J Med Sci, Volume 52, Number 2, 2020 April: 108-119 108 *corresponding author: idhasafitri98@gmail.com Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Volume 52, Number 2, 2020; 108-119 http://dx.doi.org/10.19106/JMedSci005202202002 Submited: 2017-05-30 Accepted : 2019-10-04 Keywords: breast carcinoma; CXCL-12 mRNA expression; lymph nodes; metastasis; prognostic factor; The prognostic value of lymph nodes mRNA CXCL12 expression in the breast cancer Idha Safitri*, Irianiwati Widodo, Didik Setyo Heriyanto Department of Anatomical Pathology, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada, Yogyakarta, Indonesia. ABSTRACT Prognosis of breast carcinoma is influenced by age, tumor size, histological grade and type, lymph node status, as well as metastasic status. Chemokine receptor CXCR-4 with its ligand, CXCL-12, may play an important role in metastasis of breast carcinoma. However, the role of CXCL-12 mRNA as a prognostic factor and a therapeutic target of human breast cancer remains controversial. This study aimed to investigate the level of CXCL-12 mRNA expression in lymph nodes of patients with invasive ductal breast carcinoma and the difference within the prognostic factors. Axillary lymph nodes obtained from 50 cases of invasive ductal breast carcinoma, were divided into two groups, with and without lymph node metastasis. Each group consisted of 25 cases. Total RNA was extracted from formalin-fixed paraffin-embedded. The CXCL-12 mRNA expression was examined using qRT-PCR method. The mean differences between the two groups were analyzed using Mann-Whitney test. The differences between CXCL-12 mRNA expression and each prognostic factor ware analyzed using Mann-Whitney comparison test. CXCL-12 mRNA expression was significantly higher in the lymph node of patients with metastasis of breast carcinoma compared to the non-metastasis cases (p<0.01). There were significant differences between CXCL-12 mRNA expression with poorly histological grade (p=0.003), bigger primary tumor size (p=0.005) and age of ≥45 y.o (p=0.012) in the metastatic group, but there were no significant differences between both age of <45 and ≥45 y.o.This study suggests that the higher CXCL-12 mRNA expression level are associated with bigger tumor size and poor differentiation in breast cancer patient with lymph nodes metastasis. ABSTRAK Prognosis karsinoma payudara dipengaruhi oleh usia, ukuran tumor, derajat dan tipe histologis, status kelenjar getah bening serta status metastasis. Reseptor kemokin CXCR-4dengan ligannya, CXCL-12 berperan penting dalam metastasis karsinoma payudara. Namun peran CXCL-12 mRNA sebagai faktor prognostik dan target terapi kanker payudara masih kontroversial. Penelitian ini bertujuan untuk mengkaji tingkat ekspresi mRNA CXCL-12 pada kelenjar getah bening pasien karsinoma payudara duktal invasif dan perbedaan faktor prognostiknya. Kelenjar getah bening aksila diperoleh dari 50 kasus karsinoma payudara duktal invasif, dibagi menjadi dua kelompok, dengan dan tanpa metastasis kelenjar getah bening. Setiap kelompok terdiri dari 25 kasus.RNA total diekstraksi dari formalin-fixed paraffin-embedded. Ekspresi mRNA CXCL-12 diperiksa dengan metode qRT-PCR. Perbedaan rata-rata antara kedua kelompok dianalisis menggunakan uji Mann-Whitney. Perbedaan antara ekspresi mRNA CXCL-12 dan masing-masing faktor prognostik dianalisis dengan uji perbandingan Mann-Whitney. Ekspresi mRNA CXCL-12 lebih tinggi secara nyata pada kelenjar getah bening pasien dengan metastasis karsinoma payudara dibandingkan dengan kasus non-metastasis (p <0,01). Ada perbedaannyata antara ekspresi CXCL-12 mRNA dengan derajat histologis yang buruk (p = 0,003), ukuran tumor primer yang lebih besar (p = 0,005) dan usia ≥ 45 tahun (p = 0,012) pada kelompok metastasis, tetapi tidak adaperbedaan nyata antara usia <45 dan≥ 45 tahun. Penelitian ini menunjukkan bahwa tingkat ekspresi CXCL-12 mRNA yang lebih tinggi berkaitan dengan ukuran tumor yang lebih besar dan diferensiasi yang buruk pada pasien kanker payudara dengan metastasis kelenjar getah bening.