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EKSPRESI IMMUNOHISTOKIMIA VITAMIN-D RESEPTOR, KI-67, P21, P27, P63, BCL-2 SEL TROFOBLAS MOLAHIDATIDOSA: ANALISIS JALUR SINYAL ONKOGEN DAN RISIKO TUMOR TROFOBLAS GESTASIONAL

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Background: Hydatidiform mole is part of the spectrum of gestational trophoblastic disease and may progress to gestational trophoblastic tumor (GTT). This progression is thought to be associated with dysregulation of cell proliferation, cell-cycle control, and apoptosis. Molecular biomarkers such as Vitamin D Receptor (VDR), Ki-67, p21, p27, p63, and Bcl-2 are involved in oncogenic signaling pathways, but their interrelationships and dominant pathways in GTT development remain unclear. Methods: This observational case-control study analyzed immunohistochemical expression of VDR, Ki-67, p21, p27, p63, and Bcl-2 in hydatidiform mole tissues. Statistical analyses were performed using STATA, including bivariate analysis, correlation, multiple linear regression, and path analysis to evaluate inter-biomarker relationships and their contribution to GTT occurrence. Results: The hydatidiform mole and GTT groups showed comparable demographic and most clinical characteristics. Immunohistochemical expression of VDR, Ki-67, p21, p27, and Bcl-2 was significantly associated with GTT occurrence, whereas p63 showed no significant association. Ki-67 demonstrated the most prominent difference between groups, with higher expression in the GTT group and the best discriminatory performance. Reduced expression of p21 and p27 in the GTT group reflected impaired cell-cycle arrest. Multivariate and path analyses indicated that the proliferative signaling pathway was the dominant pathway leading to GTT, with additional contributions from cell-cycle dysregulation and anti-apoptotic signaling. Conclusion: Progression from hydatidiform mole to gestational trophoblastic tumor is predominantly driven by increased cellular proliferation accompanied by impaired cell-cycle regulation and apoptosis. These findings support the role of integrated immunohistochemical biomarker panels in understanding GTT pathogenesis and risk stratification. Keywords:, Bcl-2, Gestational trophoblastic tumor, Hydatidiform mole, Ki-67, p21, p27, p63, Vitamin D receptor

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Detail Information

Series Title

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Call Number

T1943242026

Publisher

Indralaya : Prodi Sains Biomedis Program Doktor ,Fakultas Kedokteran Universitas Sriwijaya., 2026

Collation

xxv, 141 hlm.; ilus.; 29 cm

Language

Indonesia

ISBN/ISSN

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Classification

618.307

Content Type

Text

Media Type

unmediated

Carrier Type

-

Edition

-

Subject(s)

Prodi Sains Biomedis Program Doktor
Mola Hidatidosa — Patologi

Specific Detail Info

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Statement of Responsibility

KA

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