Hubungan Polimorfisme Gen Reseptor Vitamin D APA1 dengan Kadar Vitamin D Plasma pada Penderita Kanker Payudara

Abstract

Latar belakang: Kanker payudara merupakan jenis kanker yang paling umum terdapat pada wanita di seluruh dunia. Statistik menunjukkan kanker payudara adalah penyebab kematian kedua setelah kanker paru.Vitamin D diyakini memiliki sifat anti karsinogenik secara independen efektif dalam melindungi dari kanker payudara,secara biologis vitamin D aktif, dapat menghambat proliferasi sel, induksi deferensiasi dan apoptosis serta menghalangi angiogenesis pada sel payudara normal dan maligna. Walaupun demikian multifaktor resiko ini termasuk defisiensi vitamin D masih terjadi kontroversi. Polimorfisme sering dihubungkan dengan tumorigenesis. Polimorfisme gen reseptor vitamin D ApaIdi intron VIII diduga berhubungan dengan defisiensipada kanker payudara. Tujuan: menganalisis hubungan polimorfisme gen reseptor vitamin D ApaI dengan kadar vitamin D plasma pada kanker payudara. Metode; berbentuk studi observasional analitik dengan desain cross sectional. Sebanyak 52 pasien kanker payudara rawat jalan di RSUP-HAM Medan dipilih sebagai subjek penelitian menggunakan tehnik consecutive sampling. Data polimorfisme diperoleh melalui pemeriksaan melalui metode PCR-RFLP mengunakan enzim restriksi endo nuclease ApaI dan pengujian kadar serum 25(OH)D menggunakan metode enzyme-linked immunoabsorbent assay (ELISA). Analisis data menggunakan uji statistik kruskal willis Hasil:Didapatkan semua varian genotip polimorfisme gen reseptor vitamin D ApaI yaitu AA (21,1%), Aa (51,9%) dan aa (26,9%). Sedangkan kadar vitamin D paling banyak ditemukan di kelompok sufisiensi (46,2%), insufisiensi (38,5%) dan defisiensi (15,4%).Simpulan: tidak terdapat hubungan yang signifikan antara polimorfisme gen reseptor vitamin D ApaI dengan kadar vitamin D plasma pada pasien kanker payudara (p value=0,072)

Background: Breast cancer is the most common type of cancer found in women throughout the world. Statistics show breast cancer is the second leading cause of death after lung cancer. Vitamin D is believed to have anti-carcinogenic properties independently effective in protecting against breast cancer, biologically active vitamin D, can inhibit cell proliferation, induction of differentiation and apoptosis and block angiogenesis in normal and malignant breast cells. However this multifactorial risk including vitamin D deficiency is still controversial. Polymorphism is often associated with tumorigenesis. The polymorphism of the ApaI vitamin D receptor gene in introns VIII is thought to be associated with deficiency in breast cancer.Objective: to analyze the relationship between the polymorphism of the ApaI vitamin D receptor gene and plasma vitamin D levels in breast cancer. Method; in the form of analytic observational study with cross sectional design. As many as 52 outpatient breast cancer patients in Medan-HAM General Hospital were selected as research subjects using consecutive sampling techniques. Polymorphism data obtained through PCR-RFLP examination using the ApaI nuclease endo enzyme and testing of serum 25 (OH) D levels using the enzyme-linked immunoabsorbent assay (ELISA) method. Data analysis using kruskal willis statistical test Results: All genotypic variants of the ApaI vitamin D receptor gene polymorphism were obtained (AA (21.1%), Aa (51.9%) and AA (26.9%). While the most vitamin D levels are found in the suficiency group (46.2%), insufficiency (38.5%) and deficiency (15.4%). Conclusion: there is no significant relationship between the polymorphism of the ApaI vitamin D receptor gene and plasma vitamin D levels in breast cancer patients (p value = 0.072)