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Background: Nasopharyngeal carcinoma (NPC) recurrency rate is still high despite patients receiving complete treatment. The response to treatment may vary depending on the type of histopathology and Epstein-Barr virus, however the mechanism remains unclear. Recent studies have found that there is a relationship between response to treatment and the presence of cancer stem cells (CSCs). CD44+ cancer stem cells may cause cancer cells to be resistant to treatment. Therefore, this cross-sectional study aims to determine the correlation between CD44 + cancer stem cell expression and the histopathological types of NPC. Method: Samples were obtained from NPC biopsies of type I, II, III patients (based on WHO histopathology criteria), who had not received prior treatment. CD44+ expression was examined using immunohistochemistry methods by staining CD44+ monoclonal antibodies. The degree of CD44+ cell membrane expression was based on the immunoreactive score scale or the Remmele index scale. Results: Most histopathological types were WHO type III (21 patients, 50%), followed by type II (18 patients, 42.86%), and type I (3 patients, 7.14%). CD44 + expression on type I showed one patient had moderate positive and two patients had a high-positive expression. In type II, 10 were moderate positive and eight were high-positive. In type III, one patient was low-positive, 11 were moderate positive and nine patients were high-positive. Statistical analysis showed that the CD44+ expression difference between the three histopathology types were not statistically significant. Conclusion: There were no correlations between CD44 + expression and histopathological type of NPC.

Laryngopharyngeal reflux (LPR) can contribute to chronic rhinosinusitis (CRS). Pepsin is believed to be one of the causes of CRS. Pepsin can be a promising biomarker because it is only produced by gastric parietal cells, so it can explain the correlation of CRS with LPR. This study aims to determine the relationship between CRS and LPR based on nasal pepsin examination. The design in this study is a cross-sectional prospective with statistical analysis using the Chi-square method. The research sample were patients with complaints of runny nose and nasal congestion within 12 weeks and met the inclusion and exclusion criteria. All samples were subjected to nasal endoscopy and fiber optic laryngoscope and have Reflux Symptoms Index (RSI) > 13. Specimens from the samples were obtained through the nasal washing method, and pepsin was evaluated using the PepTest lateral flow device. A total of 35 samples in this study consisted of 13 men (37.14%) and 22 women (62.85%). The highest age in the CRS group was the 18-40-year-old group with 16 (64%). A total of 20 (83.3%) CRS patients were positive for pepsin p=0.04 (p<0.05).

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