AbstrakTerapi target (targeted therapy) pada karsinoma kolorektal merupakan terapi alternatif yang diharapkan memberikan hasil yang lebih baik diantaranya dengan pemberian metabolit aktif vitamin D, yaitu calcitriol dan inhibitor Phosphatidyl Inositol 3 Kinase (PI3K). Penelitian ini bertujuan untuk mengetahui korelasi imunoekspresi VDR dan PI3K terhadap derajat diferensiasi adenokarsinoma kolorektal. Penelitian ini menggunakan desain potong lintang dengan analisis kategorik dari 30 blok parafin adenokarsinoma kolorektal (kelompok low grade dan high grade masing-masing 15 kasus) dari Departemen Patologi Anatomi Fakultas Kedokteran Universitas Padjadjaran/RSUP Hasan Sadikin Bandung. Analisis Lambda menunjukkan bahwa imunoekspresi VDR dan PI3K masing-masing memengaruhi diferensiasi adenokarsinoma kolorektal (p=0,029, p=0,0225, R= 0,533). Berdasarkan nilai p, PI3K lebih kuat daripada VDR dalam memengaruhi derajat diferensiasi. Analisis Spearman menunjukkan imunoekspresi VDR dan PI3K tidak terbukti berkorelasi dengan diferensiasi (p=0,186, p>0,05, R: 0,248) secara bersamaan/simultan. Imunoekspresi VDR dan PI3K berkorelasi positif dengan kelompok low grade. Disimpulkan bahwa VDR tidak menggunakan jalur MAPK bersama-sama dengan PI3K dalam memengaruhi diferensiasi adenokarsinoma kolorektal. (p=0.029, p=0.0225, R=0.533). Based on p value, PI3K is stronger than VDR in influencing the degree of differentiation. Spearman analysis showed that simultaneous immunoexpression of VDR and PI3K was not shown to correlate with differentiation (p= 0186, p<0.05, R: 0.248). Positive immunoexpression of VDR and PI3K correlates with low-grade group. It can be concludes that VDR does not use the MAPK pathway together with PI3K to affect differentiation of colorectal adenocarcinoma.

AbstrakKeganasan terbanyak ketiga di dunia pada organ kolorektal adalah karsinoma yang berasal dari lapisan epitel mukosa. Modalitas yang digunakan untuk terapi karsinoma kolorektal stadium lanjut selain operasi adalah kemoterapi dan saat ini dikembangkan terapi target sebagai alternatif terapi, yaitu metabolit aktif vitamin D, calcitriol. Calcitriol bekerja sinergis dengan agen kemoterapi yang aktivitasnya dimediasi oleh vitamin D reseptor (VDR). Penelitian ini bertujuan mengetahui korelasi imunoekspresi VDR dengan stadium dan derajat diferensiasi Colorectal carcinoma (CRC) is a malignancy from mucosal epithelium of the colon/rectum. The treatment modalities used for advance stage colorectal carcinoma therapy is chemotherapy, in addition to surgery. Targeted therapy is currently being developed as an alternative therapy. One of the agents used in this therapy is calcitriol. Calcitriol is an active metabolite of vitamin D. Calcitriol works synergistically with chemotherapeutic agents and its activity is mediated by the vitamin D receptor (VDR). VDR plays a role in the inhibition of tumor progression via induction of cellular differentiation and proliferation inhibition. In this study, imunoexpression of vitamin D receptor was examined in conjunction with the staging and degree of differentiation (grading) of colorectal adenocarcinoma. The study objects include 35 colorectal adenocarcinoma paraffin blocks created from colectomy which were collected at the Department of Patology Anatomic of Dr. Hasan Sadikin General Hospital Bandung from January 2009-June 2014. The blocks were divided into three groups of staging (I, II, and III) and three groups of grading: well, moderately, and poorly differentiated. Immunostaining was used to evaluate the VDR immunoexspression by histo-score. The data were tested using rank spearman test. There was a weak negative correlation between VDR imunoexpression and staging(p=0.045, R=-0.341), and a moderate positive correlation between VDR imunoexpression and grading (p=0.000, R=0.558). It is concluded that a significant correlation of VDR imunoexpression with staging and grading of colorectal adenocarcinoma is found and this finding can be used as a reference for further studies in the development of targeted therapies. [MKB. 2016;48(2):123-8]