HUBUNGAN ANTARA HITUNG AgNOR DENGAN GRADING HISTOLOGI PADA KARSINOMA DUKTUS INFILTRATIF PAYUDARA

Abstract

Background.Argyrophilic nucleolar organizer regions (AgNOR) have been correlated with proliferative activity of neoplasms. Increased AgNOR may reflect increase proliferative activity of cells. To explore this hypothesis, 38 breast carcinoma ,infiltrating duct carcinoma type were process for AgNOR silver staining . AgNOR count were expressed as mean AgNOR/nucleus per 100 cel and percentage of tumor cell with five AgNOR/nucleus or more. The first count was designated mean AgNOR or mAgNOR, and the second count was designated AgNOR proliferative indeks or p_AgNOR. We correlated the AgNOR count with tumor histological grading. Methods. Tumor sample obtain from 38 patients who underwent surgery between 1999 and 2001 in Kariadi Hospital Semarang. The cases were classfied according to World Health Organization. All tumors were infiltrating duct carcinoma. Tumor grade was reevaluated by two observer, and established using the modified semikuntitative criteria of Bloom and Richardson. Two representative section with the same grade were recut for the AgNOR silver staining using the two above-mentioned count. Result. There were : 4 patients grade 1(01), 23 patients G2, and 11 patients G3. Using Spearman's rank statistical analysis, both count of AgNOR show a statistically significant correlation with histological grading. The mean AgNOR have a correlation degree 0,838 (P = 0.00) ; and pAgNOR counts have correlation degree 0,826 (P = 0.00) Conclusion. AgNOR count showed a statistically significant correlation with histoligical grade in invasive ductal carcinoma Key words : AgNOR, infiltraring duct carcinoma of the breast, proliferative activity, grading. Latar belakang AgNOR berhubungan dengan aktivitas proliferasi tumor. Bertambahnya jumlah AgNOR menunjukkan peningkatan aktivitas proliferasi. Untuk menggali hipotesa ini , kami melakukan pulasan AgNOR pada 38 sampel karsinoma duktus infiltratif payudara. Dilakukan 2 cara penghitungan AgNOR, yaitu hitung rerata AgNOR atau m AgNOR pada tiap inti per 100 sel , dan p AgNOR yaitu jumlah inti sel yang memiliki anak inti lima atau lebih per 100 sel. Dilakukan penghitungan korelasi antara hitung AgNOR dengan grading histologis. Metode. Diperoleh sebanyak 38 sampel pasien yang menjalani mastektomi di Rumah Sakit dokter Kariadi Semarang dari tahun 1999 hingga tahun 2001. Dilakukan penggolongan tumor menurut kriteria WHO. Semuanya dari jenis karsinoma duktus infiltratif Penilaian ulang grading tumor dilakukan oleh 2 orang peneliti, menggunakan metode semikuantitatif dari Bloom dan Richardson yang telah diperbaharui. Diambil 2 bagian potongan pada tiap sampel dengan grade sama untuk dipulas dengan pulasan AgNOR, dan dilakukan penghitungan dengan kedua cara tersebut di atas. Hasil . Didapatkan grade 1 (G1) sebanyak 4 sampel penderita, G2 23 sampel penderita, dan G3 11 sampel penderita. Pada uji statistik menggunakan ranking Spearman, didapatkan derajat korelasi antara grading dengan rerata AgNOR sebesar 0,838 (P = 0.00) dan dengan p AgNOR sebesar 0,826 (P = 0.00) Kesimpulan. Terdapat hubungan yang bermakna antara hitung AgNOR dengan grading pada Karsinoma duktus infiltratif payudara . Key words : AgNOR, infiltrating duct carcinoma of the breast, proliferative activity, grading.