Narra J

Comparison of PD-L1, CTR-1, VEGF, and p53 expression in sensitive and resistant epithelial ovarian cancer (EOC) patients to platinum-based chemotherapy

The current standard treatment for ovarian cancer is a combination of cytoreductive surgery and platinum-based chemotherapy; however, many patients develop resistance, leading to a high recurrence rate. The aim of this study was to analyze the expression of PD-L1, CTR-1, VEGF, and p53 in epithelial ovarian cancer (EOC) patients, comparing those sensitive and resistant to platinum-based chemotherapy. A cross-sectional study was conducted among EOC patients who underwent surgery and platinum-based chemotherapy between 2020 and 2023 at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, with evaluations performed six months post-chemotherapy. The expression of PD-L1, CTR-1, VEGF, and p53 were measured using immunohistochemistry (IHC) and compared between chemotherapy-sensitive and resistant patients. A total of 65 patients were included: 31 resistant and 34 sensitive cases. The results showed higher PD-L1 expression in the resistant group compared to the sensitive group (mean combined positive score (CPS) of 0.46±0.29 vs 0.17±0.09, p<0.001). The CTR-1 expression was lower in the resistant group (immunoreactive score 2.90±1.30) compared to the sensitive group (immunoreactive score 6.82±2.68) with p<0.001. VEGF and p53 expression were also higher in the resistant group (6.68±2.59 vs 2.76±1.10 and 64.68±13.54% vs 30.15±13.06%, respectively) compared to the sensitive group, with both having p<0.001. The study suggests that increased expression of PD-L1, VEGF, and p53 and decreased CTR-1 expression are associated with platinum-based chemotherapy resistance among EOC patients. Therefore, these biomarkers might have the potential for predicting treatment responses and understanding resistance mechanisms.

Genetic variations of the L2 gene in human papillomavirus (HPV) type 16 from cervical cancer patients in Sumatra region, Indonesia

The L2 protein, a minor capsid component of human papillomavirus (HPV), plays a critical role in the HPV life cycle by packaging the viral genome with the L1 protein and facilitating DNA transport to the nucleus. Identifying genetic variations in the L2 gene is essential for improving vaccine development, diagnostic accuracy, and understanding viral evolution, potentially contributing to more effective HPV vaccines. The aim of this study was to investigate the genetic variation of the L2 gene in cervical cancer specimens collected from patients in Riau Province, Indonesia. A single-center, cross-sectional study was conducted at Arifin Achmad General Hospital, Riau Province, involving cervical cancer patients with confirmed HPV16 infection between January 2018 and August 2020. Demographic, clinical, and risk factor data were collected through structured interviews and direct assessments. Cervical biopsy specimens were collected, and viral DNA was extracted for L2 gene amplification using polymerase chain reaction (PCR). Sequencing was conducted on PCR products, followed by single-nucleotide polymorphism (SNP) identification through alignment with the HPV16 reference genome. The amplification and sequencing of the HPV16 L2 gene from 22 cervical cancer specimens revealed 36 SNPs, including 31 nonsynonymous and five synonymous mutations. High-frequency mutations were observed at nucleotide positions 4,074 and 4,177, each detected in 95.45% of the samples. Notable insertions were found at positions 3,668–3,669 and 4,275–4,276, indicating substantial sequence variation. Phylogenetic analysis grouped the sequences into three clusters, with most belonging to sub-lineage A2 (European), while others aligned with A4 (Asian) and East Asian lineages. The observed genetic diversity in the HPV16 L2 gene may reflect regional viral evolution and has potential implications for future vaccine development.

Factors associated with awareness of and undergoing Pap smear tests among Jordanian women

Several screening methods are used to detect cervical cancer, with Pap smear test is considered as one of the most reliable screening methods to diagnose cervical cancer. The aim of this study was to investigate the factors associated with awareness of undergoing Pap smear tests among Jordanian women. A cross-sectional study was conducted among 525 Jordanian women attending the outpatient maternity hospital consecutively from February to July 2023. Data encompassed demographic characteristics (age, occupation, and education), awareness of Pap smears, beliefs regarding their importance, sources of information, and the history of undergoing Pap smear tests were collected using a structured questionnaire. Of the total 525 Jordanian women, 87.6% were aware of Pap smears. The awareness varied significantly depending on age and education level. Women aged 41–50 (adjusted odds ratio (AOR): 6.0; 95%CI: 2.3–15.3) and with a university education (AOR: 2.6; 95%CI: 1.4–4.8) were associated with increased odds of being aware of Pap smears. Among the women who were aware of Pap smears, the majority (94.1%) expressed belief in the importance of undergoing Pap smear tests and 61.7% reported having undergone the procedure at least once in their lives. In the multivariate analysis, women aged 30–40 years (AOR: 1.7; 95%CI: 1.1–2.8), 41–50 years (AOR: 4.1; 95%CI: 2.3–7.3), and older than 50 years (AOR: 9.8; 95%CI: 4.2–23.0) had a higher likelihood of undergoing Pap smear tests than those of under 30 years old. Being a housewife (AOR: 1.7; 95%CI: 1.1–2.7) and those who believed in the importance of Pap smear testing (AOR: 2.6; 95%CI: 1.1–6.0) were also more likely to have a Pap smear test. Nearly half of the women who had undergone Pap smears reported doing so every 2–3 years, while 25.7% indicated annual screening. Importantly, the overwhelming majority (97.9%) preferred the procedure to be performed by a gynecologist. In conclusion, the majority of women were aware of Pap smears. Two-thirds of women reported having undergone the procedure at least once. Prevention programs targeting cervical cancer and Pap smear tests should be tailored to women with low education, younger than 30 years, and those employed to maximize screening uptake for cervical cancer.