Hubungan antara Genotyping DNA Human Pappillomavirus (HPV) dengan Respons Terapi Radiasi pada Adenokarsinoma Serviks

WIDYORINI LESTARI HARDJOLUKITO

Abstract


ABSTRACT
The object of this study to know the type of DNA Human Papilloma Virus genotyping in adenocarcinoma cervical cancer,
espescially in Cipto Mangunkusomo Hospital and Cancer Centre Dharmais Hospital. The importance of human
papilloma virus (HPV) infection in the outcome of cervical cancer after radiotherapy remains unknown. Our study
explored whether the HPV status of tumors and also persistence of the HPV infection is related with the outcome of
radiotherapy in patients with cervical cancer.
The biopsy cervix samples taken from 12 patients with Adenocarcinoma cervical cancer (Stage IIB-IIIB) that met in the
inclusion criteria. The HPV genotyping examination was conducted twice, before and 3 month after radiation therapy. The
subjects treated by radiation therapy without sensitizer according to standard procedures. After underwent complete
radiation, response of radiation therapy was conducted by clinical assessment and repeated HPV genotyping test.
Result: a total of 12 patients had been collected in this study. From this sample, there were found HPV-positive tumors in
91,7% (11 cases ) of patients, with the details of a single infection of 75% and 16,7% multiple infections. Based on the type
of HPV type 18 was obtained (66,7%), type 45: 8,3%. Persistent infection with HPV after radiation encountered by 41,7%.
Complete clinical responsse observed in the single infection group number of 66,7%, while in the group of multiple
infections by 50% (p = 1,000). While HPV infection settled with a complete clinical responsse by 16,7% (p = 0,015).
There werent clinically relationships between clinical complete responsse with single or multiple HPV infection (p =
1,000). There were clinically relationship between persistent HPV infection with complete clinical responsse (p = 0,015).
Keyword: cervical cancer, genotyping HPV DNA, persistent infection, clinical responsse


ABSTRAK
Penelitian ini bertujuan untuk mengetahui jenis genotipe DNA HPV pada kasus adenokarsinoma serviks , terutama di
RSUPN Cipto Mangunkusumo dan RS Kanker Dharmais. Penelitian ini juga bertujuan untuk mengetahui hubungan
antara genotipe DNA HPV dengan respons klinis radiasi serta mengetahui terjadinya infeksi HPV menetap respons
klinis terapi radiasi.
Dua belas penderita kanker serviks stadium IIB-IIIB dengan hasil histopatologi adenokarsinoma serviks sesuai dengan
kriteria inklusi dilakukan pemeriksaan genotipe HPV DNA yang berasal dari biopsi serviks. Sampel penelitian diberikan
tata laksana dengan terapi radiasi tanpa sensitizer sesuai prosedur standar. Tiga bulan setelah dinyatakan selesai
radiasi, dilakukan penilaian respons klinis radiasi dan pemeriksaan genotipe DNA HPV ulang.
Dari 12 sampel penelitian, didapatkan infeksi HPV sebelum radiasi 11 sampel (91,7%) dengan perincian infeksi tunggal
75% dan infeksi multipel 16,7%. Berdasarkan tipe HPV, diperoleh infeksi tunggal tipe 18 (66,7%) dan tipe 45 (8,3%).
Infeksi menetap HPV setelah radiasi, baik pada infeksi tunggal maupun multipel sebesar 41,7%. Respons klinis komplit
dijumpai pada kelompok infeksi tunggal sejumlah 66,7%; sedangkan pada kelompok infeksi multipel sebesar 50%
(p=1,000) dan infeksi HPV menetap dengan respons klinis komplit sebesar 20,0% (p=0,015). Penelitian ini menyimpulkan bahwa tipe HPV DNA terbanyak dijumpai pada penderita adenokarsinoma serviks adalah tipe 18, yaitu 83,4%. Infeksi HPV menetap setelah radiasi sebanyak 41,7%. Tidak terdapat perbedaan respons klinis antara infeksi tunggal dan infeksi multipel HPV, tetapi tidak terdapat hubungan yang signifikan (p=1,000). Infeksi menetap HPV berhubungan secara klinis dengan respons klinis terapi radiasi (p=0,015).


Kata Kunci: kanker serviks, adenokarsinoma, tipe DNA HPV, infeksi HPV menetap, respons terapi.


Keywords


cervical cancer, genotyping HPV DNA, persistent infection, clinical responsse

References


Lindel K, Burri P, Studer HU, Altermatt HJ, Greiner RH,

Gruber G. Human papillomavirus status in advanced cervical

cancer: predictive and prognostic significance for curative

radiation treatment. Int J Gynecol Cancer. 2005;15:278-84.

Franco EL, Franco ED, Ferenczy A. Cervical cancer: epidemiology,

prevention and the role of human papilloma virus. CMAJ

;164(7):1017-25.

Castellsague X. Natural history and epidemiology of HPV

infection and cervix. Gynecology Oncology 2008;110:4-7.

Sasieni P, Adams J. Changing rates of adenocarcinoma and

adenosquamous carcinoma of the cervix in England. Lancet

;357(9267):1490-3.

Harriet O, Smith MD, Michael F, Tiffany D, Qualls CR, Key

CR. The Rising Incidence of Adenocarcinoma Relative to

Squamous Cell Carcinoma of the Uterine Cervix in the United

StatesA 24-Year Population-Based Study. Gynecologic

Oncology 2000;78:97-105.

Nagai Y, Toma T, Moromizato H, Maehama T, Asato T, Kariya

KI, et al. Persistence of human papillomavirus infection as

a predictor for recurrence in carcinoma of the cervix after

radiotherapy. American Journal of Obstetrics and Gynecology

;191:1907-13.

Chaterjee R, Mandal B, Bandyopadhyay S. Detection of HPV

DNA in Cervical Carcinomas after Treatment in India.

International Journal Human Genetic 2005;5(1):27-31.

Harima Y, Sawada S, Nagata K, Sougawa M, Ohnishi T.

Human papilloma virus (HPV) DNA associated with prognosis

of cervical cancer after radiotherapy. International Journal of

Radiation Oncology, Biology, Physics 2002;52(5):1345-51.

Munagala R, Dona MG, Rai SN, Jenson AB, Bala N, Ghim

SJ, et al. Significance of multiple HPV infection in cervical

cancer patients and its impact on treatment responsse.

International Journal of Oncology 2009;34(1):263-71.

Tjokroprawiro BA, Hartono P, Andrijono, Budiono, Supriana

N. Eliminasi human papillomavirus (HPV) dan responss

terapi pada adenokarsinoma serviks dan karsinoma sel

skuamosa serviks yang mendapat pengobatan kemoradiasi.

Obstetri Ginekologi Indonesia 2008;32:5-15.

Aziz MF. Gynecological cancer in indonesia. Gyncologic

Oncology 2009;20(1):8-10.Lai CH, Chou HH, Chang CJ, Wang

CC, Hsueh S, Huang YT, et al. Clinical implications of human

papillomavirus genotype in cervical adeno-adenosquamous

carcinoma. European Journal of Cancer (Oxford, England :

2013;49(3):633-41.

Tase T, Okagaki T, Clark BA, Manias DA, Ostrow RS, Twiggs

LB, et al. Human papillomavirus types and localization in

adenocarcinoma and adenosquamous carcinoma of the

uterine cervix: a study by in situ DNA hybridization. Cancer

Research 1988;48(4):993-8.

Doorbar J. Molecular biology of human papillomavirus

infection and cervical cancer. Clinical Science (London,

England : 1979) 2006;110(5):525-41.

Wang CC, Lai CH, Huang HJ, Chao A, Chang CJ, Chang TC,

et al. Clinical effect of human papillomavirus genotypes in

patients with cervical cancer undergoing primary radiotherapy.

International Journal of Radiation Oncology, Biology, Physics

;78(4):1111-20.

de Sanjose S, Quint WG, Alemany L, Geraets DT, Klaustermeier

JE, Lloveras B, et al. Human papillomavirus genotype attribution

in invasive cervical cancer: a retrospective cross-sectional

worldwide study. The Lancet Oncology 2010;11(11):1048-56.

Bosch FX, Manos MM, Munoz N, Sherman M, Jansen AM,

Peto J, et al. Prevalence of human papillomavirus in cervical

cancer: a worldwide perspective. International biological

study on cervical cancer (IBSCC) Study Group. Journal of the

National Cancer Institute 1995;87(11):796-802.

Schellekens MC, Dijkman A, Aziz MF, Siregar B, Cornain S,

Kolkman-Uljee S, et al. Prevalence of single and multiple

HPV types in cervical carcinomas in Jakarta, Indonesia.

Gynecol Oncol. 2004;93(1):49-53.

Badaracco G, Savarese A, Micheli A, Rizzo C, Paolini F, Carosi

M, et al. Persistence of HPV after radio-chemotherapy in

locally advanced cervical cancer. Oncology Reports

;23(4):1093-9.

Munagala R, Dona MG, Rai SN, Jenson AB, Bala N, Ghim

SJ, et al. Significance of multiple HPV infection in cervical

cancer patients and its impact on treatment responsse.

International Journal of Oncology 2009;34(1):263-71.

Conesa-Zamora P. Immune responsses against virus and

tumor in cervical carcinogenesis: Treatment strategies for

avoiding the HPV-induces immune escape. Gyncologic Oncology

;131:480-8.

Narayan K, McKenzie AF, Hicks RJ, Fisher R, Bernshaw D,

Bau S. Relation between FIGO stage, primary tumor volume,

and presence of lymph node metastases in cervical cancer

patients referred for radiotherapy. Int J Gynecol Cancer

;13(5):657-63.

Pecorelli S. Revised FIGO staging for carcinoma of the vulva,

cervix, and endometrium. International Journal of Gynaecology

and Obstetrics: The Official Organ of The International

Federation of Gynaecology and Obstetrics 2009;105(2):103-4.

Leveque J, Laurent JF, Burtin F, Foucher F, Goyat F, Grall JY,

et al. Prognostic factors of the uterine cervix adenocarcinoma.

European Journal of Obstetrics, Gynecology, and Reproductive

Biology 1998;80(2):209-14.

Perez CA, Grigsby PW, Nene SM, Camel HM, Galakatos A,

Kao MS, et al. Effect of tumor size on the prognosis of

carcinoma of the uterine cervix treated with irradiation alone.

Cancer 1992;69(11):2796-806.

Baalbergen A, Ewing-Graham PC, Hop WC, Struijk P, Helmerhorst

TJ. Prognostic factors in adenocarcinoma of the uterine cervix.

Gynecol Oncol. 2004;92(1):262-7.

Bachtiary B, Obermair A, Dreier B, Birner P, Breitenecker G,

Knocke TH, et al. Impact of multiple HPV infection on

responsse to treatment and survival in patients receiving

radical radiotherapy for cervical cancer. International Journal

of Cancer Journal International Du Cancer 2002;102(3):237-43.

Kim JY, Nam BH, Lee JA. Is human papillomavirus genotype

an influencing factor on radiotherapy outcome? Ambiguity

caused by an association of HPV 18 genotype and adenocarcinoma

histology. Journal of Gynecologic Oncology 2011;22(1):32-8.

Lea JS, Sheets EE, Wenham RM, Duska LR, Coleman RL, Miller

DS, et al. Stage IIB-IVB cervical adenocarcinoma: prognostic

factors and survival. Gynecol Oncol. 2002;84(1):115-9.

Ferdousi J, Nagai Y, Asato T, Hirakawa M, Inamine M, Kudaka

W, et al. Impact of human papillomavirus genotype on

responsse to treatment and survival in patients receiving

radiotherapy for squamous cell carcinoma of the cervix.

Experimental and Therapeutic Medicine 2010;1(3):525-30.

Molano M, Acosta PM, Bravo MM. Types and variants of

human papillomavirus in patients with cervical cancer

submitted to radiotherapy. Biosalud 2007;6:45-7.

Singh RK, Maulik S, Mitra S, Mondal RK, Basu PS, Roychowdhury

S, et al. Human papillomavirus prevalence in postradiotherapy

uterine cervical carcinoma patients: correlation with recurrence

of the disease. Int J Gynecol Cancer 2006;16(3):1048-54.


Full Text: PDF

DOI: 10.33371/ijoc.v9i1.368

Article Metrics

Abstract view : 570 times
PDF - 205 times

Refbacks

  • There are currently no refbacks.


Copyright (c) 2015 Indonesian Journal of Cancer