Hubungan Ekspresi Imunohistokimia Programmed Cell Death Ligand-1 (PD-L1) pada Melanoma Malignan dengan Karakteristik Klinikopatologi di RSUP Haji Adam Malik Medan

Abstract

Malignant melanoma is a potentially aggressive and lethal malignancy deriving from melanocytic cells. Although it comprises only 3% of all cutaneous malignancies diagnosed each year, malignant melanoma contributes to 75% of all skin cancer deaths. In the last decades, there have been advances in immune checkpoint inhibitor (ICPI) development in treating melanoma metastases. ICPI such as programmed cell death ligand-1 (PD L1) is primary membrane-bound protein expressed in dendritic cells and monocytes. Programmed cell death protein- 1 (PD-1) inhibitors or PD-L1 inhibitors will clinically improve treatment response and overall survival rates in many types of tumors. Nowadays, PD-L1 is being intensively used in cancer patient management revolution, especially in melanoma and non small cell lung cancer. Therefore, the researchers were interested in assessing the relationship between PD-L1 immunohistochemical expression and clinicopathology of malignant melanoma patients in General Hospital Haji Adam Malik Medan. Objective: To analyse the relationship between PD-L1 immunohistochemical expression and clinicopathology characteristics of malignant melanoma in General Hospital Haji Adam Malik Medan. Materials and Methods: A cross-sectional analytic study was performed using formalin-fixed tissue paraffin blocks from 18 skin cancer patients histopathologically diagnosed as malignant melanoma. Clinical data of patients (age, gender, tumor location) was acquired from medical record. Each slide was double blindly reevaluated by researcher and two pathologist. Tumor depth, tumor invasion and histopathological subtypes was evaluated. After that, each slide was stained with PD-L1 immunohistochemistry. Then, the relationship between PD-L1 immunohistochemical expression and clinicopathology characteristics of malignant melanoma was assessed and analyzed with statistical software by using the chi-square or Fisher’s exact test. Results and Discussion: In this study found that there are statistically significant relationship between the expression of PD-L1 with Breslow and tumor location in malignant melanoma (p value 0.045 and 0.013, respectively). Gadiot et al also discovered that there is significant correlation between PD-L1 expression with Breslow. Massi et al. stated that PD-L1 is a prognostic marker in melanoma. Based on multivariat analyses, found that Breslow-thickness is an independent risk factors for melanoma-specific death. High PD-L1 expression is often correlated with prognosis of malignant melanoma, and this prognosis is related with stage.