Hubungan Ekspresi Imunohistokimia Anaplastic Lymphoma Kinase (ALK) dengan Derajat Stromal Tumor Infiltrating Lymphocytes (sTILs) pada Adenokarsinoma Prostat

Abstract

Latar Belakang: Kanker prostat saat ini menempati urutan kelima penyebab kematian pada pria. Immunoterapi digunakan sebagai paradigma baru pengobatan prostat, dimana respon terapi ditujukan pada peran Tumor Infiltrating Lymphocytes (TILs). Ditemukannya fusi gen Anaplastic Lymphoma Kinase (ALK) pada beberapa jenis keganasan telah terbukti secara klinis menunjukkan respon target terapi yang efektif bagi penderita dengan ALK positif. Pada saat ini kombinasi terapi terus dikembangkan terutama pada kasus rekurensi dan metastasis, sehingga perlu dilakukan penelitian pada adenokarsinoma prostat. Tujuan: Untuk menganalisis hubungan ekspresi imunohistokimia ALK dengan derajat stromal TILs pada Adenokarsinoma Prostat. Metode: Blok paraffin dari 32 jaringan adenokarsinoma prostat digunakan untuk menilai derajat stromal TILs secara histopatologi dan pewarnaan imunohistokimia ALK. Hasil dianalisis menggunakan SPSS versi 22. Hasil dan Diskusi: ALK terekspresi pada 87,5% spesimen adenokarsinoma prostat. Tidak terdapat hubungan yang signifikan antara ekspresi imunohistokimia ALK dengan derajat Stromal TILs, namun terdapat kecenderungan bahwa grade group V menunjukkan persentase ekspresi yang luas dan intensitas yang kuat pada semua sediaan. Simpulan: Ekspresi ALK positif pada adenokarsinoma dengan high grade dapat dijadikan sebagai prognosis dan pilihan terapi pada adenokarsinoma prostat. Evaluasi subset TILs dapat diteliti lebih jauh lagi untuk dapat dinilai hubungan nya terhadap ekspresi ALK.

Background: Prostate cancer is currently the fifth leading cause of death in men. Immunotherapy is used as a new paradigm of prostate treatment, where the therapeutic response is aimed at the role of Tumor Infiltrating Lymphocytes (TILs). The discovery of Anaplastic Lymphoma Kinase (ALK) gene fusion in several types of malignancies has been clinically proven to demonstrate an effective therapeutic target response for patients with positive ALK. Currently, combination therapy continues to be developed, especially in cases of recurrence and metastasis, so it is necessary to research on prostate adenocarcinoma. Objective: To analyze the correlation of ALK immunohistochemical expression with the degree of stromal tumor infiltrating lymphocytes (sTILs) in prostate adenocarcinoma. Methods: Paraffin block of 32 prostate adenocarcinoma tissue was used to assess the stromal degree of TILs on histopatology and staining ALK immunohistochemistry. Results were analyzed using SPSS version 22. Results and Discussion: ALK was expressed in 87.5% of prostate adenocarcinoma specimens. There was no significant relationship between the immunohistochemical expression of ALK and the degree of stromal TILs, but there was a tendency that the grade group V showed a broad percentage of expression and strong intensity on all preparations. Conclusion: Positive ALK expression in adenocarcinoma with high grade can be used as a prognosis and a treatment option in prostate adenocarcinoma. The evaluation of the subset of TILs can be investigated further to assess its relationship to ALK expression.