Perbedaan Tampilan Imunohistokimia P63 antara Neoplasia Intraepitel Prostat dengan Adenokarsinoma Prostat

Abstract

Sometimes prostate adenocarcinoma especially well differentiated was very difficult to differentiate with prostate intraepithelial neoplasia by histopathology examination with hematoxylin eosine staining. To differentiate it needful more other accurate stain, as utilizes one of immunohistochemistry of basal cell markers such as p63. The purpose of this research is to prove distinctive of p63 immunohistochemistry expression among prostate intraepithelial neoplasia and prostate adenocarcinoma. This research constitute analytic descriptive research with design cross sectional. Observational sample contain 49 paraffin blocks of prostate tissue from TURP ( transurethral resection of prostate ) or surgical prostatectomy have been diagnosed by hematoxylin eosin's staining. This p63 immunohistochemistry assay has sensitivity 68%, specificity 75%, positive predictive value 74%, negative predictive value 69% and likelihood ratio + 2,72. It has significant difference of p63 expression among prostate intraepithelial neoplasia with prostate adenocarcinoma (p<0.05) which p63 expression in prostate intraepithelial neoplasia is more stronger. It has very significant correlation among aberrant p63 expression with Gleason score in prostate adenocarcinoma (p<0.001).

Kadangkala adenokarsinoma prostat terutama yang well differentiated sulit dibedakan dengan neoplasia intraepitel prostat secara histopatologi dengan pewarnaan hematoksilin eosin. Untuk membedakannya diperlukan pewarnaan lain yang lebih akurat, seperti menggunakan salah satu imunohistokimia petanda sel basal seperti p63. Tujuan penelitian ini adalah membuktikan adanya perbedaan tampilan imunohistokimia p63 antara neoplasia intraepitel prostat dengan adenokarsinoma prostat. Penelitian ini merupakan penelitian deskripsi analitik dengan rancangan cross sectional. Sampel penelitian sebanyak 49 blok paraffin jaringan prostat dari TURP (transurethral resection of prostate) atau surgical prostatectomy yang telah didiagnosa dengan pewarnaan hematoksilin eosin. Pemeriksaan imunohistokimia p63 ini memiliki sensitifitas sebesar 68%, spesifitas sebesar 75%, nilai prediktif positif sebesar 74%, nilai prediktif negatif sebesar 69% dan likelihood ratio + sebesar 2,72. Terdapat perbedaan tampilan p63 yang bermakna antara neoplasia intraepitel prostat dengan adenokarsinoma prostat (p<0.05) dimana p63 lebih tertampil pada neoplasia intraepitel prostat. Terdapat korelasi yang sangat bermakna antara tampilan aberrant p63 dengan Gleason score pada adenokarsinoma prostat (p<0.001).