Pustaka Ilmiah Universitas Padjadjaran

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Ekspresi Vascular Endothelial Growth Factor dan Ekspresi Tissue Factor berdasarkan Respons Terapi Kemoradiasi Cisplatin pada Penderita Karsinoma Nasofaring Stadium Lanjut (Differences between Vascular Endothelial Growth Factor Expression and Tissue Factor Expression Based on Cisplatin Chemoradiation Therapy Response in Advanced Stage Nasopharyngeal Cancer)

Vascular endothelial growth factor (VEGF) merupakan faktor angiogenik yang berperan dalam angiogenesis tumor. Tissue factor (TF) merupakan inisiator utama pembekuan darah dan merangsang protein yang mengatur angiogenesis. Penelitian bertujuan mengetahui perbedaan ekspresi VEGF dengan ekspresi TF pada penderita KNF stadium lanjut berdasarkan respons terapi kemoradiasi. Dilakukan penelitian kohort prospektif pada penderita KNF stadium III, IVa, dan IVb berdasarkan AJCC edisi ke-7 tahun 2010. Ekspresi TF dan VEGF diperiksa dengan imunohistokimia dan respons kemoradioterapi dievaluasi dengan memakai Response Evaluation Criteria in Solid Tumours (RECIST) revisi versi 1.1 tahun 2009. Analisis statistik yang digunakan adalah Uji eksak Fisher. Selama penelitian Oktober 2012–Oktober 2013 didapatkan 35 penderita KNF yang memenuhi kriteria inklusi dan 5 orang dikeluarkan dari penelitian. Pada kelompok respons didapatkan 17 dari 23 penderita ekspresi VEGF = 25%; 6 dari 23 penderita ekspresi VEGF <25%; 16 dari 23 penderita ekspresi TF = 33%; 7 dari 23 penderita ekspresi TF <33% (p=1,000) serta pada kelompok tidak respons 5 dari 27 penderita ekspresi VEGF =25%; 2 dari 7 penderita ekspresi VEGF <25%; 4 dari 7 penderita ekspresi TF = 33%; 3 dari 7 penderita ekspresi TF <33% (p=0,657). Simpulan, tidak terdapat perbedaan ekspresi VEGF dengan ekspresi TF pada penderita KNF stadium lanjut berdasarkan respons terapi kemoradiasi. Vascular endothelial growth factor (VEGF) is a proangiogenic factor involved in the angiogenesis of NPC. Tissue factor (TF), the main initiator of blood coagulation, also signals protein that regulates angiogenesis. This studanalyzed the differences between VEGF expression and TF expression in tumor tissue based on chemoradiation therapy response. Prospective cohort study was performed in NPC patients stage III, IVa and IVb according tthe AJCC VII staging system. TF expression and VEGF expression were measured by immunohistochemistry, and chemoradiotherapy responses was evaluated by RECIST version 1.1 2009. Statistical analysis was performed using Fisher Exact test. From October 2012 to October 2013, 35 NPC patients were eligible for this study and 5 patients were excluded. In response group, there were 73.9% patients with VEGF expression =25%, 26.1% patients with VEGF expression <25%; 69.6% patients with TF expression =33%, 30.4% patients with TF expression <33% (p=1,000) and in no response group, there were 71,4% patients with VEGF expression = 25%; 28.6% patients with VEGF expression <25%, 57.1% patients with TF expression =33%, 42.9% patients with TF expression <33% (p=0.657). In conclusion, there are differences between VEGF expression and TF expression based on the chemoradiation therapy response, but they are not significantly different.