Hubungan Ekspresi Imunohistokimia CD20 dengan Derajat Infiltrasi Tumor-Infiltrating Lymphocytes (TILs) dan Grading Histologi Karsinoma Sel Skuamosa Kulit

Abstract

Latar Belakang. Tumor-infiltrating lymphocytes (TILs) merupakan salah satu faktor prognostik penting untuk berbagai tumor ganas, termasuk karsinoma sel skuamosa (KSS) kulit. TILs terdiri dari berbagai subset, yang dikelompokkan menjadi sel T dan sel B. Sel B merupakan kelompok sel imun yang jarang diteliti dan terabaikan dalam imunologi tumor selama bertahun-tahun. Peran sel B pada imunitas tumor masih menimbulkan pertentangan. Efek antitumor berasal dari fungsinya sebagai antigen presenting cells, pembunuhan sel secara langsung, produksi antibodi, peningkatan proliferasi sel T sitotoksik, migrasi dan berfungsinya sel dendritik, serta pembentukan struktur limfoid tersier. Akan tetapi, beberapa penelitian justru menunjukkan kemampuan sel B untuk menghambat respon sitotoksik sel T dan regresi tumor. Hal ini mungkin disebabkan oleh produksi tumor necrotizing factor-α dan interleukin-10. Peran sel B pada proses karsinogenesis dan perkembangan KSS kulit belum jelas dan penelitian tentang peran sel B pada KSS kulit masih sangat terbatas. Tujuan. Menganalisis hubungan ekspresi imunohistokimia CD20 dengan derajat infiltrasi TILs dan grading histologi KSS kulit. Bahan dan Metode. Penelitian analitik dengan pendekatan cross-sectional menggunakan slide dengan pewarnaan Hematoxyline&Eosin dan blok parafin penderita KSS kulit yang dipulas dengan pewarnaan imunohistokimia CD20. Analisis statistik dilakukan dengan uji Kruskal-Wallis untuk melihat hubungan ekspresi CD20 dengan derajat infiltrasi intratumoral dan stromal TILs serta grading histologi KSS kulit. Hasil. Berdasarkan analisis statistik Kruskal-Wallis terhadap 45 sampel KSS kulit dengan menguji hubungan ekspresi imunohistokimia CD20 terhadap derajat infiltrasi intratumoral TILs dan stromal TILs, diperoleh nilai p-value sebesar 0,479 dan 0,904 (p > 0,05) sedangkan hubungan ekspresi imunohistokimia CD20 terhadap grading histologi menunjukkan nilai p-value sebesar 0,091 (p > 0,05). Simpulan. Tidak terdapat hubungan bermakna antara ekspresi imunohistokimia CD20 dengan derajat infiltrasi intratumoral dan stromal TILs pada KSS kulit. Terdapat kecenderungan hubungan antara ekspresi imunohistokimia CD20 dengan grading histologi KSS kulit.

Background. Tumor-infiltrating lymphocytes (TILs) have been important prognostic factors for many malignancies, including cutaneous squamous cell carcinoma (cSCC). TILs are composed of many subsets, categorized into T-cells and B-cells. The tumor immune response of B-cells is poorly investigated and ignored for years. The role of B –cells in tumor immunology is still controversial. Antitumorigenic effects come from the ability to present antigen, kill the tumor cells directly, produce antibodies, increase cytotoxic T-cell proliferation, induce dendritic cells migration, and form the tertiery lymphoid structure. However, several studies precisely showed the ability of B-cells to inhibit the cytotoxic response of T-cells and tumor regression. These are probably due to the secretion of tumor-necrotizing factor-α and interleukin-10. The role of B-cells in carcinogenesis and tumor progression of cSCC is still unclear and studies about B-cells in cSCC are still limited. Objective. To analyze the correlation of immunohistochemical expression of CD20 with the level of TILs and histological grading of cSCC. Material and Methods. This is an analytical research with cross sectional approach using the slide stained with Hematoxylin&Eosin and the paraffine block from the patients diagnosed as cSCC which were cut and stained with the immunohistochemical staining of CD20. The statistical analysis with Kruskal-Wallis method is used to analyze the correlation of immunohistochemical expression of CD20 with the level of TILs and the histological grading of cSCC. Results. Based on the statistical analysis with Kruskal-Wallis method for 45 samples of the patients with cSCC to analyze the correlation of immunohistochemical expression of CD20 with the level of intratumoral TILs and stromal TILs, the p-value is 0,479 and 0,904 (p>0,05). The correlation of immunohistochemical expression of CD20 with the histological grading showed the p-value of 0,091 (p>0,05). Conclusion. There are not relation between the immunohistochemical expression of CD20 with the level of intratumoral TILs and stromal TILs at cSCC, but the expression CD20 tends to have a correlation with the histological grading of cSCC.