Ramadhan, Rakhmad (2018) Hubungan Ekspresi Cluster Differentiation 133/Epithelial Cell Adhesion Molecule (CD133/EpCAM) sebagai Penanda Berbasis Sel Punca Kanker dan Serum Alpha Fetoprotein (AFP) pada Pasien Penyakit Hati Lanjut. Magister thesis, Universitas Brawijaya.
Abstract
Latar Belakang: Peningkatan kadar AFP serum seringkali terdapat pada pasien karsinoma sel hati (KSH) yang sudah dalam stadium lanjut. CD133 dan EpCAM merupakan penanda sel punca KSH yang terkait dengan onset, progresivitas, prognosis, dan luaran pasien KSH. Namun sampai saat ini penelitian sel punca KSH belum ada di Indonesia. Tujuan : Untuk mengetahui ekspresi penanda sel punca kanker CD133/EpCAM, dan AFP serta korelasi antara ekspresi sel punca kanker dengan kadar AFP serum pada pasien penyakit hati lanjut. Metode: Penelitian survei dengan pengambilan sampel secara potong lintang. Pada populasi pasien hepatitis B dan atau C kronik, dengan atau tanpa sirosis hati, atau KSH di RSUD dr. Saiful Anwar Malang. Pengukuran ekspresi CD133 dan EpCAM serum menggunakan metode flow cytometry. Pengukuran kadar AFP serum menggunakan metode ELISA. Analisis data menggunakan uji komparatif (Oneway ANOVA, T tidak berpasangan, Mann-Whitney, Chi-square, Kruskal-Wallis) dan uji korelatif (Pearson dan Spearman) dengan signifikansi bila p<0,05. Hasil: Subjek penelitian sebesar 44 subjek dominan laki-laki 33 subjek, terbagi dalam 3 kelompok yaitu 16 subjek hepatitis kronik, 15 subjek sirosis hati, dan 13 subjek KSH. Hasil rerata ekspresi sel punca kanker CD133+/EpCAM- dan AFP memiliki perbedaan yang bermakna (p=0,038; p=0,000). Analisis post hoc Mann- Whitney pada AFP memiliki perbedaan yang bermakna pada kelompok hepatitis kronis dan karsinoma sel hati, serta pada sirosis hati dan karsinoma sel hati (p=0,000; p=0,000). Korelasi antara ekspresi CD133+/EpCAM-, CD133-/EpCAM+, dan CD133+/EpCAM+ dengan kadar AFP serum memiliki perbedaan yang tidak bermakna (r=-0,262 p=0,086; r=0,195 p=0,204; r=0,059 p=0,706). Kesimpulan: Ekspresi CD133+/EpCAM- dan kadar AFP serum memiliki perbedaan yang bermakna pada derajat penyakit hati lanjut. Tidak ada korelasi antara ekspresi sel punca kanker dengan kadar AFP serum. Penelitian lanjutan diperlukan dengan subjek yang lebih homogen menilai sensitivitas, spesifisitas, progresi, dan luaran penyakit hati lanjut.
English Abstract
Background: Serum AFP levels enhancement are often present in hepatocellular carcinoma (HCC) patients who are already in an advanced stage. CD133 and EpCAM are markers of HCC stem cells expected to be early HCC markers associated with onset, progression, prognosis and outcome patient with HCC. However, HCC stem cell research has not been present in Indonesia. Objectives: The aims of the research is determining the expression of cancer stem cell markers CD133, EpCAM, AFP and correlation between cancer stem cell expression with serum AFP levels in patient with advanced liver disease. Methods: Survey research with cross sectional sampling. The population is chronic hepatitis B and/or C patients, with or without liver cirrhosis, or HCC in dr. Saiful Anwar General Hospital. Measurement of CD133 and EpCAM expression use flow cytometry method. Measurement of serum AFP level use ELISA methods. Data analysis use comparative test (Oneway ANOVA, unpair T-test, Mann-Whitney, Chi-square, Kruskal-Wallis) and use correlation test (Pearson and Spearman) with significance p<0,05. Results: These subject of the study were 44 subjects with male dominant (33 patients) devided into 3 groups: 16 chronic hepatitis subjects, 15 liver cirrhosis subjects, and 13 HCC subjects. The mean result of cancer stem cell CD133+/EpCAM- and AFP have significant difference (p=0,038, p=0,000). Post hoc analysis Mann-Whitney for AFP also has significant difference between chronic hepatitis group and hepatocellular carcinoma group, and between liver cirrhosis and hepatocellular carcinoma (p=0,000; p=0,000). Even post hoc analysis for CD133+/EpCAM- has no significant difference. There were no significant correlation between CD133+EpCAM-, CD133-EpCAM+, and CD133+EpCAM+ with serum AFP level (r=-0,262 p=0,086; r=0,195 p=0,204; r=0,059 p=0,706). Conclusions: Expression of CD133+/EpCAM- and serum AFP level has significant difference in grading of advanced liver disease. There is no significant correlation between cancer stem cell expression and serum AFP level. Further studies needed with more homogen subjects to evaluate sensitivity, specificity, progressivisity, and outcome in advance liver disease patient.
Other obstract
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| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | TES/616.362 4/RAM/h/2018/041810468 |
| Uncontrolled Keywords: | Sel Punca Kanker, CD133, EpCAM, AFP, Penyakit Hati Lanjut *Cancer Stem Cell, CD133, EpCAM, AFP, advanced liver disease |
| Subjects: | 600 Technology (Applied sciences) > 616 Diseases > 616.3 Diseases of digestive system > 616.36 Diseases of biliary tract and liver > 616.362 Diseases of liver /Liver--Diseases |
| Divisions: | Profesi Kedokteran > Spesialis Ilmu Penyakit Dalam, Fakultas Kedokteran |
| Depositing User: | Endang Susworini |
| Date Deposited: | 19 Jul 2022 07:47 |
| Last Modified: | 19 Jul 2022 07:47 |
| URI: | http://repository.ub.ac.id/id/eprint/192328 |
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