Expressions of Nuclear Factor-kappa B and Peroxisome Proliferator-activated Receptor-Gamma Proportional with Clinical Staging of Nasopharyngeal Carcinoma

BACKGROUND: Nasopharyngeal carcinoma (NPC) is a malignancy induced by the mutation of the transcription factors nuclear factor-kappa B (NF-kB) and peroxisome proliferator-activated receptor-gamma (PPAR-gamma). There was no known of the study about the association and targeted therapy of NF-kB and PPAR-gamma-induced NPC. AIM: This study analyzed and compared the proportion of NF-kB and PPAR-gamma and its association with the clinical characteristic of various NPC patients. METHODS: This was a cross-sectional study and conducted in Adam Malik General Hospital. The samples were paraffin block tissue obtained from 58 NPC patients and underwent immunohistochemistry staining for NF-kB or PPAR-gamma overexpression in March–November 2018. Determination of overexpression was based on the immunoreactive score. The association of NF-kB or PPAR-gamma overexpression with the clinical characteristics of the patients was analyzed using Fisher’s exact test. RESULTS: This study showed a significant increase of NF-kB and PPAR-gamma (p < 0.05). Male was found common than women (3.46:1) with non-keratinizing squamous cell carcinoma as the most common form of NPC (75.9%) and the 41–60 years old is the most common age (56.9%). Overexpression of NF-kB and PPAR-gamma was found mostly in T3-T4 (66.0%; 69.6%), N+ (92.5%; 91.3%), and clinical Stage IV (67.9%; 73.9%), respectively. CONCLUSION: The number of samples overexpressed was proportional to the clinical stage of NPC. This study provides an insight into the relationship of NF-kB and PPAR-gamma to NPC, suggesting their role in the development of malignancy.

Sustained Tau Phosphorylation and Microglial Activation Following Repetitive Traumatic Brain Injury

BACKGROUND: Repetitive traumatic brain injury (TBI), even without acute sequela, can induce a delayed neurodegenerative with overexpression of phosphorylated tau (p-tau) as hallmark, caused by chronic inflammation mediated in part by microglial activation. AIM: The aim of this study was to examine the dynamics of p-tau accumulation and microglial activation following repetitive TBI. MATERIALS AND METHODS: Thirty Sprague–Dawley rats were randomized into a sham control group and two treatment groups receiving three successive closed-skull impacts (TBI model) from a 40-g mass dropped from a 1-m height on alternating days (days 0, 1, 3, and 7). The first treatment group was sacrificed on the last day of trauma and the second treatment group after 7 days of no trauma. The expression level of p-tau was evaluated by AT-8 antibody immunostaining and microglial activation by anti-CD-68 immunostaining. RESULTS: Immunoexpression of AT-8 was significantly elevated 7 days after TBI compared to the last day of trauma and compared to the sham control group, while CD-68 expression was significantly higher than sham controls on the last day of trauma and remained elevated for 7 days without trauma. CONCLUSION: The study showed that brain trauma can induce p-tau overexpression and microglial activation that is sustained during the non-trauma period.

Latent Membrane Protein-1 Protein Induction toward Vascular Endothelial Growth Factor Expression in the Development of Nasopharyngeal Carcinoma

BACKGROUND: Nasopharyngeal carcinoma (NPC) is associated with Epstein–Barr virus infection as the main factor. Latent membrane protein (LMP)-1 protein and vascular endothelial growth factor (VEGF) have been suggested as the prognostic biomarker for NPC. AIM: This study is conducted to analyze the overexpression of LMP-1 protein and VEGF and the combination of these two in NPC patients. The role of LMP-1 protein in the induction of VEGF is identified by analyzing the association between these two proteins. METHODS: A cross-sectional design study is conducted at Adam Malik General Hospital. Formalin-fixed, paraffin-embedded sections from the NPC tissue samples are submitted for immunohistochemistry staining. Fisher’s exact test is used to analyze variables relation. RESULTS: Among 56 samples, there was a significant correlation between LMP-1 protein overexpression with histopathological type and clinical staging, and VEGF overexpression with lymph node enlargement and clinical staging (p < 0.05). There was no significant correlation between LMP-1 protein with VEGF in NPC patients (p > 0.05). CONCLUSION: Increased expressions of LMP-1 protein, VEGF, and a combination of LMP-1 protein and VEGF are noted in correlation with increasing the clinical stages. In contrast to the previously suggested hypotheses, the correlation between these two proteins is not significant in the present study. It could happen due to the different associations of each protein overexpression toward the clinical parameter. However, these two proteins could be used in evaluating the prognosis and providing a targeted therapy to NPC.

The Association of CYP2E1 Polymorphism and Environmental Factor in Nasopharyngeal Carcinoma Patients

INTRODUCTION: Polymorphism of CYP2E1 induces nasopharyngeal carcinoma (NPC) by activating pro-carcinogens including nitrosamine. Environmental factor such as salted fish, preserved food, tobacco, and alcohol consumption which contains nitrosamine, join with CYP2E1 polymorphism leads to an increase of susceptibility for NPC. OBJECTIVE: The aims of this study were to identify CYP2E1 polymorphism and the association with other risk factors to NPC in NPC patients. METHODS: This study was analytic research with the case–control design. The samples were taken based on non-probability consecutive sampling method. The identification of CYP2E1 polymorphism was done by the PCR-RFLP method. The association of its variable to NPC was analyzed with the Chi-square test and between polymorphism of CYP2E1 with other risk factors was analyzed with stratified analysis. RESULT: We found that there was no significant association of CYP2E1 polymorphism with NPC. However, the joint effect of CYP2E1 polymorphism with smoking was significant in NPC patients. The risk for NPC in the combination of those two was 4.0-fold. CONCLUSION: The study showed the capability of genetics and environment in the development of NPC. Further study can be done to find evidence of genetics and environmental influence in the prevention and treatment of NPC.

Cyclooxygenase-2 Expression and Its Correlation with Primary Tumor Size and Lymph Node Involvement in Nasopharyngeal Carcinoma

AIM:

This study aimed to observe the cyclooxygenase-2 expression and its correlation with tumour size and lymph node involvement in nasopharyngeal carcinoma.

METHODS:

This study was cross-sectional, that enrolled 126 samples diagnosed with nasopharyngeal carcinoma in Haji Adam Malik General Hospital, Medan, Indonesia which fulfilled the inclusion criteria.

RESULTS:

Based on this study, we found that the age peak incidence of nasopharyngeal carcinoma patients about a 41-60-year-old group (57.1%), dominated by men (71.4%). Through histopathological examination, non-keratinizing squamous cell carcinoma is the most predominant type (79.4%). We also found T3 is the most prevalent primary tumour size (32.5%) with prominent lymph node involvement N3 (45.2%), and stage IV (54.8%). Cyclooxygenase-2 overexpression is prevalent among nonkeratinizing squamous cell carcinoma (81.1%), T3 primary tumour size (41.1%), N3 node involvement (60.0%), and IV clinical stage (71.6%). In addition, we found a significant relationship between cyclooxygenase-2 expressions towards tumor size (p < 0.001) and lymph node involvement (p < 0.001) in nasopharyngeal carcinoma.

CONCLUSION:

It is proved that the overexpression of cyclooxygenase-2 will increase the susceptibility of nasopharyngeal carcinoma patients having advanced primary tumour size and lymph node involvement.

Correlation of P38 Mitogen-Activated Protein Kinase Expression to Clinical Stage in Nasopharyngeal Carcinoma

BACKGROUND:

Nasopharyngeal carcinoma (NPC) is uncommon and usually diagnosed at the advanced stage. A subfamily of mitogen-activated protein kinase which is called p38 mitogen-activated protein kinase (MAPK) involved in response to stress, and plays an important role in cell regulation. There is a suggestion that p38 mitogen-activated protein kinase could be a potential biomarker to determine the clinical stage of nasopharyngeal carcinoma.

AIM:

The aim of this study is for observing and analysing the correlation of p38 mitogen-activated protein kinase expression in regards to nasopharyngeal carcinoma patient’s clinical stage.

METHODS:

This study involved 126 nasopharyngeal carcinoma patients admitted to Haji Adam Malik General Hospital.

RESULTS:

The result of this study indicates that nasopharyngeal carcinoma mostly found in the age group 41-60 years, male, non-keratinizing squamous cell carcinoma, and stage IV group. In immunohistochemistry evaluation, most of p38 mitogen-activated protein kinase overexpressed in non-keratinizing squamous cell carcinoma, T3-T4, N2-N3 and clinical stage III-IV. Spearman’s test for categorical correlation yield p-value of < 0.001.

CONCLUSION:

In conclusion, there is a significant correlation between p38 mitogen-activated protein kinase expression and the clinical stage of nasopharyngeal carcinoma.

Adenomatous Polyposis Coli, mismatch repair, and microsatellite instability in colorectal cancer based on different locations

AIM

to examine the protein expression negative (PEN) of Adenomatous Polyposis Coli (APC), Mismatch Repair (MMR), and Microsatellite Instability (MSI) status of colorectal cancer (CRC), and establish a comparison of those molecular characteristics in CRC location among Indonesian patients in Adam Malik Hospital, Pirngadi Hospital, and other hospitals within the network of Faculty of Medicine University of Sumatera Utara Medan Indonesia.

METHODS

this prospective study was conducted from April to December 2012. Fresh tissues were obtained from colorectal tumor patients. The APC-PEN, MMR (MLH1, MSH2, PMS2, MSH6)-PEN, were assessed by immunohistochemistry, and MSI by PCR using 5 microsatellite markers (BAT25, BAT26, D2S123, D5S346, D17S250), as independent variables. The tumour locations as dependent variables were divided into proximal colon (caecum, ascending colon, transverse colon); distal colon (splenic flexure, descending colon, sigmoid) and rectum. The comparative study were done by bivariate and multivariate analysis.

RESULTS

there were 77 cases of colorectal adenocarsinoma. MMR-PEN was found in 54 of 77 (70.1%). MLH1-PEN was different between distal colon and rectal cancer (p=0.008); MSH6-PEN was different between proximal colon and rectal cancer (p= 0.020). Multivariate analysis showed: MLH1-PEN was related to cancer location (p=0.006) with OR 0.12 (95% CI 0.026-0.547). It had 0.12 times probability to be found in distal than rectum. MLH1-PEN had 10 times higher probability to be found in proximal than in distal (p=0.037). MSH6-PEN was related to the location (p=0.026) with OR 0.165 (95% CI 0.034-0.803), and had 0.165 times probability to be found in proximal than rectum; and 11 times higher probability in distal than proximal colon (p=0.043). APC-PEN was related to the location (p=0.020), with OR 6.897 (95% CI 1.359-34.995), and 6.89 times higher probability in distal than in rectum, with other variables controlled. MSI-H was found in 29 of 77 (37.7%) and MSI-L/MSS in 48 (62.3%). The proportion of MSI-H displayed a tendency to occur in proximal rather than in distal colon or rectal cancer.

CONCLUSION

the underlying carcinogenic pathway or molecular background differs according to the cancer locations of CRC patients in this region. MLH1-PEN was prominent in proximal colon cancer, MSH6-PEN in distal colon and rectal cancer, and APC-PEN in distal colon respectively.