Evaluasi Tipe DNA HPV Kanker Serviks Pascaradiasi/Kemoradiasi di RSUP H Adam Malik Medan

Abstract

BACKGROUND: Current development of biomolecular techniques allows us to detect HPV DNA genotype as a method to assess therapy response in post radiation/chemoradiation cervical cancer patients. The objective of the study was to detemine the therapy's response based on HPV DNA type in post radiation/chemoradiation cervical cancer patients at H. Adam Malik General Hospital Medan. METHOD: Subjects were postradiation/ chemoradiation cervical cancer patients treated in outpatient or inpatient department of Adam Malik Hospital Medan (n = 25) obtained by consecutive sampling and met the inclusion criteria. Clinical response assessment based on the type of HPV DNA was performed to the subjects. RESULT: Partial response to therapy was found more frequently in type 16 HPV DNA with 7 (50%) patients, resistant to therapy response was found more frequently in types 16, 18 and 31, with 1 (33.3%) patient each, progressive disease response was found mostly in type 16 with 5 (62.5%) patients. Squamous cell histopathology was found more often in type 16 with 11 ( 57. 9%) patients, adenocarcinoma histopathology was found more frequently in type 18 with 3 (50%) patients. Squamous cell histopathology was found mostly in partial response to therapy group with 10 (52.6%) patients, adenocarcinoma histopathology was found mostly in partial response to therapy group with 5 (83%) patients. Chemoradiation was found more often in partial response to therapy group with 12 ( 57 .1 % ) patients, radiation therapy was found more often in partial and progressive disease response with 2 (50%) patients each. CONCLUSION: Partial response to therapy was found more often in type 16 HPV DNA. Resistant to therapy response was found more frequently in types 16, 18 and 31 HPV DNA. Progressive disease response was found mostly in type 16 HPV DNA

LA TAR BELAKANG: Perkembangan teknik biomolekuler saat ini memungkinkan kita untuk melakukan deteksi genotipe DNA HPV sebagai salah satu metode penilaian respon terapi pada penderita kanker serviks pascaradiasi/ kemoradiasi. Tujuan penelitian ini adalah untuk menilai respon terapi berdasarkan tipe DNA HPV pada penderita kanker serviks pasca radiasi/ kemoradiasi di RSUP. H. Adam Malik Medan. METODE: Subyek penelitian adalah penderita kanker serviks pascaradiasi/ kemoradiasi yang berobat di poli rawat jalan ataupun rawat inap RSUP H. Adam Malik Medan (n=25) yang diperoleh secara consecutive sampling serta memenuhi kriteria inklusi. Terhadap subyek penelitian dilakukan penilaian respon klinis berdasarkan tipe DNA HPV. HASIL: Respon terapi parsial lebih sering ditemukan pada tipe DNA HPV 16 yaitu 7 (50%) penderita, respon terapi penyakit menetap ditemukan lebih sering pada tipe DNA HPV 16, 18 dan 31 yaitu 1 (33.3%) penderita, respon terapi penyakit progresif ditemukan sebagian besar pada tipe DNA HPV 16 yaitu 5 (62.5%) penderita. Jenis histopatologi sel skuamos ditemukan lebih banyak pada tipe DNA HPV 16 yaitu 11 (57,9%) penderita, jenis histopatologi adenokarsinoma ditemukan lebih sering pada tipe DNA HPV 18 yaitu 3 (50%) penderita. Jenis histopatologi sel skuamosa ditemukan lebih banyak dengan respon terapi parsial yaitu 1 O (52.6%) penderita, jenis histopatologi adenokarsinoma ditemukan sebagian besar dengan respon terapi parsial yaitu 5 (83%) penderita. Terapi kemoradiasi ditemukan lebih banyak pada respon terapi parsial yaitu 12 ( 57 .1 % ) penderita, terapi radiasi ditemukan lebih sering pada respon terapi parsial dan penyakit progresif yaitu 2 (50%) penderita. KESIMPULAN: Respon terapi parsial ditemukan lebih banyak pada tipe DNA HPV 16. Respon terapi penyakit menetap ditemukan lebih sering pada tipe DNA HPV 16, 18 dan 31. Respon terapi penyakit progresif sebagian besar ditemukan pada tipe DNA HPV 16