Pendahuluan: Karsinoma ovarium merupakan keganasan terbanyak ke-8 pada perempuan di dunia. Karsinoma ovarium serosum merupakan keganasan ginekologi yang paling mematikan dengan perjalanan penyakit yang berbeda antara masing-masing grade. Diduga perbedaan ini disebabkan oleh adanya faktor prognostik lain yang memengaruhi luaran penyakit. Salah satu yang memengaruhi luaran penyakit adalah respon imun. Banyak efektor imun yang mendukung perkembangan tumor dan blokade efektor imun yang menimbulkan destruksi imun. Sel tumor dapat lolos dari pengenalan sel imun dan menekan aktivitas antitumor yang dimediasi sel-T sehingga mendorong pertumbuhan tumor dan metastasis melalui modulasi immune checkpoint termasuk programmed death ligand-1 (PD-L1). Tujuan penelitian: Mengetahui karakteristik dan hubungan ekspresi PD-L1 dengan derajat diferensiasi dan densitas tumor infiltrating lymphocyte (TIL) di stroma pada karsinoma ovarium serosum. Metode: Penelitian ini merupakan penelitian observasional dengan pendekatan cross sectional. Sampel penelitian ini adalah kasus karsinoma ovarium serosum dari 3 laboratorium Patologi Anatomik di kota Padang tahun 2019-2020 sebanyak 45 kasus. Derajat diferensiasi dinilai berdasarkan grading WHO 2020 dan densitas TIL dinilai berdasarkan rekomendasi The International TILs Working Group. Dilakukan pulasan imunohistokimia untuk melihat ekspresi PD-L1. Analisis bivariat menggunakan uji Chi Square dengan nilai p<0,05 dianggap bermakna. Hasil: Sebagian besar karsinoma ovarium serosum merupakan derajat diferensiasi high grade (82,2%) dan densitas TIL stroma yang tinggi (60%). Pada derajat diferensiasi high grade ekspresi PD-L1 intratumoral tinggi lebih banyak (95,7%), dibandingkan ekspresi PD-L1 rendah (68,2%). Secara statistik terdapat hubungan yang bermakna antara ekspresi PD-L1 intratumoral dengan derajat diferensiasi pada karsinoma ovarium serosum (p=0,022). Tidak terdapat hubungan antara ekspresi PD-L1 dengan densitas TIL di stroma. Kesimpulan: Semakin tinggi ekspresi PD-L1 intratumoral semakin tinggi derajat diferensiasi namun tidak terdapat hubungan antara ekspresi PD-L1 dengan densitas TIL di stroma.
BackgroundEndometrial carcinoma is the fourth most common malignancy among women worldwide with increasing incidence and death rate every year. One of the types of endometrial carcinoma is endometrioid carcinoma, originated from atypical hyperplasia and develop into carcinoma. Lack of intercellular cohesiveness in the epithelial tumors such as endometrioid carcinoma occur due to lack of expression of E-cadherin. It can also causetumor invasion and metastatic through the epithelial-mesenchymal transition (EMT) process. Tumor differentiation and tumor budding are presumed to be histopathologic representations due to lack of cohesiveness and the occurrence of the EMT process so that these two things need to be related with the expression of E-cadherin on tumor cells.MethodsAn observational study was conducted using a cross-sectional approach with 46 cases of endometrioid endometrial carcinoma.Samples were obtained from 4 Anatomical Pathology Laboratories in West Sumatra during 2016-2019 in the form of paraffin blocks and HE slides that obtained from hysterectomy surgery. Reevaluation of tumor grade and tumor budding in HE slides was performed. E-cadherin expression in tumor cells was seen by immunohistochemical staining. Bivariate statistical analysis was performed using Fisher's Exact test and the results were considered significant if the p value was <0.05.ResultsSpecimens with negative E-cadherin expression were more common in grade 2 tumors (41.7%) and grade 3 tumors (50.0%) and in specimes with positive tumor budding (91.7%). Statistical analysis revealed a significant correlation between E-cadherin expression with tumor grade (p=0.000) and tumor budding (p=0.000).ConclusionExpression of E-cadherin has a significant correlation with the tumor grade and tumor budding in endometrioid endometrial carcinoma.
Peritoneal cytology is crucial in the diagnosis and staging of abdominal and pelvic malignancies. Diagnostic pitfalls can be avoided by having an understanding of the different methods of sampling, a familiarity with cytomorphology of the various specimen types, adequate clinical history, and an ability to prepare cell blocks and/or review other prior or concurrent specimens. Ovarian cancer is the second most frequent type of gynecological malignancy but the most lethal. While high-grade serous carcinoma is the most common histological subtype, mucinous carcinoma of the ovary (MCO) was believed to constitute around 4% of ovarian malignancies. It is critical to diagnose these rare tumors correctly to ensure proper treatment, avoid mortality, and preserve fertility for young women.
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