Hubungan Ekspresi Sall Like Protein 4 (SALL4) pada Berbagai Subtipe Karsinoma Nasofaring di Rumah Sakit Umum Pusat Haji Adam Malik Medan Tahun 2020-2021

Abstract

Background: Nasopharyngeal carcinoma (NPC) is a malignant tumor in the head and neck region, originating from the nasopharyngeal epithelium. Data from the Global Burden of Cancer 2020, nasopharyngeal carcinoma ranks fifth in Indonesia from all malignancies in Indonesia. The high mortality rate indicates that the management of nasopharyngeal carcinoma through surgery, radiotherapy and chemotherapy is not fully satisfactory. It is known that the KNF subtype of keratinizing squamous cell carcinoma (KSCC) has a low response to radiotherapy and a worse prognosis compared to the subtype of non-keratinizing squamous cell carcinoma (NKSCC). While there are studies that say SALL4 has been shown to modulate the effects of radiation therapy on nasopharyngeal tumor cells. Objective: This study aims to analyze the relationship between SALL4 expression and various subtypes of nasopharyngeal carcinoma at Haji Adam Malik Hospital in Medan in 2020-2021. Methods: This type of research was descriptive analytic using 33 samples of NPC and stained with SALL4 immunohistochemistry, with a cross sectional approach. SALL4 expression is strong if score ≥ 6, and weak if score < 6. Results: From the 33 samples, the majority were male, with 26 (78.8%) samples compared to 7 (21.2%) female samples. The age group of patients with nasopharyngeal carcinoma in this study was mostly found in the age group of 41-50 years, namely 17 (51.5%) samples. In the differentiated NKSCC subtype, strong SALL4 expression was obtained in 2 (25%) samples, and weak in 6 (75%) samples. The undifferentiated NKSCC subtype obtained strong SALL4 expression in 4 (21.05%) samples, and weak in 15 (78.95%) samples. The KSCC subtype obtained strong SALL4 expression in 1 (16.7%) sample, and weak in 5 (83.3%) samples. There is no relationship between SALL4 expression in various subtypes of nasopharyngeal carcinoma. The Mann-Whitney U test was carried out on this variable and obtained a p-value of 0.7101 (p ≥ 0.05). Conclusion: There is no correlation between SALL4 expression with subtypes in nasopharyngeal carcinoma.