Hubungan Ekspresi Fibroblast Growth Factor-2 (FGF-2) dengan Tumor Payudara Phyllodes Jinak, Borderline, dan Ganas

Abstract

Background: Phyllodes tumor is biphasic, because it is composed of neoplastic stromal cells and evolution containing epithelium. However, this stromal tumor is more cellular and increases. These tumors are far less common than fibroadenoma and de novo arising, and not from previous fibroadenoma tumors. The bad changes that are feared malignant are increased stromal cellularity, anaplasia, high mitotic activity, rapidly increasing tumor size, and infiltrative edges. The incidence of phyllodes tumors <1% of all breast neoplasms is 0.3-0.5%, with the most incidence occurring at the age of 30 to 40 years. Aim: This study was aimed to analyze the relationship of Fibroblast Growth Factor-2 (FGF-2) expression with benign, borderline, and malignant phyllodes tumours of the breast. Material and Methods: This is an observationl analytic study analyzes with cross sectional approach, involving 35 paraffin block samples from phyllodes tumours. In this study we FGF-2 in 35 samples, consist of 15 samples of benign phyllodes tumours, 8 samples of borderline phyllodes tumours, and 12 samples of malignant phyllodes tumours. The specimen of this study were embedded in paraffin and each section was cut from each block. Then immunohistochemistry FGF-2 staining were done. FGF-2 expression is identified by the presence of brownish granules colored in the stroma and tumour cells, based on the percentage of the area. The FGF-2 values obtained were analyzed using statistic software. Results: In benign phyllodes, 9 samples (60%) were weakly expressed, 5 samples (33,3%) were moderately expressed, and 1 sample (6,7%) was strongly expressed. In phyllodes borderline breast tumors, no sample were weakly expressed, 6 samples (75%) were moderately expressed, and 2 samples (25%) were strongly expressed. Whereas in malignant phyllodes breast tumours, 1 sample (8,3%) was weakly expressed, 3 samples (25%) were moderately expressed, and 8 samples (66,7%) were strongly expressed by FGF-2.

Latar Belakang: Tumor phyllodes bersifat bifasik, karena tersusun dari sel stroma neoplastik dan kelenjar yang dilapisi epitel. Namun, unsur stroma tumor ini lebih seluler dan berjumlah banyak. Tumor ini jauh lebih jarang dijumpai daripada fibroadenoma dan timbul de novo, dan bukan dari suatu tumor fibroadenoma sebelumnya. Perubahan buruk yang dikhawatirkan ganas adalah peningkatan selularitas stroma, anaplasia, aktivitas mitosis tinggi, ukuran tumor cepat meningkat, dan tepi yang infiltratif. Insidensi kejadian tumor phyllodes <1% dari seluruh neoplasma payudara yaitu 0,3-0,5%, dengan insidensi paling banyak terjadi pada usia 30 hingga 40 tahun. Tujuan : Untuk mengetahui hubungan ekspresi Fibroblast Growth Factor-2 (FGF-2) dengan tumor phyllodes payudara yang bersifat jinak, borderline, dan ganas. Bahan dan Metode: Penelitian ini merupakan studi potong lintang untuk menganalisis ekspresi FGF-2 pada 35 sampel, yang terdiri 15 sampel tumor phyllodes jinak, 8 sampel tumor phyllodes borderline, dan 12 sampel tumor phyllodes ganas. Sampel penelitian berupa blok parafin yang dipotong dan dilakukan pewarnaan immunohistokimia FGF-2. Ekspresi FGF-2 diidentifikasi dengan adanya granul kecoklatan yang terwarnai pada stroma dan sel tumor, berdasarkan persentase luas area. Nilai FGF-2 yang didapatkan dianalisis dengan perangkat lunak statistik. Hasil: Pada tumor phyllodes jinak didapati 9 sampel (60%) yang terekspresi lemah, 5 sampel (33,3%) terekspresi sedang, dan 1 sampel (6,7%) yang terekspresi kuat. Pada tumor payudara phyllodes borderline, tidak didapati sampel yang terekspresi lemah, 6 sampel (75%) yang terekspresi sedang, dan 2 sampel (25%) yang terekspresi kuat. Sedangkan pada tumor payudara phyllodes ganas didapati 1 sampel (8,3%) terekspresi lemah, 3 sampel (25%) terekspresi sedang, dan 8 sampel (66,7%) yang terekspresi kuat oleh FGF-2.