Hubungan Imunoekspresi NF-kB dengan Sinus Rokitansky Aschoff pada Kolesistitis Kronik

Abstract

Karsinoma kandung empedu relatif jarang, tetapi merupakan penyakit yang sangat mematikan. Keganasan kandung empedu merupakan 3−4% dari seluruh lesi ganas dan menempati urutan ke-5 di antara tumor sistem pencernaan. Karsinoma kandung empedu sulit dideteksi dan didiagnosis pada stadium awal, karena biasanya gejalanya sangat sedikit atau tanpa gejala. Oleh karena itu sangat penting menegakkan diagnosis secara dini dan mendeteksi pasien risiko tinggi, termasuk batu dan riwayat kolesistitis kronik. Kolesistitis kronik merupakan peradangan kronik pada kandung empedu dan disertai kolelitiasis pada lebih dari 90% kasus. Batu empedu merupakan faktor etiologi yang penting pada karsinoma kandung empedu. Pada gambaran histopatologi kolesistitis kronik ditemukan sinus Rokitansky Aschoff. Pendekatan genetik telah membuktikan komponen inflamasi berperan dalam karsinogenesis, seperti primary inflammatory cytokines, interleukin-1 (IL-1), tumor necrosis factor (TNF), IL-6, dan nuclear factor-kappaB ( NF-kB). Tujuan penelitian ini untuk mengetahui hubungan imunoekspresi NF-kB dengan sinus Rokitansky Aschoff pada kolesistitis kronik. Metode penelitian adalah potong lintang terhadap 30 kasus kolesistitis kronik yang berasal dari Departemen Patologi Anatomi Rumah Sakit Dr. Hasan Sadikin Bandung/Fakultas Kedokteran Universitas Padjadjaran tahun 2010−2011. Potongan blok parafin dari jaringan kolesistitis kronik setebal 4 µm diwarnai dengan hematoksilin eosin untuk evaluasi gambaran histopatologi dan pemeriksaan imunohistokimia menggunakan polyclonal NF-kB antibody. Perhitungan sel yang imunoreaktif dilakukan di bawah mikroskop cahaya dengan pembesaran 400x, dihitung rata-rata pada 5 tempat. Hasil penelitian menunjukkan hubungan yang signifikan antara imunoekspresi NFkB dan sinus Rokitansky Aschoff (p=0,000). Simpulan, terdapat hubungan imunoekspresi NFkB dengan sinus Rokitanski Aschoff, semakin tinggi imunoekspresi NFkB semakin banyak sinus Rokitansky Aschoff. [MKB. 2014;46(2):106–11] Kata kunci : Kolesistitis kronik, NFkB, sinus Rokitansky Aschoff Correlation between Immunoexpression of NF-kB and Rokitansky Aschoff Sinuses in Chronic Cholecystitis Carcinoma of the gallbladder is relatively uncommon but it is a very lethal disease. Gallbladder cancer constitutes 3−4% of all malignant lesions and ranks 5th among the digestive system tumors. Gallblader carcinoma is difficult to detect and diagnose in early stage because it usually has very slight symptoms or asymptomatic. It becomes increasingly necessary to make early diagnosis and identification of high-risk patient,as well as gallstone and history of chronic cholecystitis. Chronic cholecystitis is a chronic inflammation of gallbladder associated with cholelithiasis in more than 90% of cases. Cholelithiasis is one of the important etiological factors in carcinoma of the gallbladder. The histological examination of chronical cholecystitis shows the presence of Rokitansky Aschoff sinuses. Genetic approaches have proven that the components of inflammation such as primary inflammatory cytokines, interleukin-1 (IL-1), tumor necrosis factor (TNF), IL-6 and nuclear factor-kB (NF-kB) play the key roles in carcinogenesis. The purpose of this study was to understand the correlation between the immunoexpression of NF-kB and Rokitansky Aschoff sinuses in chronic cholecystitis. The method was cross sectional of 30 cases of chronic cholecystitis from Department of Pathology Anatomy of Dr. Hasan Sadikin General Hospital Bandung/Faculty of Medicine Universitas Padjadjaran in 2010−2011. A section from 4 µm-thick paraffin embedded tissue of chronic cholecystitis was stained with hematoxylin eosin for histopatological evaluation and immunohistochemical using polyclonal NF-kB antibody. Immunoreactive cells was counted in five tumor areas of 400x field by light microscopy. The result showed a significant correlation between the immunoexpression of NFkB and Rokitansky Aschoff sinuses (p=0.000). In conclusion, there is a correlation between immunoexpression of NFkB and Rokitansky Aschoff sinuses because as the immunoexpression of NFkB increase, more Rokitansky Aschoff sinuses will be formed. [MKB. 2014;46(2):106–11] Key words : Chronic cholecystitis, NFkB, Rokitansky Aschoff sinuses   DOI :  10.15395/mkb.v46n2.282