Cynthia Kurniawan
UK PETRA

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Methylenetetrahydrofolate Reductase C677T Distribution among Cervical Cancer Patients at Dr. Hasan Sadikin General Hospital Maskoen, Ani Melani; Kurniawan, Cynthia; Susanto, Herman; Sahiratmadja, Edhyana
Majalah Kedokteran Bandung Vol 48, No 4 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (207.831 KB) | DOI: 10.15395/mkb.v48n4.754

Abstract

Cervical cancer is the second most common cancer among women in the world. Persistent infection with high risk human papillomavirus (HPV) is one of the necessary causes of cervical cancer development. However, host genetic factors may also play a role in cervical cancer carcinogenesis. Methylenetetrahydrofolate reductase enzyme, encoded by the MTHFR gene, regulates folate metabolism which is important for genetic expression and stability. Single nucleotide polymorphism (SNP) C677T in MTHFR gene may produce a thermo-labile enzyme, resulting in a reduced enzyme activity. The aim of this study was to explore the SNP C677T of MTHFR gene and the susceptibility to cervical cancer among cancer patients visiting Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. This descriptive quantitative study involved cervical cancer patients recruited in 2010 and their control group. Genomic DNA was extracted from patients’ blood. MTHFR C677T genotype was performed using BeadXpress Reader Illumina® and some samples were re-genotyped for confirmation using conventional PCR-RFLP. The distribution of MTHFR C677T genotype in cervical cancer patients was 71.6%, 25.4%, and 3%, and 44%, 36%, and 20% in control group for CC, CT, and TT, respectively. This yielded a statistical significant difference of CC vs CT+TT (p 0.014 with OR 3.22 and CI 95% 1.24 – 8.33). Taken together, this result indicates that T allele has a protective effect against cervical cancer development. Further studies to confirm this effect in bigger population is warranted. [MKB. 2016;48(4):216–21]Key words: Cervical cancer, MTHFR C677T, polymorphism, Bandung Distribusi C677T gen Methylenetetrahydrofolate Reductase pada Pasien Kanker Serviks di Rumah Sakit Dr. Hasan Sadikin BandungKanker serviks menduduki peringkat kedua sebagai kanker yang paling sering ditemukan pada wanita di dunia. Infeksi persisten oleh human papillomavirus (HPV) tipe risiko tinggi merupakan salah satu penyebab utama kanker serviks. Selain itu, factor genetic juga turut berperan dalam proses perkembangan kanker serviks. Enzim methylenetetrahydrofolate reductase yang disandi oleh gen MTHFR berfungsi meregulasi metabolism folat. Polimorfisme C677T pada gen MTHFR dapat membuat produksi enzim menjadi termolabil sehingga terjadi penurunan aktivitas. Distribusi folat yang abnormal dapat mengganggu proses metilasi, sintesis, dan perbaikan DNA yang dikaitkan dengan perkembangan kanker serviks. Tujuan penelitian ini adalah mengetahui distribusi polimorfisme C677T gen MTHFR pada pasien kanker serviks di Rumah Sakit Umum Dr. Hasan Sadikin Bandung, Indonesia. Penelitian deskriptif kuantitatif ini melibatkan pasien kanker serviks yang diinklusi tahun 2010 dan sebagai control adalah wanita yang datang untuk pemeriksaan PAPsmear. DNA genomic diisolasi dari darah pasien dan dihibridisasi dengan menggunakan system BeadXpress Reader Illumina® untuk menentukan jenis genotipenya. Genotipe beberapa sampel dikonfirmasi dengan metode PCR-RFLP. Hasil distribusi polimorfisme C677T gen MTHFR dengan genotipe CC, CT, dan TT pada pasien kanker serviks adalah 71,6%, 25,4%, dan 3% dan pada kontrol adalah 44%, 36%, and 20%. Hasil ini menunjukkan perbedaan yang signifikan antara pasien kanker serviks dan kontrolnya, dengan genotipe CC vs CT+TT menunjukkan nilai p=0,014 (OR 3.22 dan IK 95% 1,24–8,33). Simpulan, alel T menunjukkan efek yang protektif pada perkembangan kanker serviks. Penelitian harus dilanjutkan untuk membuktikan efek protektif alel pada kanker serviks.[MKB. 2016;48(4):216–21]Kata kunci: Kanker serviks, MTHFR C677T, polimorfisme, Bandung
Diagnosis and Management of Portal Vein Thrombosis in Liver Cirrhosis Kurniawan, Cynthia; Jasirwan, Chyntia Olivia Maurine
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 26, No 1 (2025): VOLUME 26, NUMBER 1, April, 2025
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/261202568-75

Abstract

Portal vein thrombosis is formation of thrombus in main portal vein and its branches, that may also affect superior or mesenteric veins. Rebalanced coagulation system and changes in hepatic portal venous flow augment risk of portal vein thrombosis. Modalities to identify portal vein thrombosis include ultrasonography, contrast enhanced Computed Tomography (CT), and Magnetic Resonance Imaging (MRI). The management of portal vein thrombosis in hepatic cirrhosis is challenging due to intricate balance between thrombosis and bleeding complicating treatment decision. Treatment option consisted of close monitoring, anticoagulation, thrombolysis, and trans-jugular intrahepatic portosystemic shunt (TIPS). Anticoagulant options for management of portal vein thrombosis encompass Low Molecular Weight Heparin (LMWH), Vitamin K Antagonist (VKA), and Direct Oral Anticoagulant (DOAC). There is still no consensus regarding the thrombolysis for the management of portal vein thrombosis in cirrhosis due to lack of evidence. TIPS may be considered in portal vein thrombosis with insufficient response or contraindication to anticoagulation, repeated variceal bleeding, and/ or refractory ascites which unable to be controlled by medical or endoscopic management. This review aims to discuss the current update in diagnosis and management of portal vein thrombosis in liver cirrhosis.Keywords: Cirrhosis, portal vein thrombosis, anticoagulant