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"Latar belakang: Kanker nasofaring (KNF) merupakan kanker leher kepala terbanyak di Indonesia (28,4%) dan sebagian besar terdiagnosis pada stadium lanjut. Modalitas pengobatan pada kasus KNF stadium lanjut adalah kemoterapi dan radioterapi. Namun, pada stadium sama, respon terhadap pengobatan memiliki hasil berbeda dikarenakan adanya perbedaan karakteristik biologi molekular. Cyclin D1 adalah protein yang berperan dalam siklus sel. Peningkatan ekspresi cyclin D1 akan mempercepat proliferasi. Penelitian ini ingin mengetaui tingkat ekspresi cyclin D1 terhadap respons kemoterapi. Hal tersebut berdasarkan perbedaan hasil penelitian terdahulu. Data ekspresi cyclin D1 pada KNF di Indonesia belum ada, sehingga perlu penelitian ekspresi cyclin D1 pada KNF serta hubungannya berdasarkan respons pengobatan.Metode: Penelitian ini menggunakan studi kohort retrospektif dengan subjek merupakan pasien KNF yang berobat di RSCM pada kurun waktu 2015-2018. Gambaran radiologi sebelum dan sesudah pengobatan ditinjau ulang berdasarkan kriteria RECIST. Pewarnaan imunohistokimmia cyclin D1 menggunakan antibodi monoklonal cyclin D1 NovocastraTM dengan teknik pengambilan antigen suhu tinggi dan intensitasnya dinilai dengan H-skor menurut kriteria Allred.Hasil: Terdapat 16 subjek (51,6%) dengan ekspresi cyclin D1 positif dan 15 subjek (48,4%) dengan ekspresi negatif. Peneliti menemukan bahwa ekspresi cyclin memiliki perbedaan rerata yang bermakna antara kelompok subjek yang respons (rerata 116,24 ± 57,80) dan tidak respons (rerata 77,97 ± 45,27) terhadap pengobatan (p = 0,048).Simpulan: Penelitian ini menunjukkan ekspresi cyclin D1 yang kuat pada kelompok dengan respons pengobatan yang baik.

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Background: Nasopharyngeal cancer (NPC) is the most type of head and neck cancer in Indonesia (28.4%) and mostly diagnosed at advanced stage. Treatment of this stage is chemotherapy and radiotherapy. However, patients with the same stage of disease had different treatment response probably due to different characteristics of molecular biology. Cyclin D1 is a protein involved in cell cycle, which the overexpression of it will fasten proliferation. Studies regarding the association of cyclin D1 expression and chemotherapy response have shown a different result. In Indonesia, data of cyclin D1 expression of NPC do not yet exist. This study aimed to examine the proportion of cyclin D1 in NPC and its association with treatment response.

Methods: A retrospective cohort study was conducted using subjects of NPC patients at Cipto Mangunkusumo Hospital from 2015 until 2018. The response of treatment was reviewed based on RECIST criteria. The technique used for cyclin D1 immunohistochemistry staining was antigen retrieval methods, using cyclin D1 NovocastraTM monoclonal antibody and the intensity was assessed based on Allred criteria.

Results: Sixteen subjects (51.6%) had positive expression of cyclin D1 and 15 subjects (48.4%) had negative expression. The researchers found that cyclin D1 expression had significant mean differences between groups of subjects who responded (mean ± SD = 116.24 ± 57.80) and did not respond (mean ± SD = 77.97 ± 45.27) to treatment (p = 0.048).

Conclusion: This study suggests that higher expression of cyclin D1 is associated with a good treatment response in NPC patients."

"Latar belakang: Juvenile Nasopharyngeal Angiofibroma (JNA) merupakan tumor jinak nasofaring yang bersifat hipervaskular, agresif lokal, dan destruktif. Pencitraan sebelum pembedahan untuk menentukan ukuran dan perluasan tumor, serta embolisasi preoperatif dapat mempengaruhi jumlah perdarahan intraoperatif, yang merupakan salah satu faktor morbiditas pada pasien JNA. Penelitian ini bertujuan untuk menilai pengaruh karakteristik tumor antara lain ukuran tumor, staging, dan pembuluh darah yang memperdarahi tumor, serta efek dari embolisasi preoperatif terhadap jumlah perdarahan intraoperatif.Metode: Penelitian dilakukan pada pasien JNA yang menjalani embolisasi preoperatif dan operasi pengangkatan tumor di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo sejak tahun 2018 hingga Maret 2022. Dilakukan penilaian ukuran tumor dan staging, serta identifikasi feeding artery menggunakan CT/MRI dan juga DSA embolisasi preoperatif, kemudian dilakukan analisis perbandingan dan korelasi terhadap jumlah perdaran intraoperatif.Hasil: Terdapat 21 pasien JNA yang menjalani embolisasi preoperatif dan pengangkatan tumor. Didapatkan perbedaan jumlah perdarahan intraoperatif yang bermakna antara pasien JNA stadium III dibandingkan dengan stadium I-II (p=0,006). Jumlah perdarahan intraoperatif lebih banyak pada tumor yang berukuran lebih besar, namun didapatkan korelasi yang lemah (R=0,43; p=0,051). Jumlah perdarahan intraoperatif juga berbeda bermakna pada tumor JNA dengan feeding artery dari kedua sisi arteri maksilaris interna dengan tumor JNA yang mendapatkan feeding artery satu sisi arteri maksilaris interna saja (p=0,009), serta keterlibatan feeding artery dari cabang arteri karotis interna (p=0,023). Persentase pembuluh darah yang dilakukan embolisasi preoperatif, juga mengurangi jumlah perdarahan intraoperatif (R=-0,36; p=0,113).Kesimpulan: Pencitraan preoperatif pada pasien JNA memegang peranan penting dalam menentukan perluasan tumor (staging), ukuran tumor, dan feeding artery yang berpengaruh terhadap jumlah perdarahan intraoperatif pada pasien JNA. Tindakan embolisasi preoperatif juga memiliki peranan penting dalam mengurangi jumlah perdarahan intraoperatif

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Background: Juvenile Nasopharyngeal Angiofibroma (JNA) is a benign tumor of the nasopharynx that is hypervascular, locally aggressive, and destructive. Imaging before surgery to determine the size and extent of the tumor, as well as preoperative embolization can affect the amount of intraoperative bleeding, which is one of the morbidity factors in JNA patients. This study aimed to assess the effect of tumor characteristics such as tumor size, staging, and blood vessels supplying the tumor, as well as the effect of preoperative embolization on the amount of intraoperative bleeding.

Methods: The study was conducted on JNA patients who underwent preoperative embolization and surgical removal of tumors at the Cipto Mangunkusumo National General Hospital from 2018 to March 2022. Tumor size and staging were assessed, as well as identification of feeding arteries using CT/MRI and DSA preoperative embolization, then we performed a comparative and correlation analysis of the amount of intraoperative bleeding.

Results: There were 21 JNA patients who underwent preoperative embolization and tumor removal. There was a significant difference in the amount of intraoperative bleeding between patients with stage III JNA compared to stage I-II (p = 0.006). The amount of intraoperative bleeding was higher in larger tumors, but a weak correlation was found (R=0.43; p=0.051). The amount of intraoperative bleeding was also significantly different in JNA tumors with feeding arteries from both sides of the internal maxillary artery compared to JNA tumors with feeding arteries on one side of the internal maxillary artery only (p=0.009), and the involvement of feeding arteries from the internal carotid artery branch (p=0.023). The percentage of vessels that underwent preoperative embolization also reduced the amount of intraoperative bleeding (R=-0.36; p=0.113).

Conclusion: Preoperative imaging in JNA patients plays an important role in determining tumor expansion (staging), tumor size, and feeding arteries that affect the amount of intraoperative bleeding in JNA patients. Preoperative embolization also have an important role in reducing the amount of intraoperative bleeding."

"Latar Belakang: Karsinoma narofaring (KNF) termasuk kanker dengan prevalensi yang cukup tinggi di Indonesia dengan prognosis yang cukup. Dalam menentukan progresifitas suatu kanker, didapatkan peranan penting dari penurunan tumor supresor gen dan peningkatan proliferasi. Hal tersebut ditandai oleh marker p53 sebagai gen supresor yang menginduksi apoptosis dan Ki67 sebagai marker proliferasi sel. Hingga saat ini belum terdapat penelitian mengenai hubungan overekspresi p53 dan Ki67 terhadap respon kemoradiasi dan analisis kesintasan selama 3 tahun pada KNF stadium lokal lanjut. Tujuan: Mencari hubungan antara overekspresi p53 dan Ki67 terhadap respon kemoradiasi dan kesintasan 3 tahun pasien KNF stadium lokal lanjut. Metode: Penelitian ini merupakan penelitian analitik observasional dengan desain analisis kesintasan. Penelitian ini menggunakan desain penelitian kohort retrospektif, dengan pengambilan data dari rekam medis kemudian ditelusuri riwayat perjalanan penyakitnya. Sample penelitian berupa jaringan pada blok parafin pasien KNF stadium lokal lanjut yang diambil secara consecutive sampling dari populasi penelitian dari periode 2015–2017 di RSUPN Dr. Cipto Mangunkusumo sejumlah 82 orang. Hasil: Dari total 82 pasien KNF stadium local lanjut, terdapat 65 pasien kelamin laki – laki (79,3%) dan 17 pasien perempuan (20,7%), dengan usia paling banyak pada kelompok 41 – 50 tahun sebanyak 31,8%. Overekspresi p53 ditemukan pada 36 pasien (43,9%), sementara overekspresi Ki67 ditemukan pada 35 pasien (42,7%). Dari respon kemoradiasi, pasien dengan overekspresi p53 dan Ki67 berpeluang memberikan respon negatif yang lebih tinggi dibandingkan dengan low ekspresi (RR = 3,052 dengan IK95%: 1,777 – 5,242, p = 0,009; RR = 2,573 dengan IK95%: 1,547 – 4,297, p = 0,002 berturut-turut). Dinilai dari kesintasan 3 tahun, pasien dengan overekspresi p53 memiliki kesintasan 3 tahun yang lebih buruk dibandingkan dengan low ekspresi (HR = 19,827 dengan IK95%: 5,974 – 65,798, p = <0,001). Begitu juga dengan overekspresi Ki67 memiliki kesintasan 3 tahun yang lebih rendah.

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Background: Naropharyngeal carcinoma (NPC) is a cancer with a fairly high prevalence in Indonesia with a fairly poor prognosis. Tumor supressor gene and cancer proliferation played an important roles in determining the progression of a cancer. This was indicated by the marker p53 as a suppressor gene that induces apoptosis and Ki67 as a marker of cell proliferation. There has been limited research on the relationship of p53 and Ki67 overexpression to the chemoradiation response and 3-year survival in locally advanced NPC. Objective: To determine the relationship between p53 and Ki67 overexpression with chemoradiation response to therapy and 3-year survival in locally advanced NPC patients. Methods: This research is an observational analytic study with a survival analysis design. This study used a retrospective cohort study design, by collecting data from medical records and then tracing the history of the disease. The research sample was tissue in the paraffin block of locally advanced NPC patients taken by consecutive sampling from the study population from period 2015–2017 at Dr. Cipto Mangunkusumo National Hospital with a total number of 82 patients.

Results: From a total of 82 patients with locally advanced NPC, there were 65 male patients (79.3%) and 17 female patients (20.7%), with the most age being in the 41-50 years group as many as 31.8 %. Overexpression of p53 was found in 36 patients (43.9%), while overexpression of Ki67 was found in 35 patients (42.7%). Based on therapy response, patients with overexpression of p53 and Ki67 had a higher chance of giving a negative response compared to those with low expression (RR = 3,052 with IK95%: 1,777 – 5,242, p = 0,009; RR = 2,573 with IK95%: 1,547 – 4,297, p = 0,002 respectively). Assessed by 3- year survival, patients with p53 overexpression were statistically significantly worse than those with low-expression (HR = 19,827 with IK95%: 5,974 – 65,798, p = <0,001). Likewise, Ki67 overexpression was statistically significant and had a lower 3-year survival compared to low Ki67 expression (HR = 14,634 with IK95%: 5,074 – 42,204, p = <0,001). Conclusion: Locally advanced NPC patients with p53 overexpression and Ki67 overexpression have a tendency to give a negative chemoradiation response and have a lower 3-year survival."

"Kanker nasofaring (KNF) merupakan kanker leher kepala terbanyak di Indonesia (28,4%) dan sebagian besar terdiagnosis pada stadium lanjut. Modalitas pengobatan pada kasus KNF stadium lanjut adalah kemoterapi dan radioterapi. Namun, pada stadium sama, respon terhadap pengobatan memiliki hasil berbeda dikarenakan adanya perbedaan karakteristik biologi molekular. Cyclin D1 adalah protein yang berperan dalam siklus sel. Peningkatan ekspresi cyclin D1 akan mempercepat proliferasi. Penelitian ini ingin mengetaui tingkat ekspresi cyclin D1 terhadap respons kemoterapi. Hal tersebut berdasarkan perbedaan hasil penelitian terdahulu. Data ekspresi cyclin D1 pada KNF di Indonesia belum ada, sehingga perlu penelitian ekspresi cyclin D1 pada KNF serta hubungannya berdasarkan respons pengobatan. Metode: Penelitian ini menggunakan studi kohort retrospektif dengan subjek merupakan pasien KNF yang berobat di RSCM pada kurun waktu 2015-2018. Gambaran radiologi sebelum dan sesudah pengobatan ditinjau ulang berdasarkan kriteria RECIST. Pewarnaan imunohistokimmia cyclin D1 menggunakan antibodi monoklonal cyclin D1 NovocastraTM dengan teknik pengambilan antigen suhu tinggi dan intensitasnya dinilai dengan H-skor menurut kriteria Allred. Hasil: Terdapat 16 subjek (51,6%) dengan ekspresi cyclin D1 positif dan 15 subjek (48,4%) dengan ekspresi negatif. Peneliti menemukan bahwa ekspresi cyclin memiliki perbedaan rerata yang bermakna antara kelompok subjek yang respons (rerata 116,24 ± 57,80) dan tidak respons (rerata 77,97 ± 45,27) terhadap pengobatan (p = 0,048). Simpulan: Penelitian ini menunjukkan ekspresi cyclin D1 yang kuat pada kelompok dengan respons pengobatan yang baik.

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Nasopharyngeal cancer (NPC) is the most type of head and neck cancer in Indonesia (28.4%) and mostly diagnosed at advanced stage. Treatment of this stage is chemotherapy and radiotherapy. However, patients with the same stage of disease had different treatment response probably due to different characteristics of molecular biology. Cyclin D1 is a protein involved in cell cycle, which the overexpression of it will fasten proliferation. Studies regarding the association of cyclin D1 expression and chemotherapy response have shown a different result. In Indonesia, data of cyclin D1 expression of NPC do not yet exist. This study aimed to examine the proportion of cyclin D1 in NPC and its association with treatment response. Methods: A retrospective cohort study was conducted using subjects of NPC patients at Cipto Mangunkusumo Hospital from 2015 until 2018. The response of treatment was reviewed based on RECIST criteria. The technique used for cyclin D1 immunohistochemistry staining was antigen retrieval methods, using cyclin D1 NovocastraTM monoclonal antibody and the intensity was assessed based on Allred criteria. Results: Sixteen subjects (51.6%) had positive expression of cyclin D1 and 15 subjects (48.4%) had negative expression. The researchers found that cyclin D1 expression had significant mean differences between groups of subjects who responded (mean ± SD = 116.24 ± 57.80) and did not respond (mean ± SD = 77.97 ± 45.27) to treatment (p = 0.048). Conclusion: This study suggests that higher expression of cyclin D1 is associated with a good treatment response in NPC patients."