditemukan ekspresi tinggi AR lebih banyak dibandingkan ekspresi rendah AR. Secara statistik terdapat hubungan yang signifikan antara ekspresi tinggi AR dengan Gleason score (p=0,018). Kesimpulan: Ekspresi tinggi AR merupakan penanda penting untuk progresifitas tumor. Ekspresi AR sebaiknya diperiksa pada kasus adenokarsinoma prostat untuk menentukan prognosis pasien.Kata kunci -- Adenokarsinoma prostat, Androgen receptor, Gleason score, Prognosis     Abstract Introduction: Adenocarcinoma is the most type of prostate cancer diagnosed until now. Androgen receptor (AR) plays important roles in initiation, growth and progression of prostate adenocarcinoma. However, the mechanism of AR is unclear. Analysis of AR expression as the prognostic biomarker in prostate adenocarcinoma has never been done in West Sumatera. Aims: To analyze high AR expression in determining the prognosis of prostate adenocarcinoma in West Sumatera. Method: The observational analytic study was done with cross sectional design. This study was conducted from November 2019 to October 2020. Samples of 56 prostate adenocarcinoma were collected by consecutive sampling stored in Anatomical Pathology Laboratories in West Sumatera. Hematoxylin and eosin (HE) stained slides and paraffin blocks were retrieved. Slides were evaluated to review Gleason score based on the International Society of Urological Pathology (ISUP) 2014/WHO 2016. Immunohistochemistry (IHC) staining method with AR antibody was performed to discover protein expression semiquantitatively. High AR expression was characterized by strong interpretation. Statistical data analysis used Chi-square test. Results: The results showed that the most prostate adenocarcinoma was high grade Gleason score (Gleason score 8-10) in 43 (76.79%) cases and high AR expression in 29 (51.79%) cases. High grade Gleason score of prostate adenocarcinoma showed high AR expression more than low AR expression. There was statistically significant correlation between AR expression and Gleason score (p=0.018). Conclusion: High AR expression is the important marker of tumor progression. We suggest that AR expression should be performed in patients of prostate adenocarcinoma for prognosis.  Keywords -- Prostate adenocarcinoma, Androgen receptor, Gleason score, Prognosis