Wahyuningsih Laila, Dwianingsih Ery Kus, Risanti Erika Diana, Tirtoprodjo Prijono, Rinonce Hanggoro Tri, Hakim Fikar Arsyad, Herdini Camelia, Fachiroh Jajah
Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada (FK-KMK UGM), Yogyakarta, Indonesia.
Faculty of Medicine, Universitas Muhammadiyah, Surakarta, Indonesia.
Asian Pac J Cancer Prev. 2019 Jul 1;20(7):2125-2130. doi: 10.31557/APJCP.2019.20.7.2125.
Background: Nasopharyngeal carcinoma (NPC) is a malignancy with high incidence in Southern China and South-East Asia. NPC incidence among males in Indonesia is estimated around 8.3/100,000 populations. Tobacco smoking is a common risk factor for cancer, including NPC. P16 is one of the key proteins related to the activation of apoptotic pathways, that commonly change during carcinogenesis. Carcinogenesis is often related to environmental exposure, including tobacco smoke. Objective: To analyze the association between P16 protein and smoking status among NPC subjects in Indonesia. Methods: Forty formalin fixed-paraffin embedded NPC tissue samples of known smoking status (20 smokers, 20 non-smokers) were collected from the Department of Anatomical Pathology, Dr. Sardjito Hospital, Yogyakarta. P16 was detected by immunohistochemistry staining. German semi-quantitative scoring system was applied to the P16 staining. Expression index with the score of 0 to 3 was classified as negative staining, meanwhile 4 to 12 was classified as positive staining. The association between P16 (score) and smoking status among NPC patients was analyzed using Fischer exact test. One-sided p ≤ 0.05 was considered as statistically significant. Results: All samples were Javanese males, with age range 25-76 years old. P16 positive staining among smokers was 5% (1/20), while among non-smokers was 40% (8/20). P16 among smokers was significantly lower than non-smokers patients (p=0.010). No difference was found between quantity of smoke and P16 score. Conclusion : A significant association between P16 and smoking status in Indonesian NPC patients has been revealed. The result of this study may be used to improve prevention and management of NPC cases related to smoking habit in Indonesia.
鼻咽癌（NPC）是一种在中国南方和东南亚地区高发的恶性肿瘤。印度尼西亚男性鼻咽癌发病率估计约为每10万人中有8.3例。吸烟是包括鼻咽癌在内的癌症常见危险因素。P16是与凋亡途径激活相关的关键蛋白之一，在致癌过程中通常会发生变化。致癌作用通常与包括烟草烟雾在内的环境暴露有关。目的：分析印度尼西亚鼻咽癌患者中P16蛋白与吸烟状况之间的关联。方法：从日惹市萨迪托博士医院解剖病理科收集40份已知吸烟状况的福尔马林固定石蜡包埋鼻咽癌组织样本（20名吸烟者，20名非吸烟者）。通过免疫组织化学染色检测P16。对P16染色应用德国半定量评分系统。评分为0至3的表达指数被分类为阴性染色，而4至12被分类为阳性染色。使用Fisher精确检验分析鼻咽癌患者中P16（评分）与吸烟状况之间的关联。单侧p≤0.05被认为具有统计学意义。结果：所有样本均为爪哇男性，年龄范围为25至76岁。吸烟者中P16阳性染色率为5%（1/20），而非吸烟者中为40%（8/20）。吸烟者中的P16明显低于非吸烟者患者（p = 0.010）。吸烟量与P16评分之间未发现差异。结论：已揭示印度尼西亚鼻咽癌患者中P16与吸烟状况之间存在显著关联。本研究结果可用于改善印度尼西亚与吸烟习惯相关的鼻咽癌病例的预防和管理。
