KADAR MATRIX METALLOPROTEINASE-9 (MMP-9) PADA ANAK DENGAN RETINOBLASTOMA

Introduction: Retinoblastoma is a neoplasm originating from neuroretina
(rods and cones) or glial cells, which are malignant. Retinoblastoma is the
most malignant eye tumor found in children under 5 years of age. The
cause of retinoblastoma is a gene mutation in one locus in the 13q14
chromosome band. Degradation of the extracellular matrix around tumor
cells is fundamental to the invasion and metastases of tumor cells. Matrix
metalloproteinase-9 destroys the extracellular matrix near the surface of
tumor cells, which allows tumor cells to enter the tissue along with the
destruction of the basement membrane, causing invasion and metastases
of tumor cells.
Objective: This study aims to compare the levels of Matrix
Metalloproteinase-9 (MMP-9) before chemotherapy in grade III and grade
IV retinoblastoma patients.
Methods: This study used a cross sectional design which was conducted
at the Central General Hospital (RSUP) Dr. Wahidin Sudirohusodo. The
population of this study were all retinoblastoma patients who had not
undergone chemotherapy aged 1 year to 18 years. This study compared
MMP-9 levels in children diagnosed with grade III retinoblastoma and
grade IV retinoblastoma.
Results: This study involved 38 retinoblastoma patients who were divided
into 2 groups, 13 people in the retinoblastoma grade III group and 25
patients in the grade IV retinoblastoma group. Based on the bivariate
analysis on the characteristics of gender, age, nutritional status in the
retinoblastoma grade III and grade IV retinoblastoma groups, the p value
was> 0.05, which means there was no significant difference, so it can be
concluded that the characteristics of the retinoblastoma grade III and
grade IV retinoblastoma groups were not different. The serum MMP-9
levels were both significantly elevated above normal values in the grade III
and grade IV retinoblastoma groups. Comparative analysis of MMP-9
levels in patients with retinoblastoma grade III and retinoblastoma grade IV
obtained a value of p = 0.097 (p> 0.05) which showed no significant
difference in the two groups.
Conclusion: The serum levels of MMP-9 which were both significantly
elevated above normal values in the grade III and grade IV retinoblastoma
groups proved that MMP-9 had an important role in tumor cell invasion
and metastasis and was a parameter of the advanced stage of
retinoblastoma disease.