Tesis

Hubungan antara Ekspresi OCT4 dengan Respons Terapi Kemoradiasi pada Karsinoma Nasofaring Tidak Berkeratin Tidak Bediferensiasi = Association of OCT4 expression with chemoradiation therapy response in undifferentiated non-keratinizing nasopharyngeal carcinoma.

Latar belakang: Karsinoma nasofaring (KNF) merupakan keganasan tersering di regio kepala leher. Terapi utama KNF adalah radiasi karena sifatnya yang radiosensitif, namun rekurensi lokal dan metastasis banyak terjadi. Cancer stem cell (CSC) diduga sebagai salah satu penyebabnya. Octamer binding transcription factor 4 (OCT4) merupakan salah satu penanda sel punca embrionik yang penting dalam progresi keganasan berbagai organ, termasuk nasofaring. Namun peran OCT4 sebagai prediktor respons terapi KNF masih menjadi perdebatan. Metode: Penelitian ini menggunakan metode potong lintang. Sampel berjumlah 41 kasus di Departemen Patologi Anatomik FKUI/RSCM periode Januari 2014 sampai Desember 2016. Dilakukan pulasan imunohistokimia OCT4 dan penilaian terhadap perbedaan rerata proporsi ekspresi positif kuat dan sedang OCT4 pada kelompok respons dan non-respons. Hasil: Terdapat 33 kasus (80,5%) dengan jenis kelamin laki-laki dan 8 kasus (19,5%) dengan jenis kelamin perempuan. Berdasarkan data klinik, 13 kasus (31,7%) berada dalam rentang usia 40-49 tahun, gejala terbanyak ditemukan berupa benjolan leher pada 31 kasus (75,6%) dan 18 kasus (43,9%) berada pada stadium IVA. Ditemukan perbedaan bermakna (p = 0,009) antara rerata proporsi ekspresi OCT4 positif kuat dan sedang kelompok respons (61,29%) dibandingkan kelompok non respons (37%). Kesimpulan: Kesimpulan penelitian ini adalah ditemukan hubungan bermakna antara ekspresi OCT4 dengan respons kemoradiasi KNF tidak berkeratin tidak berdiferensiasi.
Kata kunci: cancer stem cells; karsinoma nasofaring; OCT4


Background: Nasopharyngeal carcinoma (NPC) is the most common head and neck malignancy with high rate of resistance and recurrence. Cancer stem cells (CSC) is considered responsible for cancers relapse and metastasis because of its self-renewal capabilities. Expression of embryonic stem cells marker Octamer binding transcription factor 4 (OCT4) is crucial for progression of various human malignancies, including NPC. But the role of OCT4 as therapy response predictor is controversial. Method: This study is using cross-sectional method. Sample consist of 41 undifferentiated non keratinizing NPC cases diagnosed in Anatomical Pathology Departement, Faculty of Medicine, Universitas Indonesia-Dr. Cipto Mangunkusumo Hospital from January 2014 until December 2016. OCT4 immunohistochemistry staining was performed then tumour cells with strongly and moderately positive OCT4 staining were counted. Mean difference between both groups is calculated. Result: There were 33 male cases (80,5%) of 41 and 8 female cases (19,5%). 13 cases (31,7%) were age 40-49 years old. Neck mass was the most common symptom in 31 cases (75,6%) and 18 cases (43,9) were in stadium IVA. Mean difference of strongly and moderately positive OCT4 expression between responsive (61,29%) and non-responsive (37%) to chemoradiation therapy were statically significant (p=0.009). Conclusion: This study suggested OCT4 expression is associated with chemoradiation therapy response.
Keywords: cancer stem cells; nasopharyngeal carcinoma; OCT4