Penggunaan Uji Imunohistokimia BerEP4 sebagai Gold Standard Deteksi Karsinoma Sel Basal


DOI : 10.33371/ijoc.v10i3.435

Basal Cell Carcinoma (BCC) is the most common malignant type of skin cancer found in the world today with a 3-10% increase in incidence each year. In Indonesia, BCC is one of the major types of skin cancer found. Therefore a method needs to be developed that can detect BCC at the early stages to prevent late diagnosis of BCC which may lead to metastasis causing disabilities to patients and increasing treatment costs. Various studies have shown BerEP4 as an effective and efficient tool that can be used for early diagnosis and prevention of recurrence post-surgery. This study aims to evaluate the use of BerEP4 in detecting early BCC cells and its potential as a gold standard. The use of BerEP4 immunohistochemistry testing as a gold standard for the routine examination for cases of BCC is expected to be able to increase and improve early diagnosis as well as prevent recurrence postsurgery.

Karsinoma Sel Basal (KSB) merupakan jenis kanker kulit yang paling banyak ditemukan di dunia saat ini dan terjadi peningkatan 3-10% jumlah penderita KSB setiap tahun. Di Indonesia, KSB merupakan salah satu jenis kanker kulit yang utama. Oleh karena itu, dibutuhkan suatu metode yang dapat mendeteksi KSB pada stadium awal karena diagnosis yang terlambat dapat menyebabkan KSB bermetastasis sehingga menjadi sulit ditangani, meningkatkan risiko
penderita menjadi cacat, dan memerlukan biaya pengobatan yang mahal. Berbagai penelitian telah menunjukkan bahwa BerEP4 merupakan cara yang efektif dan efisien untuk melakukan
diagnosis dini dan pencegahan rekurensi pasca-operasi pengangkatan KSB. Penelitian ini bertujuan untuk menilai manfaat BerEP4 dalam mendeteksi sel KSB tahap dini. Diharapkan penggunaan uji imunohistokimia BerEP4 bisa menjadi gold standard pemeriksaan rutin pada kasus-kasus KSB sehingga mampu meningkatkan dan mempermudah diagnosis dini KSB serta mencegah terjadinya rekurensi pasca-operasi pengangkatan KSB.

Keyword: Basal Cell Carcinoma (BCC), immunohistochemistry, BerEP4, gold standard
  1. Chinem VP, Miot HA. Epidemiology of basal cell carcinoma. An. Bras. Dermatol. 2011;
  2. (2).
  3. Kasper M, Jaks V, Hohl D, Toftgard R. Basal cell carcinoma— molecular biology and
  4. potential new therapies. J Clin Invest. 2012;122(2):455-63.
  5. Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffel DJ, Wolff K, editors.Fitzpatrick’s
  6. Dermatology in General Medicine. 8th ed.: McGraw-Hill; 2012.
  7. Flohil S, Seubring I, van Rossum M, Coebergh J, de Vries E,Nijsten T. Trends in Basal
  8. Cell Carcinoma Incidence Rates: A 37-Year Dutch Observational Study. J Invest
  9. Dermatol. 2013;133(4).
  10. Kumar S, Mahajan BB, Kaur S, Yadav A, Singh N, Singh A. A Study of Basal Cell
  11. Carcinoma in South Asians for Risk Factor and Clinicopathological Characterization:
  12. A Hospital Based Study. J Skin Cancer. 2014;2014.
  13. Bader RS, Santacroce L, Diomede L, Kennedy AS. Basal Cell Carcinoma Medscape
  14. Emedicine. [Online].; 2014 [cited 2015 01 06. Available from:
  16. Suriadiredja AS. Epidemiologi kanker kulit. MDVI. 2011;38(2):61.
  17. Azamris. Kanker Kulit di Bangsal Bedah RS Dr. M. Djamil Padang Januari 2002 -
  18. Maret 2007. Cermin Dunia Kedokteran. 2011;38(2):109-10.
  19. Goppner D, Leverkus M. Basal Cell Carcinoma: From the Molecular Understanding
  20. of the Pathogenesis to Targeted Therapy of Progressive Disease. J Skin Cancer.
  21. ;2011
  22. Wolff K, Johnson RA. Fitzpatrick’s Color Atlas & Synopsis of Clinical Dermatology.
  23. th ed.: McGraw-Hill; 2009.
  24. Li G, Tietze J, Kulichova D, Ruzicka T, Berking C, Maier T. High-Definition Optical
  25. Coherence Tomography in the Diagnosis of Basal Cell Carcinoma Evaluated by an
  26. Experienced Versus Inexperienced Investigator. J Clin Exp Dermatol Res. 2014;5(4).
  27. Woods TR, Cohen DM, Islam MN, Kratochvil FJ, Stewart JCB, Reeder SL, et al.
  28. Intraoral Basal Cell Carcinoma, a Rare Neoplasm: Report of Three New Cases with
  29. Literature Review. Head Neck Pathol. 2014;8(3):339-48.
  30. Koutlas I, Koch CA, Vickers RA, Brouwers FM, Vortmeyer AO. An unusual ostensible
  31. example of intraoral basal cell carcinoma. J Cutan Pathol. 2009;36(4):464-70.
  32. Karahan N, Baspinar S, Yildirim M, Barut I. The use of Ber-EP4 antigen in the
  33. differential diagnosis of basosquamous carcinoma from squamous and basal cell
  34. carcinoma. Türk Patoloji Dergisi. 2006;22(2):87-91. Pengunaan Uji
  35. Imunohistokimia BerEP4 sebagai Gold Standard Deteksi Karsinoma Sel Basal
  36. –85 Indonesian Journal of Cancer Vol. 10, No. 3 July - September 2016 85
  37. Mosterd K, Thissen M, van Marion A, Nelemans P, Lohman B, Steijlen B, et al.
  38. Correlation between histologic findings on punch biopsy specimens and subsequent
  39. excision specimens in recurrent basal cell carcinoma. J Am Acad Dermatol. 2011;
  40. (2):323-7.
  41. Alhumaidi A. Practical immunohistochemistry of epithelial skin tumor. Indian J
  42. Dermatol Venereol Leprol. 2012;78(6):698-708.
  43. Dasgeb B, Mohammadi TM, Mehregan DR. Use of Ber-EP4 and Epithelial Specific
  44. Antigen to Differentiate Clinical Simulators of Basal Cell Carcinoma. Biomark
  45. Cancer. 2013;5:7-11.
  46. Maetzel D, Denzel S, Mack B, Canis M, Went P, Benk M, et al. Nuclear signalling by
  47. tumour-associated antigen EpCAM. Nat Cell Biol. 2009; 11(2):162-71.
  48. Mashhood AA, Sarfraz T, Atique M, Asif M. Sensitivity and Specificity of Ber-EP4
  49. Immunostaining in Basal Cell Carcinoma Cases in Asian Skin. Pakistan Armed
  50. Forces Medical Journal.2011;(3).
  51. Krahl D, Sellheyer K. Monoclonal antibody Ber-EP4 reliably discriminates between
  52. microcystic adnexal carcinoma and basal cell carcinoma. J Cutan Pathol.
  53. ;34(10):782-7.
  54. Sellheyer K, Nelson P, Kutzner H, Patel RM. The immunohistochemical differential
  55. diagnosis of microcystic adnexal carcinoma, desmoplastic trichoepithelioma and
  56. morpheaform basal cell carcinoma using BerEP4 and stem cell markers. J Cutan
  57. Pathol. 2013; 40:363-70.
  58. Costescu M, Coman OA, Tampa M, Irina T, Coman L, Georgescu SR. Axillary basal
  59. cell carcinoma – a rare form of a frequent kind of carcinoma. Rom J Morphol
  60. Embryol. 2013; 54(3Suppl): 851-56.
  61. Tchernev G, Ananiev J, Cardoso JC, Wollina U. Metatypical Basal Cell Carcinomas: a
  62. Successful Surgical Approach to Two Cases with Different Tumor Locations.
  63. MAEDICA. 2014;9(1):79-82.
  64. Tarallo M, Cigna E, Frati R, Delfino S, Innocenzi D, Fama U, et al. Metatypical basal
  65. cell carcinoma: a clinical review. J Exp Clin Cancer Res. 2008;27(1):65.
  66. Claassen SL, Royer MC, Rush WL. Granular cell basal cell carcinoma: report of a
  67. case and review of the literature. Am J Dermatopathol. 2014;36(7):121-4.
  68. Jedrych J, Busam KJ. Multiple lesions of granular cell basal cell carcinoma: a case
  69. report. J Cutan Pathol. 2014; 41(1):45-50.
  70. Patil DT, Goldblum JR, Billings SD. Clinicopathological analysis of basal cell
  71. carcinoma of the anal region and its distinction from basaloid squamous cell
  72. carcinoma. Modern Pathology. 2013; 26: p. 1382-89.
  73. Kreuter A, Bechara FG, Stucker M, Brockmeyer NH, Altmeyer P, Wieland U. Perianal
  74. basal cell carcinoma unusual localization of a frequent tumor. J Dtsch Dermatol Ges.
  75. ; 10(1): p.59-61.
  76. Sook KY, Keun LS. Different Protein Expressions between Peripheral
  77. Ameloblastoma and Oral Basal Cell Carcinoma Occurred at the Same Mandibular
  78. Molar Area. Korean J Pathol. 2014;48(2):151-58.
  79. Fan YS, Carr RA, Sanders DS, Smith AP, Lazar AJ, Calonje E. Characteristic Ber-EP4
  80. and EMA expression in sebaceoma is immunohistochemically distinct from basal cell
  81. carcinoma. Histopathology. 2007;51(1):80-6.
  82. Bozinovic MT, Krasic D, Katic V, Rancic D, Krstic M, Djordjevic JJ, et al. Comparative
  83. analysis of clinicopathological and immunohistochemical characteristics of Merkel
  84. cell carcinoma. J BUON. 2014;19(2):530-4.
  85. Ansai S, Takayama R, Kimura T, Kawana S. Ber-EP4 is a useful marker for follicular
  86. germinative cell differentiation of cutaneous epithelial neoplasms. J Dermatol.
  87. ;39(8):688-92.
  88. Raflizar, Nainggolan O. Faktor Determinan Tumor/Kanker Kulit di Pulau Jawa
  89. (Analisia Data Riskesdas 2007). Buletin Penelitian Sistem Kesehatan.
  90. ;13(4):386-93.
  91. Filho L, de Oliveira de Avelar Alchorne A, Pereira GC, Lopes L, de Carvalho T.
  92. Histological and immunohistochemical evaluation of basal cell carcinoma following
  93. curettage and electrodessication. Int J Dermatol. 2008;47(6):610-4.

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Article Info
Submitted: 2016-11-17
Published: 2016-11-18
Section: Research Articles
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