Hubungan Ekspresi Calretinin dan Choline Transporter dengan Keberadaan Sel Ganglion dan Serabut Saraf dalam Diagnosis Penyakit Hirschsprung di RSUP Dr. M. Djamil Padang Tahun 2021-2022

Dini Kusumardani, Noza Hilbertina, Tofrizal Tofrizal, Aswiyanti Asri, Budi Pratama Arnofyan, Husna Yetti

Abstract


Latar Belakang: Penyakit Hirschsprung merupakan kelainan bawaan yang ditandai dengan tidak adanya sel ganglion di lapisan submukosa atau muskularis propria dari kolon distal dan rektum. Prevalensi kejadiannya 1:5000 kelahiran hidup di populasi umum. Diagnosis pasti penyakit Hirschsprung adalah dengan pemeriksaan histopatologi untuk menentukan adanya sel ganglion dan serabut saraf, tetapi pada sampel jaringan dengan lapisan submukosa yang tidak adekuat dapat sulit untuk menentukan sel ganglion dan serabut saraf. Untuk mengatasi masalah ini dapat dilakukan pemeriksaan imunohistokimia Calretinin dan Choline Transporter. Calretinin, merupakan protein pengikat kalsium yang terlibat dalam pensinyalan kalsium. Calretinin tidak diekspresikan pada segmen aganglionik dan bersifat imunopositif pada sel ganglion atau serabut saraf kolon normal. Choline Transporter merupakan penanda alternatif untuk saraf kolinergik yang efektif dalam mengidentifikasi kasus penyakit Hirschsprung dan secara kualitatif mirip dengan Asetilkolinesterase. Tujuan: penelitian ini bertujuan untuk mengetahui hubungan Calretinin dengan keberadaan sel ganglion dan Choline Transporter dengan keberadaan serabut saraf dalam menegakkan diagnosis penyakit Hirschsprung. Metode: Penelitian ini merupakan penelitian cross sectional dengan sampel sebanyak 70 kasus penyakit Hirschsprung yang telah didiagnosis di Laboratorium Patologi Anatomi RSUP Dr. M. Djamil Padang 2021-2022. Sampel diperoleh secara simple random sampling dari blok paraffin. Dilakukan penilaian ulang pada slaid untuk menilai gambaran histopatologis. Ekspresi Calretinin dan Choline Transporter dilihat dengan pemeriksaan imunohistokimia. Untuk mengetahui korelasi dilakukan analisis statistik bivariat menggunakan uji chi-square dengan tingkat kemaknaan p<0,05. Hasil: Dari 70 kasus, didapatkan ekspresi Calretinin negatif pada 28 kasus (80%) dan memiliki hubungan yang bermakna dengan keberadaan sel ganglion (p = 0,003). Didapatakan ekspresi Choline Transporter positif pada 29 kasus(82,86%) dan memiliki hubungan yang bermakna dengan keberadaan serabut saraf (p = 0,000). Kesimpulan: Penelitian ini menyimpulkan bahwa terdapat hubungan yang bermakna antara ekspresi Calretinin dengan keberadaan sel ganglion dan ekspresi Choline Transporter berhubungan dengan serabut saraf.


Keywords


ekspresi Calretinin, ekspresi Choline Transporter, penyakit Hirschsprung, sel ganglion, serabut saraf

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DOI: https://doi.org/10.33854/heme.v6i2.1484

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