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.

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.

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.

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.

Intoduction: Cytochrome P450 2E1 (CYP2E1) is the enzyme as a part of CYP 450 enzyme families. It acts in phase I metabolism which result in the formation of electrophilic molecule and elevation of reactive oxygen species (ROS). Review: The last is responsible in development of cancer by damaging the protein and DNA, leading to mutation and increase cell proliferation. Nitrosamine as the most carcinogen for nasopharyngeal carcinoma (NPC) is the substrate of this enzyme. This chemical is contained in the salted fish, tobacco smoke, beer, and preserved food such as meat product. Nitrosamine needs CYP2E1 to activate the pro-carcinogen in order to act is carcinogenic effect. Polymorphism of CYP2E1 is associated with higher transcriptional activity and enzyme activity. Conclussion: It means the ability of this enzyme to activate pro-carcinogen of nitrosamine will increase, leading to higher chance to develop cancer, including NPC.