Hubungan Igg(Igg1 Dan Igg2) Dengan Stadium Dalam Penanggulangan Karsinoma Payudara

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THE CORRELATION OF IgG (lgG1

and IgG2)

AND THE

STAGING IN THE MANAGEMENT

OF BREAST CANCER

ABSTRACT

In

breast cancer the stage ( TNM ) determines the treatment as well as the

prognosis. The transformation of a normal cell to a malignancy can result that the

tumors express the antigens ( unique tumor-specific antigens

and

tumors

associated antigens ) which permit the immunologic reaction. Serologic analysis

of

antibody

responses (lgG

and

subclasses) may be much more common.

The objective of the study is

1. to analyse whether

there is a relationship between the stages and the

shift of the concentration of IgG in the peripheral blood

2. to analyse whether the shift of the concentration of IgG is followed by the

shift of the concentration of IgG subclasses ( IgG1 and IgG2 )

3. to analyse whether there is a correlation between the shift of fgG

concentration and the shift of the subclasses concentration

4. to analyse whether the shift can be applied clinically

57 women age 25-79 years from September 2001 untill March 2003, who were

newly diagnosed with breast cancers ( 18 early stages, 22 locally advanced and

17 metastasic breast cancers) were examined

for the association

of the

concentrations of the IgG,IgG1 and IgG2 in the peripheral blood and the stages

of the tumors. All

blood were collected and allowed to clot following

centrifugation of 3000 rpm at room temperature. All sample were stored at - 40

C temperature until use. For the determination of IgG and the SUbclasses,

commercially available RID plates from the binding sites were used. 20 healthy

women were taken as control.

The result of the study shows

the mean concentration

of

IgG and

IgG1 between the stages and the control group are statistically different,( p<

0.005 and p< 0.05 ) but not with the mean concentration of IgG2. There is a

strong positive correlation between the shift of the concentration of JgG and IgG1

( r= 0.9 ) and a weak positive

correlation between

the shift of the mean

concentration of IgG and IgG2 ( r=0.3 ). The Cut off point of IgG between the

healthy control and the cancer patient is 12.8

mg/ml

(sensitivity 75

%,

spesificity

79

%),

the cut off point of IgG1 between the operable and the non- operable is

8.21 mglml ( sensitivity 60

%,

spesificity 61

%),

the cut off point of IgG2 between

the operable and the non-operable is 5.5 mglmJ ( sensitivity 70

%,

spesificity 71

%)

The analysis of IgG, IgG1 and IgG2 may significantly contribute to the

immunodiagnosis of patient with breasr cancer,

Key words. Cancer management. IgG, IgG1 and IgG2

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HUBUNGAN IgG ( IgG1 dan IgG2) DENGAN

STADIUM DALAM PENANGGULANGAN

KARSINOMA PAYUDARA

ABSTRAK

Pada

karsinoma

payudara

(KPD)

stadium

menentukan

bentuk

penanggulangan dan prognose. Perobahan sel normal menjadi sel maligna

menyebabkan terjadinya perobahan sel maligna mengekspressikan antigen (

tumor specifik antigens

dan

tumor associated antigens)

yang mengakibatkan

terjadinya reaksi antigen-antibodi ( IgG dengan subklas )

Tujuan penelitian in; adalah

1

Untuk

menganalisai

perobahan

konsentrasi

IgG

darah

perifer

penderita KPD dan membandingkannya dengan perobahan stadium

(TNM)

2

Untuk menganalisa apakah perobahan IgG yang terjadi pada ad 1

diikuti perobahan subklas IgG (lgG1 dan IgG2)

3

Untuk menganalisa apakah ada korelasi perobahan IgG dengan

perobahan subkJas

4.

Untuk

menganalisa

apakah perobahan IgG dapat diaplikasikan

diklinik

Sebanyak 57 penderita KPD ( 25-76 thn), (18 stadium dini,22 stadium

lanjut 17 stadium metastase ) yang belum pernah mendapat pengobatan

dikumpulkan

selama satu tahun ,mulai September 2001 sampai Maret 2003..

Darah perifer (v cubiti) sebanyak 2 ml diambil, didiamkan 15 menit dalam

temperatur kamar. Dilakukan sentrifugasi 3000 putaran per menit dan serum

disimpan dalam pendingin - 40° sampai dilakukan pemeriksaan. Pemeriksaan

IgG,lgG1 ,lgG2 dilakukan dengan metode RID. memakai BINDARID KITS single

dilution. Yang dapat dibeli secara komersial.

Hasil penekitian menunjukkan

perbedaan

IgG dan IgG1

yang

signifikan.( p< 0.005 dan p< 0.05) antara wanita sehat,St f dan

If,

St '" dan St

IV) tetapi tidak dengan IgG2. Ada perbedaan konsentrasi rataan IgG wanita

sehat dan penderita KPD ( P < 0.0005). Ada perbedaan konsentrasi rataan IgG1

wanita sehat dengan penderita KPD (p < 0,05) Ada korefasi positif yang kuat

antara perobahan IgG dengan perobahan IgG1( p

=

0.97) dan perobahan positif

yang lemah antara perobanahan IgG dengan perobahan IgG2 ( p

=

0.39 ) pada

masing-masing stadium yang berpasangan.

Cut off point

fgG antara

wanita

kontrol dengan penderita karsinoma 12.8

mgfml

(sensitivitas 75 % spesifisitas

79

%),

cut off point

dari IgG1 antara stadium dini dan stadium lanjut 8,21

mgfml (

sensitivitas 60

%

spesifisitas 61

% )

dan

cut off point IgG2

antara stadium din;

dan stadium lanjut 5.5

mgfml

(sensitivitas 70 % spesifisitas 71 % )

Analisa IgG,lgG1 dan IgG2

dapat memberikan kontribusi kepada

imunodiagnose penderita karsinoma payudara.

Kata kunci. Penanggulangan karsinoma payudara, Immunoglcbulin G,G1 dan G2

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