Ekspresi E-cadherin pada metastasis karsinoma …...ORLI Vol. 45 No. 1 Tahun 2015 Ekspresi...

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ORLI Vol. 45 No. 1 Tahun 2015 Ekspresi E-cadherin pada metastasis karsinoma nasofaring 27 ABSTRAK Latar belakang: Karsinoma Nasofaring (KNF) adalah keganasan dengan distribusi etnis dan JHRJUD¿V \DQJ NKDV .1) PHPLOLNL NDUDNWHULVWLN \DQJ EHUEHGD GDUL NDQNHU NHSDOD GDQ OHKHU ODLQQ\D VHSHUWL SHULODNX SHUWXPEXKDQ \DQJ FHSDW NHFHQGHUXQJDQ \DQJ WLQJJL XQWXN EHUPHWDVWDVLV NH NHOHQMDU JHWDK EHQLQJ .*% UHJLRQDO GDQ RUJDQ MDXK (FDGKHULQ PHPDLQNDQ SHUDQ SHQWLQJ GDODP SHPHOLKDUDDQ adhesi antar VHOVHO HSLWHO 3HUXEDKDQ PROHNXO DGKHVL VHO (FDGKHULQ \DQJ GLPHGLDVL ROHK VHOVHO NDQNHU EHUNRQWULEXVL XQWXN SHQLQJNDWDQ SHQ\HEDUDQ VHO WXPRU GDQ SHPEHQWXNDQ PHWDVWDVLV Tujuan: Untuk PHQJHWDKXL SHUEHGDDQ HNVSUHVL (FDGKHULQ SDGD .1) \DQJ WHODK EHUPHWDVWDVLV GHQJDQ .1) \DQJ EHOXP EHUPHWDVWDVLV Metode: 'HVDLQ SHQHOLWLDQ DGDODK VWXGL NDVXVNRQWURO 6XEMHN SHQHOLWLDQ DGDODK EORN SDUD¿Q GDUL SDVLHQ .1) \DQJ WHODK PHQMDODQL ELRSVL %ORN GDUL SDVLHQ .1) \DQJ WHODK EHUPHWDVWDVLV GLNDWHJRULNDQ VHEDJDL NHORPSRN NDVXV VHPHQWDUD \DQJ WLGDN EHUPHWDVWDVLV VHEDJDL NHORPSRN NRQWURO 6DPSHO GDUL NHGXD NHORPSRN GLSHULNVD GHQJDQ PHWRGH LPXQRKLVWRNLPLD ,+. PHQJJXQDNDQ DQWLERGL (FDGKHULQ Hasil: 6DPSHO EORN SDUD¿Q PDVLQJPDVLQJ NHORPSRN WHUGLUL GDUL EORN 7HUGDSDW SHUEHGDDQ \DQJ VLJQL¿NDQ HNVSUHVL (FDGKHULQ GHQJDQ p GDQ Odds Ratio 25 LQWHUYDO NHSHUFD\DDQ 7HUGDSDW SXOD KXEXQJDQ \DQJ VLJQL¿NDQ DQWDUD SHQXUXQDQ HNVSUHVL (FDGKHULQ GHQJDQ VWDWXV .*% OHKHU (p PHWDVWDVLV MDXK p GDQ VWDGLXP SHQ\DNLW p Kesimpulan: 7HUGDSDW SHUEHGDDQ \DQJ VLJQL¿NDQ DQWDUD HNVSUHVL (FDGKHULQ SDGD NHORPSRN .1) \DQJ WHODK EHUPHWDVWDVLV GLEDQGLQJNDQ NHORPSRN .1) \DQJ EHOXP EHUPHWDVWDVLV Kata kunci: .DUVLQRPD QDVRIDULQJ HNVSUHVL (FDGKHULQ PHWDVWDVLV ABSTRACT Background: Nasopharyngeal carcinoma (NPC) is a malignancy with distinct ethnic and geographical distribution. NPC has different characteristics from other head and neck cancers, such as rapid growth behavior, high propensity to metastasize to regional lymph nodes and distant organs. E-cadherin plays an important role in the maintenance of cell adhesion between epithelial cells. Changes in the cell adhesion molecule E-cadherin mediated by cancer cells contributes to increase in the spread of tumor cells and the formation of metastasis. Purpose: To determine the difference in the expression of E-cadherin between NPC that has metastasized and NPC that has not metastasized. Method: A FDVHFRQWURO VWXG\ 6XEMHFWV ZHUH SDUDI¿Q EORFNV IURP 13& SDWLHQWV ZKR KDG XQGHUJRQH ELRSV\ %ORFNV from NPC patients who had metastasized categorized as a group of cases, while not metastasized as a control group. Samples from both groups were examined using immunohistochemistry method (IHC) with antibody E-cadherin. Result: 6DPSOHV ZHUH SDUDI¿Q EORFNV HDFK JURXS FRQVLVWHG RI EORFNV 7KHUH ZDV D VLJQL¿FDQW GLIIHUHQFH EHWZHHQ WKH H[SUHVVLRQ RI ( FDGKHULQ ZLWK S DQG 2GGV 5DWLR 52 FRQ¿GHQFH LQWHUYDO WR 7KHUH ZDV DOVR D VLJQL¿FDQW FRUUHODWLRQ EHWZHHQ UHGXFHG H[SUHVVLRQ RI (FDGKHULQ ZLWK QHFN O\PSK QRGH VWDWXV S GLVWDQW PHWDVWDVLV S DQG VWDJH RI GLVHDVH S Conclusion: 7KHUH ZDV D VLJQL¿FDQW GLIIHUHQFH EHWZHHQ WKH H[SUHVVLRQV of E-cadherin in NPC that had metastasized with the NPC that had not metastasized. Keywords: Nasopharyngeal carcinoma, E-cadherin expression, metastasis Alamat korespondensi: &DPHOLD +HUGLQL %DJLDQ ,.7+7./ )DNXOWDV .HGRNWHUDQ 8QLYHUVLWDV *DGMDK 0DGD HPDLOFDPHOLDBKHUGLQL#\DKRRFRP Laporan Penelitian Ekspresi E-cadherin pada metastasis karsinoma nasofaring Taufiqurrahman*, Camelia Herdini*, Bambang Hariwiyanto*, Harijadi** 'HSDUWHPHQ 7HOLQJD +LGXQJ 7HQJJRURN %HGDK .HSDOD /HKHU )DNXOWDV .HGRNWHUDQ 8QLYHUVLWDV *DGMDK 0DGD5XPDK 6DNLW 'U 6DUGMLWR <RJ\DNDUWD %DJLDQ 3DWRORJL $QDWRPL )DNXOWDV .HGRNWHUDQ 8QLYHUVLWDV *DGMDK 0DGD 5XPDK 6DNLW 'U 6DUGMLWR <RJ\DNDUWD

Transcript of Ekspresi E-cadherin pada metastasis karsinoma …...ORLI Vol. 45 No. 1 Tahun 2015 Ekspresi...

ORLI Vol. 45 No. 1 Tahun 2015 Ekspresi E-cadherin pada metastasis karsinoma nasofaring

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ABSTRAKLatar belakang: Karsinoma Nasofaring (KNF) adalah keganasan dengan distribusi etnis dan

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Kata kunci:�.DUVLQRPD�QDVRIDULQJ��HNVSUHVL�(�FDGKHULQ��PHWDVWDVLV

ABSTRACTBackground: Nasopharyngeal carcinoma (NPC) is a malignancy with distinct ethnic and

geographical distribution. NPC has different characteristics from other head and neck cancers, such as rapid growth behavior, high propensity to metastasize to regional lymph nodes and distant organs. E-cadherin plays an important role in the maintenance of cell adhesion between epithelial cells. Changes in the cell adhesion molecule E-cadherin mediated by cancer cells contributes to increase in the spread of tumor cells and the formation of metastasis. Purpose: To determine the difference in the expression of E-cadherin between NPC that has metastasized and NPC that has not metastasized. Method: A FDVH�FRQWURO�VWXG\��6XEMHFWV�ZHUH�SDUDI¿Q�EORFNV�IURP�13&�SDWLHQWV�ZKR�KDG�XQGHUJRQH�ELRSV\��%ORFNV�from NPC patients who had metastasized categorized as a group of cases, while not metastasized as a control group. Samples from both groups were examined using immunohistochemistry method (IHC) with antibody E-cadherin. Result:�6DPSOHV�ZHUH����SDUDI¿Q�EORFNV��HDFK�JURXS�FRQVLVWHG�RI����EORFNV��7KHUH�ZDV�D�VLJQL¿FDQW�GLIIHUHQFH�EHWZHHQ�WKH�H[SUHVVLRQ�RI�(��FDGKHULQ�ZLWK�S�������DQG�2GGV�5DWLR��52������������FRQ¿GHQFH�LQWHUYDO�������WR�����������7KHUH�ZDV�DOVR�D�VLJQL¿FDQW�FRUUHODWLRQ�EHWZHHQ�UHGXFHG�H[SUHVVLRQ�RI�(�FDGKHULQ�ZLWK�QHFN�O\PSK�QRGH�VWDWXV��S���������GLVWDQW�PHWDVWDVLV��S ��������DQG�VWDJH�RI�GLVHDVH��S ��������Conclusion:�7KHUH�ZDV�D�VLJQL¿FDQW�GLIIHUHQFH�EHWZHHQ�WKH�H[SUHVVLRQV�of E-cadherin in NPC that had metastasized with the NPC that had not metastasized.

Keywords: Nasopharyngeal carcinoma, E-cadherin expression, metastasisAlamat korespondensi:�&DPHOLD�+HUGLQL��%DJLDQ�,.�7+7�./�)DNXOWDV�.HGRNWHUDQ�8QLYHUVLWDV�*DGMDK�0DGD��HPDLO�FDPHOLDBKHUGLQL#\DKRR�FRP

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Ekspresi E-cadherin pada metastasis karsinoma nasofaringORLI Vol. 45 No. 1 Tahun 2015

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.ULWHULD� LQNOXVL� SHQHOLWLDQ� LQL� DGDODK�SDVLHQ� \DQJ� WHUGLDJQRVLV� .1)�� PHPLOLNL�GDWD� OHQJNDS� GDQ� WHUGRNXPHQWDVL� SDGD�UHNDP� PHGLV� �KDVLO� LQWHUSUHWDVL� ELRSVL��CT scan�� 5RQWJHQ� WRUDNV�� 86*� DEGRPHQ�� GDQ�bone survey�� VHUWD�EHOXP�SHUQDK�PHQMDODQL�UDGLRWHUDSL�GDQ�NHPRWHUDSL��.ULWHULD�HNVNOXVL�DGDODK� SDVLHQ� .1)� GHQJDQ� EORN� SDUD¿Q�\DQJ� UXVDN� VHKLQJJD� WLGDN� GDSDW� GLODNXNDQ�SHPHULNVDDQ�,+.�

-DULQJDQ� KDVLO� ELRSVL� GL¿NVDVL� GHQJDQ�IRUPDOLQ� NHPXGLDQ� GLVLPSDQ� GDODP� EORN�SDUD¿Q��.XUDQJ�OHELK�GXD�VDPSDL�OLPD�SRWRQJ�MDULQJDQ� GHQJDQ� WHEDO� ���� ȝP� GLOHWDNNDQ�di deck glass� GDQ� GLNHULQJNDQ� SDGD� VXKX���o�&�VHODPD�VDWX�PDODP��NHPXGLDQ�GLFXFL�XQWXN�PHQJKLODQJNDQ�UHVLGX�SDUD¿Q�GHQJDQ�menggunakan xylene� GXD� NDOL� VHODPD� ���PHQLW� SDGD� VXKX���o &��GLODQMXWNDQ�GHQJDQ�

GHKLGUDVL�PHQJJXQDNDQ�ODUXWDQ�HWDQRO����������� GDQ� ����� 6HEHOXP� SHQJHFDWDQ�� deck glass� GLFXFL� PHQJJXQDNDQ� EXIIHU� 3%6��3HQJHFDWDQ�PDVLQJ�PDVLQJ� VHGLDDQ� VDPSHO�PHQJJXQDNDQ�DQWLERGL�(�FDGKHULQ��(NVSUHVL�(�FDGKHULQ� GLQLODL� GHQJDQ� KDVLO� SRVLWLI�DWDX� QHJDWLI�� 7LQJNDW� LPXQRUHDNWLYLWDV�(�FDGKHULQ� GLQLODL� VHFDUD� VHPLNXDQWLWDWLI�EHUGDVDUNDQ� LQWHQVLWDV� SHZDUQDDQ� GDQ�SURSRUVL� VHO� WXPRU� \DQJ� SRVLWLI�� 'L� EDZDK�PLNURVNRS�GHQJDQ�SHPEHVDUDQ������ ODSDQJ�SDQGDQJ�GLSLOLK�VHFDUD�DFDN�GL� OLPD� WHPSDW������ VHO� SHU� ODSDQJ� SDQGDQJ��� (NVSUHVL�(�FDGKHULQ� SRVLWLI� WHUOLKDW� SDGD� PHPEUDQ�PDXSXQ� SDGD� VLWRSODVPD� VHO� WXPRU� \DQJ�EHUZDUQD� NHFRNODWDQ�� 3HQLODLDQ� ,+.�GLODNXNDQ� VHSHUWL� \DQJ� GLODNXNDQ� ROHK�'HO�0XUR�HW�DO����HNVSUHVL�(�FDGKHULQ�SRVLWLI�MLND�UHUDWD� SHUVHQWDVH� HNVSUHVL� (�FDGKHULQ!����VHO� WXPRU�� VHGDQJNDQ� QHJDWLI� MLND� UHUDWD�SHUVHQWDVH�HNVSUHVL�(�FDGKHULQ������

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.DUDNWHULVWLN� VXEMHN� SHQHOLWLDQ�LQL� PHOLSXWL� MHQLV� NHODPLQ�� XPXU�� MHQLV�KLVWRSDWRORJL�� GDQ� VWDGLXP� SHQ\DNLW��+RPRJHQLWDV� VXEMHN� SHQHOLWLDQ� WHUFDQWXP�SDGD�WDEHO�����

Tabel 1. Karakteristik subjek penelitian

Karakteristik subjek Kasusn (%)

Kontroln(%)

Totaln(%)

Nilai p

1. Jenis kelamin �/DNL�ODNL��������3HUHPSXDQ

����������������

���������������

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2. Umur ������WDKXQ��������!���WDKXQ

����������������

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�����

3. Jenis histopatologi :+2�WLSH�,��������:+2�WLSH�,,��������:+2�WLSH�,,,

0��������������

0��������������

0��������������

�����

4. Stadium �6WDGLXP�,���������6WDGLXP�,,���������6WDGLXP�,,,���������6WDGLXP�,9

0���������������������

���������������������������

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ORLI Vol. 45 No. 1 Tahun 2015 Ekspresi E-cadherin pada metastasis karsinoma nasofaring

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5HUDWD� SHUVHQWDVH� VHO� WXPRU� \DQJ�WHUHNVSUHVL�GLKLWXQJ�GDUL�OLPD�ODSDQJ�SDQGDQJ�EHVDU��SHPEHVDUDQ����[��\DQJ�GLSLOLK�VHFDUD�DFDN� SHU� ���� VHO� WXPRU�� 6XEMHN� SHQHOLWLDQ�GHQJDQ� UHUDWD� SHUVHQWDVH� VHO� WXPRU� \DQJ�

WHUHNVSUHVL� !���� GLNDWHJRULNDQ� VHEDJDL�HNVSUHVL� (�FDGKHULQ� SRVLWLI�� VHGDQJNDQ�\DQJ� ����� GLNDWHJRULNDQ� VHEDJDL� HNVSUHVL�(�FDGKHULQ�QHJDWLI�

Tabel 2. Analisis ekspresi E-cadherin terhadap kelompok kasus dan kontrol

Ekspresi E-cadherin Kasusn (%)

Kontroln(%) Nilai p Odd Ratio

(IK 95%)Negatif ���������� �������� ������ ���������������������Positif �������� ����������

*bermakna p�����

3DGD� WDEHO� ��� HNVSUHVL� (�FDGKHULQ�SRVLWLI� GLWHPXNDQ� SDGD� ��� EORN� SDUDILQ�GDQ� HNVSUHVL� (�FDGKHULQ� QHJDWLI� VHEDQ\DN���� EORN� SDUDILQ� \DQJ� WHUEDJL� PHQMDGL� ���NHORPSRN��3DGD�NHORPSRN�NDVXV��VHEDQ\DN����EORN�SDUDILQ���������\DQJ�GLQLODL�VHEDJDL�HNVSUHVL�QHJDWLI�GDQ���EORN�SDUDILQ���������\DQJ�GLQLODL�HNVSUHVL�SRVLWLI��VHGDQJNDQ�SDGD�NHORPSRN�NRQWURO�KDPSLU�VHPXD�EORN�SDUDILQ���� �������� \DQJ� GLQLODL� VHEDJDL� HNVSUHVL�

(�FDGKHULQ�SRVLWLI�GDQ�KDQ\D����������\DQJ�GLQLODL�VHEDJDL�(�FDGKHULQ�QHJDWLI�

8QWXN�PHQJHWDKXL�KXEXQJDQ�SHQXUXQDQ�HNVSUHVL� (�FDGKHULQ� GHQJDQ� EHEHUDSD�JDPEDUDQ�NOLQLV�.1)�VHSHUWL�MHQLV�NHODPLQ��XPXU�� MHQLV� KLVWRSDWRORJL�� XNXUDQ� WXPRU��VWDWXV� .*%�� PHWDVWDVLV� MDXK�� GDQ� VWDGLXP�SHQ\DNLW� GLODNXNDQ� GHQJDQ� DQDOLVLV� x2 test NRPSDUDWLI� NDWHJRULN� WLGDN� EHUSDVDQJDQ��WDEHO����

Tabel 3. Hubungan ekspresi E-cadherin dengan beberapa gambaran klinis KNFEkspresi E-cadherin positif

n (%)Ekspresi E-cadherin negatif

n(%) Nilai p

Jenis kelamin��������/DNL�ODNL��������3HUHPSXDQ

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Jenis histopatologi��������:+2�WLSH�,,��������:+2�WLSH�,,,

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Ukuran tumor���������7��7�7��7�

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Status KGB������1��1�������1��1�

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Metastasis jauh M0������0�

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Ekspresi E-cadherin pada metastasis karsinoma nasofaringORLI Vol. 45 No. 1 Tahun 2015

'DUL� WDEHO� ��� WHUOLKDW� MXPODK� SDVLHQ�.1)� EHUMHQLV� NHODPLQ� ODNL�ODNL� OHELK�EDQ\DN� GDULSDGD� SHUHPSXDQ�� \DLWX� ODNL�ODNL�VHEDQ\DN����RUDQJ���������VHGDQJNDQ�SHUHPSXDQ� ��� RUDQJ� �������� GHQJDQ�UDVLR� ODNL�ODNL� �� SHUHPSXDQ� VHEHVDU� �������Dengan menggunakan x2 test�� WLGDN�WHUGDSDW� SHUEHGDDQ� \DQJ� VLJQLILNDQ� SDGD�MHQLV� NHODPLQ� DQWDUD� NHORPSRN� NDVXV� GDQ�NHORPSRN�NRQWURO�GHQJDQ�QLODL�p �������

8PXU�VXEMHN�SHQHOLWLDQ�WHUPXGD�DGDODK���� WDKXQ� GDQ� \DQJ� WHUWXD� DGDODK� ��� WDKXQ�GHQJDQ�UDWD�UDWD�XPXU����WDKXQ��.HORPSRN�XPXU� WHUEDQ\DN� DGDODK� ������ WDKXQ�VHEDQ\DN����RUDQJ����������'HQJDQ�x2 test WLGDN�GLGDSDWNDQ�SHUEHGDDQ�\DQJ�VLJQLILNDQ�SDGD� XPXU� DQWDUD� NHORPSRN� NDVXV� GHQJDQ�NHORPSRN�NRQWURO��p �������

-HQLV� KLVWRSDWRORJL� \DQJ� WHUEDQ\DN�SDGD� SHQHOLWLDQ� LQL� DGDODK� :+2� WLSH�,,,� �undifferentiated carcinoma��� \DLWX�VHEDQ\DN� ��� SDVLHQ� ��������� VHGDQJNDQ�:+2� WLSH� ,,� �non-keratinizing squamous cell carcinoma�� VHEDQ\DN� �� SDVLHQ� �������GDQ� WLGDN� GLGDSDWNDQ� MHQLV� KLVWRSDWRORJL�

:+2� WLSH� ,� �keratinizing squamous cell carcinoma���+DVLO�x2 test PHQXQMXNNDQ�WLGDN�WHUGDSDW� SHUEHGDDQ� VLJQLILNDQ� SDGD� MHQLV�KLVWRSDWRORJL�DQWDUD�NHGXD�NHORPSRN�GHQJDQ�nilai p �������

%HUGDVDUNDQ�VWDGLXP�SHQ\DNLW�SDGD�WDEHO���� GLGDSDWNDQ� �� SDVLHQ� ������� WHUGLDJQRVLV�.1)� SDGD� VWDGLXP� ,�� �� SDVLHQ� ��������VWDGLXP� ,,�� ��� SDVLHQ� �������� VWDGLXP�,,,�� GDQ� ��� SDVLHQ� �������� VWDGLXP� ,9��.HEDQ\DNDQ�SDVLHQ���������SDGD�SHQHOLWLDQ�LQL�GDWDQJ�NH�SROLNOLQLN�7+7�./�5683�'U��6DUGMLWR� WHUGLDJQRVLV� SDGD� VWDGLXP� ODQMXW��7LGDN� WHUGDSDW� SHUEHGDDQ� \DQJ� VLJQLILNDQ�SDGD� VWDGLXP� SHQ\DNLW� DQWDUD� NHORPSRN�NDVXV�GHQJDQ�NHORPSRN�NRQWURO�GHQJDQ�QLODL�p ������

3HQLODLDQ�HNVSUHVL�(�FDGKHULQ�GLODNXNDQ�ROHK�VHRUDQJ�DKOL�3DWRORJL�$QDWRPL�GHQJDQ�PHODNXNDQ�SHPHULNVDDQ�,+.�PHQJJXQDNDQ�DQWLERGL� (�FDGKHULQ�� HNVSUHVL� (�FDGKHULQ�SRVLWLI� WHUOLKDW� SDGD� PHPEUDQ� PDXSXQ�SDGD� VLWRSODVPD� VHO� WXPRU� \DQJ� EHUZDUQD�NHFRNODWDQ��JDPEDU����

�$� (B)

(C) (D)

Gambar 1.�(NVSUHVL�(�FDGKHULQ�SDGD�MDULQJDQ�ELRSVL�QDVRIDULQJ��$�GDQ�%��HNVSUHVL�(�FDGKHULQ��SDQDK�ZDUQD�PHUDK��WHUOLKDW�SDGD�KDPSLU�VHPXD�VHO�WXPRU��!������PDVLQJ�PDVLQJ�SDGD�SHPEHVDUDQ����[�GDQ����[�&�GDQ�'��SDQDK�ZDUQD�PHUDK��HNVSUHVL�(�FDGKHULQ�WHUOLKDW�KDQ\D�SDGD�VHEDJLDQ�NHFLO�VHO�WXPRU���������PDVLQJ�PDVLQJ�SDGD�SHPEHVDUDQ����[�GDQ����[�

ORLI Vol. 45 No. 1 Tahun 2015 Ekspresi E-cadherin pada metastasis karsinoma nasofaring

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5HUDWD� SHUVHQWDVH� VHO� WXPRU� \DQJ�WHUHNVSUHVL�GLKLWXQJ�GDUL�OLPD�ODSDQJ�SDQGDQJ�EHVDU��SHPEHVDUDQ����[��\DQJ�GLSLOLK�VHFDUD�DFDN� SHU� ���� VHO� WXPRU�� 6XEMHN� SHQHOLWLDQ�GHQJDQ� UHUDWD� SHUVHQWDVH� VHO� WXPRU� \DQJ�

WHUHNVSUHVL� !���� GLNDWHJRULNDQ� VHEDJDL�HNVSUHVL� (�FDGKHULQ� SRVLWLI�� VHGDQJNDQ�\DQJ� ����� GLNDWHJRULNDQ� VHEDJDL� HNVSUHVL�(�FDGKHULQ�QHJDWLI�

Tabel 2. Analisis ekspresi E-cadherin terhadap kelompok kasus dan kontrol

Ekspresi E-cadherin Kasusn (%)

Kontroln(%) Nilai p Odd Ratio

(IK 95%)Negatif ���������� �������� ������ ���������������������Positif �������� ����������

*bermakna p�����

3DGD� WDEHO� ��� HNVSUHVL� (�FDGKHULQ�SRVLWLI� GLWHPXNDQ� SDGD� ��� EORN� SDUDILQ�GDQ� HNVSUHVL� (�FDGKHULQ� QHJDWLI� VHEDQ\DN���� EORN� SDUDILQ� \DQJ� WHUEDJL� PHQMDGL� ���NHORPSRN��3DGD�NHORPSRN�NDVXV��VHEDQ\DN����EORN�SDUDILQ���������\DQJ�GLQLODL�VHEDJDL�HNVSUHVL�QHJDWLI�GDQ���EORN�SDUDILQ���������\DQJ�GLQLODL�HNVSUHVL�SRVLWLI��VHGDQJNDQ�SDGD�NHORPSRN�NRQWURO�KDPSLU�VHPXD�EORN�SDUDILQ���� �������� \DQJ� GLQLODL� VHEDJDL� HNVSUHVL�

(�FDGKHULQ�SRVLWLI�GDQ�KDQ\D����������\DQJ�GLQLODL�VHEDJDL�(�FDGKHULQ�QHJDWLI�

8QWXN�PHQJHWDKXL�KXEXQJDQ�SHQXUXQDQ�HNVSUHVL� (�FDGKHULQ� GHQJDQ� EHEHUDSD�JDPEDUDQ�NOLQLV�.1)�VHSHUWL�MHQLV�NHODPLQ��XPXU�� MHQLV� KLVWRSDWRORJL�� XNXUDQ� WXPRU��VWDWXV� .*%�� PHWDVWDVLV� MDXK�� GDQ� VWDGLXP�SHQ\DNLW� GLODNXNDQ� GHQJDQ� DQDOLVLV� x2 test NRPSDUDWLI� NDWHJRULN� WLGDN� EHUSDVDQJDQ��WDEHO����

Tabel 3. Hubungan ekspresi E-cadherin dengan beberapa gambaran klinis KNFEkspresi E-cadherin positif

n (%)Ekspresi E-cadherin negatif

n(%) Nilai p

Jenis kelamin��������/DNL�ODNL��������3HUHPSXDQ

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ORLI Vol. 45 No. 1 Tahun 2015 Ekspresi E-cadherin pada metastasis karsinoma nasofaring

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proliferatinglymphoblastoid cell� VHFDUD�WHUXV� PHQHUXV� GHQJDQ� PHQJHNVSUHVLNDQ� ��SURWHLQ�latent�YLUXV��\DLWX���nuclear antigen ((SVWHLQ�%DUU� 1XFOHDU� $QWLJHQ� �(%1$���������$�� ��%���&�� GDQ�/3�� GDQ� �� SURWHLQ�PHPEUDQ�/03�����$��GDQ��%����

/03�� PHUXSDNDQ� SURWHLQ� PHPEUDQ�\DQJ� WHUGLUL� GDUL� GRPDLQ� SHQGHN� 1+2�terminal��HQDP�GRPDLQ� WUDQVPHPEUDQ��GDQ�200 asam amino domain COOH-terminal��.HEDQ\DNDQ�signal�/03��GLEDWDVL�COOH-Terminal Activation Region� �&7$5��� \DQJ�NHPXGLDQ� GLEDJL� ODJL�PHQMDGL� GXD� GRPDLQ�XWDPD�� &7$5�� GDQ� &7$5��� &7$5��berhubungan dengan Tumor Necrosis Factor �71)��Receptor Associated Factor Proteins �75$)��� VHGDQJNDQ� &7$5�� EHULQWHUDNVL�GHQJDQ� 71)� Receptor Associated Death Domain Protein� �75$''��� &7$5�� GDQ�&7$5�� PHPHGLDVL� MDOXU� 1)ț%� GDQ� S���Mitogen Activated Protein Kinase�0$3.���3DGD� &7$5��� NKXVXVQ\D� DVDP� DPLQR� ��WHUDNKLU� �<<'��� PHUXSDNDQ� ORNDVL� NXQFL�/03��PHPLFX�DNWLYLWDV�$3���PHODOXL�MDOXU�F�-XQL�1+��WHUPLQDO�NLQDVH��-1.����

.HPDPSXDQ� PLJUDVL� /03�� \DQJ�WLQJJL� EHUKXEXQJDQ� GHQJDQ� HNVSUHVL�(�FDGKHULQ�\DQJ�PHUXSDNDQ�PROHNXO�DGKHVL�DQWDU� VHO� \DQJ� VHULQJ� KLODQJ� SDGD� EHUEDJDL�NDQNHU� WHUPDVXN�.1)���� +LSHUPHWLODVL� JHQ�(�FDGKHULQ���PHQ\HEDENDQ��HNSUHVL��(�FDGKHULQ���PHQXUXQ� GHQJDQ� PHPDFX� DNWLYDVL� '107�ROHK� /03����� '107� PHQJXEDK� VWUXNWXU�kromatin dengan menambahkan gugus PHWLO� SDGD� VLWRVLQ� &S*� dinucleotides��0HWLODVL� &S*� islands� \DQJ� WHUOHWDN� GL�GDODP� SURPRWHU� GDQ� SURNVLPDO� HNVRQ�JHQ� PHQ\HEDENDQ� WHUMDGLQ\D� SHUHNUXWDQ�IDNWRU� SURWHLQ� WDPEDKDQ� VHSHUWL� methyl�&S*� binding proteins dan transcriptional repressors�� VHKLQJJD� JHQ� VXOLW� PHQJDNVHV�IDNWRU�WUDQVNULSVL��GDQ�DNKLUQ\D�WHUMDGL�gene silencing��5HJXODVL�GDHUDK�WUDQNULSVL�'107�WHUGLUL�GDUL���SURPRWHU��3���3���3���GDQ�3����3�� DGDODK� SURPRWRU� XWDPD� \DQJ� WHUOHWDN�SDGD�&*�rich���

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3DGD� WDEHO� �� PHQXQMXNNDQ� DGDQ\D�KXEXQJDQ�WHUEDOLN�DQWDUD�HNVSUHVL�(�FDGKHULQ�GHQJDQ� NHMDGLDQ� PHWDVWDVLV�� (NVSUHVL�(�FDGKHULQ� QHJDWLI� PHPLOLNL� KXEXQJDQ�\DQJ�VLJQLILNDQ�GHQJDQ�NHMDGLDQ�PHWDVWDVLV�SDGD�SDVLHQ�.1)�GHQJDQ�QLODL�S��������+DO�LQL� PHQXQMXNNDQ� EDKZD� JDQJJXDQ� DGKHVL�DQWDU� VHO� \DQJ� GLPHGLDVL� ROHK� (�FDGKHULQ�GDSDW�PHQ\HEDENDQ� OHSDVQ\D� VHO�VHO� WXPRU�GDUL� WXPRU� SULPHU� \DQJ� VHPXOD� GLLNDW� ROHK�(�FDGKHULQ� VHKLQJJD� GDSDW� PHQ\HEDENDQ�PHWDVWDVLV�

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'DUL� WDEHO� �� GDSDW� GLNHWDKXL� WLGDN�WHUGDSDW� KXEXQJDQ� \DQJ� VLJQLILNDQ� DQWDUD�SHQXUXQDQ�HNVSUHVL�(�FDGKHULQ�GHQJDQ�MHQLV�kelamin (p �������� XPXU� �p �������� GDQ�

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Ekspresi E-cadherin pada metastasis karsinoma nasofaringORLI Vol. 45 No. 1 Tahun 2015

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ORLI Vol. 45 No. 1 Tahun 2015 Ekspresi E-cadherin pada metastasis karsinoma nasofaring

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