ABSTRAK
Latar Belakang: Infeksi Helicobacter Pylori dapat menginduksi reaksi inflamasi kronis pada lambung yang menyebabkan perubahan struktur histologis dari mukosa lambung dan mungkin berujung pada keganasan. Inflamasi kronis ini diperantarai salah satunya oleh enzim Cyclooxygenase-2 (COX-2) yang diketahui juga berperan dalam tumorgenesis dengan mekanisme menghambat apoptosis, menstimulasi proiferasi sel, dan lain sebagainya. Penelitian ini bertujuan untuk mengetahui hubungan ekspresi COX-2 dengan status diagnosis H. Pylori, serta korelasinya dengan derajat histopatologi mukosa lambung berdasarkan updated-sydney grading system.
Metode Penelitian: Penelitian observasional analitik pada 30 sediaan blok paraffin mukosa gaster pada pasien dengan gastritis kronis yang menjalani biopsi endoskopi di RSUD Dr. Moewardi tahun 2014-2015. Sampel dideparafinisasi dan kemudian dicat menggunakan Hematoksilin Eosin dan imunohistokimia COX-2. Hasil derajat histopatologi diinterpretasi berdasarkan updated-sydney grading system, dan interpretasi semikuantitatif untuk imunohistokima COX-2 oleh dua orang peneliti. Data dianalisis menggunakan uji komparatif chi square dan korelasi spearman.
Hasil Penelitian: Ekspresi COX-2 berkorelasi positif dengan derajat infiltrasi limofsit (r = 0,443; p = 0,007), atrofi kelenjar (r = 0,346; p = 0.03), dan densitas H. Pylori (r = 0,414; p = 0.011). Tidak ada hubungan signifikan antara ekspresi COX-2 dengan status diagnosis H. Pylori positif dan negatif.
Simpulan Penelitian: Terdapat korelasi signifikan antara ekspresi COX-2 dengan infiltrasi limfosit, atrofi kelenjar, dan densitas H. Pylori pada mukosa gaster, gastritis kronis. Tidak terdapat korelasi yang signifikan antara COX-2 dengan parameter updated-sydney grading system lain. Ekspresi COX-2 tidak berhubungan pula dengan status diagnosis H. Pylori pada kasus gastritis kronis.
Kata Kunci : Gastritis kronis, Helicobacter Pylori, Cyclooxygenase-2, Updated-sydney grading system  
ABSTRACT
Background: Helicobacter Pylori infection have capabilities to induce chronic inflammation which later will lead to a metaplasia of gastric mucosa and a chance for developing gastric cancer. A pro-inflammatory enzyme which take a major part in chronic inflammation, Cyclooxygenase-2 (COX-2), has already known also promoting tumorgenesis, stimulating cells proliferation, and inhibiting apoptosis. This study aims to elucidate the association between of COX-2 expression in both H. Pylori positive and negative chronic gastritis, and how its correlate with histopatological finding based on updated-sydney grading system.
Methods: This is an observational cross-sectional study. All 30 paraffin-embedded gastric tissue samples were collected from patients who were diagnosed with chronic gastritis and underwent endoscopic biopsy in RSUD Dr. Moewardi from 2014 until 2015. Using monoclonal antibody immunohistochemistry, the COX-2 expression were interpreted semmiquantitively, while histopatological finding were interpreted based on updated-sydney grading system using hematoxylin eosin staining. Both data were analyzed using chi square and spearman correlation.
Results: The expression of COX-2 was significantly correlated with a higher grade of chronic inflammation mononuclear lymphocytic infiltration (r = 0,443; p = 0,007), glandular atrophy (r = 0,346; p = 0.03), and density of H. Pylori (r = 0,414; p = 0.011). COX-2 expressions were found not to be significantly associated with status of H. Pylori positive nor negative (p > 0,05).
Conclusions: This research shows a significant correlation between COX-2 expression on lymphocytic infiltration, glandular atrophy, and density of H. Pylori, but there were no significant correlation between COX-2 on the other updated-sydney grading system parameters. COX-2 expression also found not to be significantly associated with diagnostic status of H. Pylori in chronic gastritis patients.
Keywords: Chronic gastritis, Helicobacter Pylori, Cyclooxygenase-2, Updated-sydney grading system