UI - Disertasi Membership :: Kembali

UI - Disertasi Membership :: Kembali

Penetapan potensi metastasis kelenjar getah bening lokoregional pada karsinoma sel skuamosa laring: pemeriksaan ekspresi biomarka HPV, EGFR, MMP-9, timp-1, vegf, e-kaderin, dan kolagen tipe IV = Potential metastatic locoregional lymph nodes on squamous cell carcinoma larynx examination of biomarker expression HPV, EGFR, MMP 9 timp 1 vegf e cadherin and collagen type IV / Fauziah Fardizza

Fauziah Fardizza; Bambang Hermani, promotor; Harahap, Alida Roswita, co-promotor; Siregar, Nuryati Chairani, co-promotor; Suhendro, examiner; Susyana Tamin, examiner; Muchtaruddin Mansyur, examiner; Andrijono, examiner ; Zainal Adhim, examiner; Agus Surono, examiner (Fakultas Kedokteran Universitas Indonesia, 2016)

 Abstrak

ABSTRAK
Biomarka untuk memprediksi metastasis KGB lokoregional sampai saat ini belum akurat.
Angka metastasis tersamar pada karsinoma laring bervariasi yaitu 165%. Dibutuhkan
biomarka tumor yang dapat memberikan informasi adanya metastasis KGB lokoregional
pada pasien KSS laring stadium lanjut tanpa keterlibatan KGB lokoregional (N0), sehingga
diharapkan menjadi acuan untuk dilakukan diseksi leher selektif. Beberapa biomarka yang
berhubungan dengan agresivitas dan prediksi metastasis yaitu Epidermal Growth Factor
Receptor (EGFR), Matrix Metallo-proteinase (MMP)-9, Tissue Inhibitor Metallproteinase
(TIMP)-1, Vascular Endothelial Growth Factor (VEGF), Epithel Calcium Adhesi (Ekaderin)
dan kolagen tipe IV serta HPV dapat digunakan untuk memprediksi luaran pada
status pasien tumor dengan dan tanpa metastasis.
Penelitian ini ingin memeriksa peran infeksi HPV sebagai faktor onkogenesis dan
kejadian metastasis KGB leher pada keganasan laring berdasarkan biomarka sebagai
penetapan diagnosis metastasis KGB lokoregional.
Dilakukan Cross-sectional, double blind study dengan pengumpulan data sekunder dari
rekam medis di Departemen THT-KL FKUI-RSCM. Pemeriksaan ekspresi biomarka
dan status HPV dilakukan terhadap jaringan berupa blok parafin dari pasien karsinoma
laring Ekspresi biomarka dilakukan dengan pemeriksaan imunohistokimia, dan identifikasi
virus HPV dengan nested PCR, dilanjutkan dengan flow-through hybridization.
Didapatkan proporsi HPV KSS laring sebanyak 28,7% dengan infeksi HPV risiko tinggi
sebanyak 9,15% dan HPV 16 merupakan tipe yang terbanyak. Analisis multivariat
Mantel-Haenszel didapatkan ekspresi tinggi biomarka EGFR, MMP-9 dan VEGF
berperan terhadap kejadian metastasis KGB pada KSS laring stadium lanjut tanpa
infeksi HPV dengan OR 3,38; 5,14. Keadaan tersebut tidak berperan lagi bila terdapat
infeksi HPV Dari penelitian ini didapatkan suatu algoritma penatalaksanaan KSS laring
stadium lanjut khususnya untuk penentuan tatalaksana diseksi leher pada N0.
Infeksi HPV didapati pada KSS laring stadium lanjut, HPV 16 merupakan tipe HPV
yang terbanyak. Biomarka penanda metastasis didapatkan pada EGFR; MMP-9; VEGF
dengan kekuatan 2;1;6.

ABSTRACT
Biomarkers to predict locoregional lymph nodes metastasis is not yet accurate until
now. The number of occult metastasis in laryngeal carcinoma varies between 165%.
A tumor biomarker that can give information on the existence of locoregional lymph
node involvement in patients with or without signs of clinical locoregional lymph node
involvement, as guidelines whether selective neck dissection is needed in N0 cases. For
patients that need additional treatment biomarkers that are correlated with aggresivity
and metastasis prediction such as EGFR, MMP-9, TIMP-1, VGEF, E-cadherin, collagen
Type IV and HPV are also needed to predict the outcome of patients with or without
lymph node metastasis.
This study aimed to investigate the evidence of HPV infection in laryngeal carcinoma
and the role of biomarkers EGFR, MMP-9, TIMP-1, VEGF, E-cadherin and collagen
type IV, in a late stadium laryngeal SCC observed clinically, especially in N0 and also
to predict diagnosis of a locoregional lymph node that has potential for metastasis.
Cross-sectional, double blind study with planned data collection was performed in the
Department of ENT FKUI-RSCM. Data were taken from Formalin Fixed Paraffin
Embedded (FFPE) of laryngeal cancer specimen after laryngectomies. Samples were
analysed by nested Polymerase Chain Reaction (PCR) and continuous flow-through
hybridizationed for genotyping. Expression of EGFR, MMP-9, TIMP-1, VEGF, Ecadherin,
and collagen Type IV as metastasis biomarker were evaluated by
immunohistochemistry.
Overall HPV proportion in laryngeal cancer was 28.7%. A total of 9,15% laryngeal
cancer patients were infected with high risk HPV type and HPV 16 was the most
frequently observed. Mantel-Haenszel multivariate analysis found that HPV infection did
not play role in neck metastasis eventhough there were positive evidence of metastasis
biomarker. In contrast, the absent of HPV infection, positif metastasis biomarker of EGFR
and VEGF have risk for neck nodes metastasis with OR 3.38; 5.14 fold consecutively.
The algorithm was formed from the PM model to determine the metastasis potential to
locoregional lymph nodes of late stadium laryngeal SCC with N0.
HPV was found to be the oncogenic factor of the laryngeal SCC and HPV 16 was the
most frequently observed type in laryngeal SCC. Biomarkers to predict locoregional
lymph nodes metastasis are EGFR; VEGF with strenght 2;1;6.

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 Metadata

Jenis Koleksi : UI - Disertasi Membership
No. Panggil : D-Pdf
Entri utama-Nama orang :
Entri tambahan-Nama orang :
Entri tambahan-Nama badan :
Program Studi :
Subjek :
Penerbitan : Jakarta: Fakultas Kedokteran Universitas Indonesia, 2016
Bahasa : ind
Sumber Pengatalogan : LibUI ind rda
Tipe Konten : text
Tipe Media : computer
Tipe Carrier : online resource
Deskripsi Fisik : xxiv, 152 pages : illustration ; 28 cm + appendix
Naskah Ringkas :
Lembaga Pemilik : Universitas Indonesia
Lokasi : Perpustakaan UI, Lantai 3
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No. Panggil No. Barkod Ketersediaan
D-Pdf 07-19-891874386 TERSEDIA
Ulasan:
Tidak ada ulasan pada koleksi ini: 20434257
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