Background: Epstein Barr, virus ( EBV ) infection has been frequently related with Nasopharyngeal Carcinoma (NPC), this virus makes the tissue of nasopharyng express Nuclear Factor Kappa Beta  (NFκB). NFκB and c-myc are two transcriptional factor for proliferation. NFκB and c-myc are two sign system for malignancy. The administration of neoadjuvant chemotherapy may prevent the apoptosis and inhibit the proliferation. Purpose: To evaluate the effect of neoadjuvant chemotherapy upon the expression level of NFκB and c-myc in undifferentiated NPC. Method: Quasi Experimental research by one group before and after intervention design. Ten sampels were collected from nasopharyngeal biopsy tissue which had been diagnosed as undifferentiated NPC. Wilcoxon signed Ranks test and Spearman’s were used to analized data, utilizing SPSS 15.0 underwindows program. Result: After neoadjuvant chemotherapy,   there were significant increase (p=0.005) for expression of NFκB (1.11 ± 1.14 / 4.92 ± 2.79) and significant  increase for expression of c-myc (1.15 ± 0,78 / 3.04 ± 1.91). There were significant corelation between  expresion of NFκB and c-myc in undifferentiated NPC (p=0.001). Conclussion: There were significant increase in expression of NFκB and c-myc after neoadjuvant chemotherapy in undifferentiated NPC, and   significant corelation between expresion of NFκB and c-myc in undifferentiated NPC. Keywords: nasopharyngeal carcinoma, neoadjuvant chemotherapy, NFκB and c-myc   Abstrak :  Latar belakang: Patogenesis Karsinoma Nasofaring (KNF) banyak dikaitkan dengan infeksi virus Epstein Barr. Virus ini menyebabkan jaringan mengekspresikan Nuclear Factor Kappa Beta (NFκB). NFκB  dan c-myc merupakan faktor transkripsi, yang menyebabkan proliferasi jaringan. Adanya ekspresi NFκB dan c-myc merupakan dua faktor penting sebagai penanda terjadinya keganasan. Pemberian kemoterapi neoadjuvant diharapkan dapat menghambat proses proliferasi dan menyebabkan terjadinya apoptosis. Tujuan: Mengetahui pengaruh kemoterapi neoadjuvant terhadap ekspresi NFκB dan c-myc pada KNF jenis undifferentiated dan hubungan antara ekspresi NFκB dan c-myc. Metode dan bahan penelitian: Penelitian eksperimen kuasi dengan rancangan one group before and after intervention.  Sebanyak 10 sampel dari jaringan biopsi KNF jenis undifferentiated, masing-masing dilakukan pemeriksaan ekspresi NFκB dan     c-myc sebelum dan sesudah pengobatan. Analisa dengan Uji statistk Wilcoxon signed Ranks test dan Spearman’s menggunakan SPSS 15.0 program underwindow. Hasil penelitian: Setelah kemoterapi neoadjuvant terjadi peningkatan signifikan (p=0,005) ekspresiNFκB (1,11 ± 1,14 dibanding 4,92 ± 2,79) dan terjadi peningkatan signifikan (p=0.025) ekspresi c–myc (1,15 ± 0,78 dibanding 3,04 ± 1,91). Analisis hubungan antara ekspresi NFκB dengan c-myc pada KNF jenis undifferentiated memenuhi garis liniar dan signifikan (p=0,001). Kesimpulan: Terdapat peningkatan ekspresiNFκB dan c-myc sesudah kemoterapi neoadjuvant yang signifikanpada KNF jenis undifferentiated. Terdapat hubungan signifikan antara ekspresi NFκB dengan c-myc pada KNF jenis undifferentiated. Kata kunci: karsinoma nasofaring, kemoterapi neoadjuvant, NFκB dan c-myc

Background: Epstein-Barr virus (EBV) infection in undifferentiated type nasopharyngealcarcinoma (NPC) will express antigenic proteins such as LMP1 and triggering a cascade ofimmunocompetent cells (CD4+ and CD8+). The ratio of CD4+/CD8 illustrates the potential eliminationof intracellular pathogens and tumor cells. Neoadjuvant chemotherapy will suppress the growth of tumorcells and immune system cells   that leads to cellular immune decline. Objective: To know the influence ofneoadjuvant chemotherapy on the expression of LMP1, the immune system and the relationship betweenthe expression of LMP1 with the ratio of CD4+/CD8++. Method: The design was one group before andafter intervention, with 10 samples of undifferentiated NPC, biopsied before and after neoadjuvant chemotherapy, and got immunohistochemical examination. We used mouse antihuman LMP1, mouse monoclonal antihuman CD4+ and antihuman CD8 antibodies. Data were analyzed with the WilcoxonSigned Ranks test, and Spearman’s Linear Regression. Result: After neoadjuvant chemotherapy, we + found statistically significant decline in LMP1 expression (p = 0.007), CD4+ (p = 0.041) and CD8   (p= 0.005). The ratio of CD4+/CD8 increase was not statistically significant (p = 0.646). The relationshipbetween the expression of LMP1 with the ratio of CD4++/CD8was very weak (r = 0.17) and no statisticallysignificant (p = 0.646). Conclusion: Neoadjuvant chemotherapy in undifferentiated type NPC causes adecrease in the expression of LMP1 and immunological status (CD4 + +, CD8 ) and increase in the ratioof CD4+/CD8+. The relationship between the expression of LMP1 with the ratio of CD4+ was veryweak and not significant. Keywords: nasopharyngeal carcinoma, expression of LMP1, CD4+, CD8++/CD8, ratio of CD4,neoadjuvant chemotherapy.+++/CD8+  Abstrak :  Latar belakang: Infeksi Epstein-Barr virus (EBV) pada karsinoma nasofaring (KNF) jenis takberdiferensiasiakanmengekspresikan protein antigen antara lain LMP1 dan memicu hadirnyasel-selimunokompeten(CD4+ dan CD8+). Rasio CD4+/CD8 menggambarkan potensi eliminasi patogen intraseldan sel tumor. Kemoterapi neoadjuvant akan menghambat pertumbuhan sel tumor dan juga menghambatpembentukan sel-sel sistem imun tubuh sehingga berefek pada penurunan imunitas seluler. Tujuan:Mengetahui pengaruh kemoterapi neoadjuvant terhadap ekspresi LMP1, sistem imun dan hubunganantara ekspresi LMP1 dengan rasio CD4+/ CD8++. Metode: Desain penelitian one group before and afterintervention, menggunakan 10 sampel biopsi KNF tak-berdiferensiasi, sebelum dan sesudah kemoterapineoadjuvant dilakukan pemeriksaan imunohistokimia. Antibodi yang digunakan ialah antibodi mouseantihuman LMP1, monoclonal mouse antihuman CD4+ dan antihuman CD8. Data penelitian dianalisisdengan Wilcoxon Signed Ranks test, Regresi Linier dan Spearman’s dengan program statistik SPSS forWindows. Hasil: Setelah kemoterapi neoadjuvant terjadi penurunan signifikan secara statistik baikekspresi LMP1 (p=0,007); CD4+ (p=0,041), maupun CD8+ (p=0,005). Rasio CD4++/CD8 meningkat tidaksignifikan secara statistik (p=0,646).   Hubungan antara ekspresi LMP1 dengan rasio CD4 sangatlemah (r = 0,17) dan tidak signifikan secara statistik (p=0,646). Kesimpulan: Kemoterapi neoadjuvantpada KNF jenis tak-berdiferensiasi menyebabkan penurunan ekspresi LMP1 dan status imunologi(CD4+,CD8+) serta peningkatan rasio CD4+/CD8++++/CD8/CD8. Hubungan antara ekspresi LMP1 dengan rasio CD4/CD8 sangat lemah dan tidak signifikan. Kata kunci: karsinoma nasofaring, ekspresi LMP1, CD4++, CD8+, rasio CD4, kemoterapineoadjuvant.