Gatot Purwoto

Expression of miR-92a and miR-125b and Their Association with Chemoradiotherapy Response in Locally Advanced Cervical Cancer

Cervical cancer remains a major cause of morbidity and mortality, with most cases in Indonesia diagnosed at a locally advanced stage. Although concurrent chemoradiotherapy is the standard treatment, response varies. Dysregulation of microRNAs (miRNAs), particularly oncogenic miR-92a and tumor suppressor miR-125b, may contribute to treatment resistance. This study aimed to evaluate the association between miR-92a and miR-125b expression and chemoradiotherapy response in locally advanced cervical cancer. This single-center retrospective cohort study included patients with stage IB3–IVA cervical cancer treated with chemoradiotherapy between 2019 and 2025. miRNA expression levels were measured from pretreatment tumor biopsy specimens. Poor response was defined as incomplete response or disease progression after treatment. Appropriate comparative, predictive, and survival analyses were performed. Sixty-eight patients were included. Poor response was significantly associated with underweight body mass index, elevated miR-92a, and reduced miR-125b expression (p < 0.05). High miR-92a and low miR-125b expression were also associated with shorter overall survival (p < 0.001). A combined model incorporating BMI, miR-92a, and miR-125b showed good predictive performance. Elevated miR-92a and reduced miR-125b are associated with poor treatment response and worse survival. These miRNAs may support risk stratification and treatment personalization in locally advanced cervical cancer.

Exploring Knowledge, Attitudes, Practices, and Information-Seeking on HPV Infection and Cervical Cancer Prevention in Rural Indonesia

Cervical cancer remains a leading public health problem in Indonesia, with low screening and HPV vaccination coverage, particularly in rural areas where knowledge gaps and limited healthcare access persist. This study aims to assess the knowledge, attitudes, and practices (KAP) regarding HPV infection and cervical cancer, and the role of information-seeking behavior in identifying effective channels for raising awareness on these issues. A cross-sectional study was conducted between 20 March 2023 and 20 January 2024, involving 220 women from two rural districts in North Moluccas, selected via convenience sampling. Data were collected using a validated questionnaire administered through face-to-face interviews. Data were analyzed using SPSS version 25.0 with descriptive statistics, normality testing (Kolmogorov-Smirnov), bivariate analyses (Chi-square, Fisher's Exact, Pearson's or Spearman's tests), and multivariate logistic regression (backward LR, p < 0.05), with model performance assessed using ROC curves and AUC values. Most participants demonstrated poor KAP, with 18.7% showing good knowledge, 22.7% expressing a positive attitude, and 44.5% engaging in favorable practices. KAP were found to be positively correlated (p<0.001). Key predictors of good knowledge included higher education (AOR = 7.07), family history of cancer (AOR = 15.20), private vehicle use (AOR = 4.15), and active health-information seeking behavior (HISB) (AOR = 3.41). Determinants for a positive attitude included higher education (AOR = 3.79), family history of cancer (AOR = 4.42), active HISB (AOR = 3.88), and good knowledge (OR = 10.29). Favorable practices were influenced by private vehicle use (AOR = 2.66) and positive attitude (AOR = 20.62). In conclusion, KAP are influenced by HISB, and involving healthcare workers in providing information, particularly through digital platforms, has the potential to improve KAP in rural communities.

High ALDH-1 Expression Predicts Non-Complete Response of Radiotherapy in Stage III Squamous Cell Cervical Carcinoma Patients

ALDH1 is a cervical cancer stem cell marker that has radioresistance profile. Recurrence and metastasis following radiotherapy are still being problems of most patients. This study aimed to determine the correlation between ALDH1 and radiotherapy response in stage III squamous cell cervical carcinoma (SCCC) of the cervix. A total 58 of 360 patients of stage III SCCC who received external beem radiation and brachytherapy (2016-2021) at Cipto Mangunkusumo Hospital met the eligibility criteria of this study. Pre- and post-irradiation MRI examinations and ALDH expression with immunohistochemistry (Santa Cruz®) were performed on formalin-fixed paraffin-embedded of pre-treatment cervical tissue biopsy taken from RSCM pathological anatomy laboratory. Patients were divided into two groups, complete responders vs non-complete responders. ALDH-1 scores were compared between two groups to assess ALDH-1 expression. The statistical analyses were carried out by SPSS 24. The optimal ALDH-1 score cut-off point on the radiation response was 166.05 pg/mL which was obtained from the analysis of the ROC curve. The AUC value was 0.682 with sensitivity and specificity, 63,6% and 64%, respectively. ALDH score ≥166.05 increased the risk by 3.127 times for not achieving complete response (adj OR 3.127, 95% CI 1.034 - 9.456, p = 0.043). Pre-radiation tumor size (p = 0.593), degree of differentiation (p = 0.161), renal abnormalities (p = 0.114), and keratinization (p = 0.477) were not associated with radiation response. High ALDH expression was associated with non-complete radiation response in stage III squamous cell cervical carcinoma. .

A decade data of HPV genotypes in metropolitan regions of Indonesia: paving the way for a national cervical cancer elimination strategy

Human papillomavirus (HPV) infection is a global public health concern and associated with cervical cancer. HPV genotype mapping has an essential role in prevention and control strategy in developing more suitable HPV vaccine for Indonesia. This was a descriptive retrospective cross-sectional study from 2012 until 2022 at Kalgen Laboratory, Jakarta from all over the metropolitan regions. The total 76,413 samples were collected with consecutive sampling, which 694 excluded, thus final samples used were 75,719. HPV DNA test was performed using the polymerase chain reaction (PCR): SPF10-DEIA-LiPA25 methods. HPV genotyping procedures included DNA extraction, PCR using the HPV XpressMatrix kit, and hybridization. From 75,719 samples, 93.4% was negative for intraepithelial lesion or malignancy (NILM). Among 6.6% of total 75,719 samples of abnormal cytology groups, 53.8% were atypical squamous cells of undetermined significance (ASCUS), 32.9% were low grade intraepithelial lesion (LSIL), and 13.3% were high grade intraepithelial lesion (HSIL). The most common high risk HPV genotypes among HSIL were 16, 18, 52, 58, 33, 51, and 53. Single HPV infection was more common compared to multiple infections. This study showed that HR-HPV types among HSIL were 16, 18, 52, 58, 33, 51, and 53. HPV 52 was the most frequent type among NILM, ASCUS, and LSIL. Thus, it could serve as a potential future reference to create a more suitable HPV nonavalent vaccine for Indonesian population based on its different epidemiology.