Hubungan Ekspresi Sex Determining Region Y Box 2 (SOX2) dengan Grading Histopatologi, Invasi Vaskular Intramural dan Ekstramural pada Adenokarsinoma Kolorektal

Abstract

Background: The incidence and mortality of colorectal carcinoma (CRC) worldwide varies widely (up to 10 times). Colorectal carcinoma ranks third in the world and is the most common cause of death in the world. Ninety percent of colorectal malignancies are adenocarcinomas. The sex determining region Y box 2 (SOX2) is a protein encoding 317 amino acids and belongs to the SOX family of transcription factors (SRY-related high mobility group box). Immunohistochemical expression of SOX2 is associated with high tumor grade, invasion, metastasis as well as a prognostic predictor of colorectal adenocarcinoma. Objective: To analyze the relationship of SOX2 immunohistochemistry expression with histopathological grading, intramural and extramural vascular invasion in colorectal adenocarcinoma. Materials and Methods: 35 samples in the form of histopathological slides from surgical tissue diagnosed with colorectal adenocarcinoma, reviewed slides and assessed for grading and intramural and extramural vascular invasion by the researcher and two anatomic pathologists, then performed immunohistochemical staining of SOX2 and assessed for expression and then analyzed correlation between variables using the Chi-square and Mann-Whitney correlation test. Results: Based on the Chi-square correlation test, there was no significant relationship between SOX2 expression and grading (p= 0.884) and the Mann-Whitney correlation test showed no significant relationship between SOX2 expression and vascular invasion, both intramural and extramural (p= 0.390). Conclusion: SOX2 expression can be used as an additional prognostic factor in the management of colorectal adenocarcinoma patients and may be used for other targeted therapies.

Latar Belakang: Angka kejadian dan kematian karsinoma kolorektal (KKR) di seluruh dunia sangat bervariasi (mencapai 10 kali lipat). Karsinoma kolorektal menempati urutan ketiga terbanyak di dunia serta merupakan penyebab kematian terbanyak di dunia. Sembilan puluh persen keganasan pada kolorektal adalah jenis adenokarsinoma. Sex determining region Y box 2 (SOX2) merupakan pengkodean protein terdiri dari 317 asam amino dan termasuk dalam famili SOX faktor transkripsi ( SRY- related high mobility group box). Ekspresi imunohistokimia SOX2 dikaitkan dengan tumor high grade, invasi, metastasis serta prediktor prognostik pada adenokarsinoma kolorektal. Tujuan: Menganalisis hubungan ekspresi imunohistokimia SOX2 dengan grading histopatologi, invasi vaskular intramural dan ekstramural pada adenokarsinoma kolorektal. Bahan dan Metode: 35 sampel berupa slaid histopatologi dari jaringan operasi yang didiagnosis adenokarsinoma kolorektal, dilakukan review slide dan di nilai grading dan invasi vascular intramural dan ekstramural oleh peneliti dan dua orang ahli Patologi Anatomik, kemudian dilakukan pewarnaan imunohistokimia SOX2 serta dinilai ekspresinya kemudian di analisis korelasi antar variable menggunakan uji korelasi Chi-square dan Mann-Whitney. Hasil: Berdasarkan uji korelasi Chi-square tidak terdapat hubungan yang signifikan ekspresi SOX2 dengan grading (p= 0,884) dan uji korelasi Mann-Whitney tidak terdapat hubungan yang signifikan antara ekspresi SOX2 dengan invasi vascular baik intramural maupun ekstramural (p= 0,390). Simpulan: Ekspresi SOX2 dapat dijadikan salah satu faktor prognosis tambahan dalam tatalaksana pasien adenokarsinoma kolorektal dan kemungkinan untuk terapi target lainnya.