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"Latar belakang: Infeksi Human Papilloma Virus (HPV) merupakan salah satu faktor etiologi KSS (Karsinoma Sel Skuamosa) kepala dan leher serta mempengaruhi hasil terapi. Hipoksia tumor menunjukkan respon terapi yang buruk pada sebagian besar keganasan, termasuk KSS. Studi ini bertujuan mengevaluasi karakteristik HPV dan hipoksia dalam KSS rongga mulut dan orofaringeal serta kaitannya terhadap respons radiasi.Metode: Penelitian eksperimental pada KSS rongga mulut dan orofaring yang telah menjalani terapi radiasi di Departemen Radioterapi antara Januari 2013 hingga Desember 2017.Hasil: Dari total 18 subjek, 44,4% memiliki infeksi HPV positif, 66,7% menunjukkan marker hipoksia positif. Hubungan infeksi HPV dan hipoksia dalam penelitian ini menunjukkan tidak ada hubungan yang signifikan (OR HPV = 2,0 (0,2-15,3), OR hipoksia positif = 0,6 (0,15-2,5), atau hipoksia negatif = 1,2 (0,6-2,3), p = 0,638). Dalam penelitian ini, enam pasien (33,3%) memiliki respon lengkap, tujuh pasien (38,8%) memiliki respon parsial, satu pasien memiliki respon stabil, dan empat pasien (22,2%) memiliki respon progresif terhadap radiasi. Tidak ada hubungan yang signifikan antara HPV + / hipoksia +, HPV + / hipoksia-, HPV- / hipoksia +, dan kelompok HPV- / hipoksia- terhadap tanggapan terapi (p = 0,514).Kesimpulan: Peningkatan insiden HPV dan hipoksia tumor yang tinggi pada pasien dengan rongga mulut dan kanker orofaringeal. Namun, tidak ada efek signifikan dari HPV dan tumor hipoksia terhadap respons radiasi. Hipoksia berhubungan dengan respon progresif.

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Background: Human Papilloma Virus (HPV) infection can lead to head and neck cancer and affect therapy outcomes. Hypoxic tumors are known to show poor therapy response in majority of malignancies, including Squamous Cell Carcinoma (SCC). This study aimed to show characteristics of HPV and hypoxia in oral cavity and oropharyngeal cancer and their association in radiation response.

Method: We conducted an experimental study on patients diagnosed with oral cavity cancer and oropharyngeal cancer who had undergone radiation therapy in Radiotherapy Department between January 2013 until December 2017.

Result: From a total of eighteen subjects, 44.4% had positive HPV infection, 66.7% had positive for hypoxia.. The association of HPV infection and hypoxia in this study showed no significant relationship (OR HPV = 2.0(0.2-15.3), OR positive hypoxia = 0.6(0.15-2.5), OR negative hypoxia = 1.2(0.6-2.3), p=0.638). In this study, six patients (33.3%) had complete response, seven patients (38.8%) had partial response, one patient (5.6%) had stable response and four patients (22.2%) were progressive respon to the radiation. There was also no statistically significant association between HPV+/hypoxia+, HPV+/hypoxia-, HPV-/hypoxia+, and HPV-/hypoxia- group against therapy responses (p=0.514). In this study all progressive response related with hypoxia status.

Conclusion: There were high incidences of HPV and tumor hypoxia in patients with oral cavity and oropharyngeal cancer. However, there was no significant effects of HPV and tumor hypoxia to final radiation response. Hypoxia related to progressive disease. "

"Infeksi Human Papillomavirus (HPV) pada kasus karsinoma sel skuamosa (KSS) rongga mulut dan orofaring semakin meningkat, keterlibatan HPV sudah banyak dibuktikan meningkatkan risiko terjadinya keganasan selain konsumsi rokok dan alkohol. Keterlibatan HPV terbukti memberikan respon radiasi yang lebih baik yang berujung kepada prognosis. Polymerase Chain Reaction (PCR) merupakan baku emas diagnostik infeksi HPV yang memiliki kekurangan hanya bisa dilakukan di laboratorium tertentu dengan biaya relatif mahal, sementara metode lain menggunakan p16 surrogate biomarker dengan imunohistokimia (IHK) sangat tergantung dari cutoff point yang ditetapkan. Penelitian ini merupakan uji diagnostik p16 surrogate biomarker dengan IHK terhadap baku emas pada kasus KSS rongga mulut dan orofaring. Hasil penelitian ini menunjukkkan cutoff point p16 IHK yang mendekati hasil PCR adalah 50%, dengan sensitivitas 66% dan spesifisitas 84%, dapat digunakan untuk mendiagnosis infeksi HPV pada kasus KSS rongga mulut dan orofaring.

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Prevalence of Human Papillomavirus (HPV) infection in cases of oral and oropharyngeal squamous cell carcinoma (SSC) is increasing, HPV involvement has been shown to increase the risk of malignancy in addition to cigarette and alcohol consumption. HPV involvement proves to provide a better radiation response that leads to better prognosis. Polymerase Chain Reaction (PCR) is the gold standard examination for diagnostics of HPV infection yet can only be performed in certain laboratories at relatively expensive cost, while other methods using surrogate biomarkers p16 with immunohistochemistry (IHC) are highly dependent on the specified cutoff point. This study was a diagnostic test of surrogate biomarker p16 with IHC on HPV examination using PCR in cases of oral cavity and oropharynx SSC. The results of this study obtained a minimum 50% cutoff point of IHC approaching PCR result with sensitivity of 66% and specificity of 84%, and applicable to diagnose HPV infection in cases of oral cavity and oropharynx SCC replacing PCR examination."

"Pendahuluan: Pemeriksaan baku emas swab nasoorofaring dengan metode Reverse transcriptase polymerase chain reaction (RT-PCR) merupakan prosedur diagnostik yang dilakukan pada pasien dengan suspek COVID-19. Metode lain yang digunakan yaitu dengan pemeriksaan serologi yang mulai terbentuk dalam beberapa hari hingga minggu.Tujuan: Untuk mengetahui hubungan antara hasil swab nasoorofaring dan uji serologi terhadap luaran pasien COVID-19 dalam evaluasi masa rawat 14 hariMetode: Analisis observasional kohort retrospektif terhadap pasien COVID-19 yang dirawat di RS Rujukan Respirasi Nasional Persahabatan, Jakarta, Indonesia secara total sampling diperoleh dari bulan Maret 2020 sampai Mei 2020. Kami meninjau rekam medis 132 pasien dengan diagnosis probable case dan confirmed case COVID-19 yang memenuhi kriteria inklusi.Hasil: Sebanyak 132 pasien yang termasuk dalam penelitian ini, didominasi oleh laki-laki sebanyak 51,5% dengan usia rerata 50,23 tahun. Derajat pneumonia berturut-turut yaitu derajat ringan, sedang, dan berat (17,4%, 57,6%, dan 25,0%). Proporsi pasien dengan komorbid sebanyak 71,2%. Proporsi penggunaan alat bantu napas terbanyak yaitu penggunaan kanula hidung (69,7%) diikuti berturut-turut oleh Ventilator, non rebreathing mask dan high flow nasal cannule (13,6%, 9,1% dan 7,6%).. Proporsi kematian sebesar 18,3%, dengan proporsi kematian pada confirmed case sebanyak 21,3% dan probable case sebanyak 19,3%. Tingkat kematian pada confirmed case berkorelasi terhadap jenis kelamin laki-laki (p =0,009), derajat pneumonia berat (p=0,000), penggunaan alat bantu napas bukan kanula hidung (p=0,000) dan komorbid (p=0,021). Tingkat kematian pada probable case berkorelasi dengan derajat pneumonia berat (p=0,000), penggunaan alat bantu napas bukan kanula hidung (p=0,000).Kesimpulan: Kombinasi penggunaan swab nasoorofaring dan hasil uji serologi dapat memprediksi luaran pasien COVID-19 dalam evaluasi masa rawat 14 hari. Derajat pneumonia berat dan penggunaan alat bantu napas bukan kanula hidung merupakan prediktor buruk terhadap luaran pasien COVID-19.

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Introduction: Reverse transcriptase polymerase chain reaction (RT-PCR) to detect SARS- CoV-2 is a gold standard method in a patient with suspected COVID-19 and achievable by means of nasopharyngeal and oropharyngeal swab. Serological test is another method to detect the antibody which is produced in a several days or week.

Aims: To determine the association between nasooropharyngeal swab and serological test to predict the mortality of COVID-19 patient after 14-days admission.

Methods: We performed an observational retrospective cohort analysis of COVID-19 patients treated at National Respiratory Referral Hospital Persahabatan Jakarta, Indonesia. Subjects by means of total sampling were COVID-19 patients between March to May 2020. We reviewed the medical records of 132 patients categorized as probable and confirmed cases whom met the inclusion criteria. Their 14-days course of the treatment were observed.

Results: We included 132 patients, which dominated by males (51.5%) with mean age of

50.23 years old. Cases were mild pneumonia, moderate pneumonia, and severe pneumonia (17.4%, 57.6%, and 25.0%, respectively). Most patients presented with comorbidities (71,2%). Most patients required oxygen supplementation by nasal cannula (69.7%), followed by mechanical ventilator, non-rebreathing mask, and high flow nasal cannula (13.6%, 9.1%, and 7.6%, respectively). Patient deaths were 18.3%, including 21.3% among confirmed cases and 19.3% among probable cases. Mortality among confirmed case were correlated with male sex (p=0.009), severe pneumonia (p=0.000), supplemental oxygen delivery requiring device other than nasal cannula (p=0.000), and comorbidities (p=0.021). Mortality among probable cases were correlated with severe pneumonia (p=0.000), and supplemental oxygen delivery requiring device other than nasal cannula (p=0.000).

Conclusions: Combination of nasooropharyngeal swab and serological test results predicted the 14-days outcomes of COVID-19 patients. Severe pneumonia and supplemental oxygen delivery requiring device other than nasal cannula were predictors of poor COVID-19 outcomes as observed from our study."