PEMERIKSAAN IMUNOHISTOKIMIA CLAUDIN-4 PADA PREPARAT CELL BLOCK CAIRAN EFUSI PLEURA BERDASARKAN KATEGORI DIAGNOSTIK THE INTERNATIONAL SYSTEM FOR REPORTING SEROUS FLUID CYTOPATHOLOGY
IMMUNOHISTOCHEMICAL EXAMINATION OF CLAUDIN-4 ON CELL BLOCK PREPARATIONS OF PLEURAL EFFUSION FLUIDS BASED ON DIAGNOSTIC CATEGORIES OF THE INTERNATIONAL SYSTEM FOR REPORTING SEROUS FLUID CYTOPATHOLOGY
Abstract
Efusi pleura mencerminkan kondisi patologis seperti gangguan paru, pleura, sistemik, hingga keganasan. Pemeriksaan sitologi dan imunohistokimia (IHK) cairan efusi pleura bertujuan untuk menilai keterlibatan pleura terhadap metastasis dan meningkatkan ketepatan diagnosis serta penilaian prognostik. Claudin-4, protein transmembran, diketahui terekspresi secara konsisten pada adenokarsinoma metastatik. Penelitian ini bertujuan mengetahui ekspresi IHK Claudin-4 pada sediaan cell block cairan efusi pleura berdasarkan The International System for Reporting Serous Fluid Cytopathology. Penelitian ini merupakan studi deskriptif analitik dengan pendekatan potong lintang terhadap 49 sampel cairan efusi pleura yang diproses menjadi cell block, kemudian dilakukan pewarnaan Hematoksilin-Eosin dan IHK Claudin-4 di RS Pendidikan Prof. dr. Chairuddin Panusunan Lubis USU. Hasil menunjukkan kelompok usia terbanyak 41–50 tahun (32,65%), laki-laki lebih banyak (55,10%), cairan transudat (57,14%), dan volume efusi 11–20 mL (30,61%). Diagnosis sitologi terbanyak adalah kategori NFM (85,72%) dan MAL (14,28%). Ekspresi Claudin-4 positif ditemukan pada seluruh sampel kategori MAL (7/7) dan negatif pada kategori NFM (42/42). Simpulan: Ekspresi Claudin-4 positif pada semua kasus MAL dan negatif pada NFM, menunjukkan potensi Claudin-4 sebagai penanda diagnostik untuk efusi pleura maligna.
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