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Bioscientia Medicina : Journal of Biomedicine and Translational Research

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ISSN : - EISSN : 25980580 DOI : https://doi.org/10.37275/bsm

Core Subject : Health, Science,

Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience

This journal welcomes the submission of articles that offering a sensible transfer of basic research to applied clinical medicine. BioScientia Medicina covers the latest developments in various fields of biomedicine with special attention to : 1.Rhemumatology 2.Molecular aspect of Indonesia Traditional Herb 3.Cardiology and Cardiovascular diseases 4.Genetics 5.Immunology 6.Environmental health 7.Toxicology 8. Neurology 9. Pharmacology 10. Oncology 11. Other multidisciplinary studies related medicine. The views of experts on current advances in nanotechnology and molecular/cell biology will be also considered for publication as long as they have a direct clinical impact on human health.

Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)

Articles 1,518 Documents

134 135 136 137 138

Efficacy, Safety, and Metabolic Effects of Low-Molecular-Weight Heparin versus Unfractionated Heparin in Chronic Hemodialysis: A Systematic Review and Meta-Analysis of Clinical Studies Evelin Veronike; Harnavi Harun; Drajad Priyono; Deka Viotra
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1494

Background: The optimal anticoagulation for chronic hemodialysis (HD) remains debated. Unfractionated heparin (UFH) is the historical standard but carries risks of metabolic complications and requires intensive monitoring. Low-Molecular-Weight Heparin (LMWH) offers pharmacological advantages, but concerns over bleeding risk in end-stage renal disease (ESRD) have limited its use. This study aimed to provide a holistic comparison by synthesizing recent evidence on the efficacy, safety, and, uniquely, the key metabolic consequences of LMWH versus UFH. Methods: This systematic review followed PRISMA 2020 guidelines. We searched PubMed, EMBASE, and CENTRAL from January 2014 to March 2025 for clinical studies comparing LMWH and UFH in chronic HD patients. We included 6 studies (3 prospective trials, 3 retrospective cohorts) totaling 7,890 patients. The primary efficacy outcome was circuit thrombosis; the primary safety outcome was major bleeding. Secondary outcomes focused on key metabolic markers (pre-dialysis potassium, lipid profile). Data from prospective trials and observational studies were analyzed separately using subgroup analysis and tested for interaction. Metabolic data were pooled using a random-effects model. Results: The analysis of key metabolic outcomes, derived from homogenous prospective trials (I2=0%), was the most robust finding. LMWH use was associated with a clinically significant reduction in pre-dialysis serum potassium (Mean Difference [MD]: -0.30 mEq/L; 95% CI: -0.50 to -0.10) and a superior atherogenic profile, including lower triglycerides (MD: -20.10 mg/dL) and higher HDL (MD: +4.50 mg/dL). For safety, no difference in major bleeding was found, a finding that was consistent across prospective trials (OR: 0.78; 95% CI: 0.33-1.85) and large retrospective cohorts (OR: 0.87; 95% CI: 0.69-1.09), with no subgroup interaction (p=0.75). Efficacy for preventing circuit thrombosis was also similar. Conclusion: This meta-analysis provides strong, high-quality evidence that LMWH confers significant and clinically relevant metabolic advantages over UFH, particularly in mitigating hyperkalemia and atherogenic dyslipidemia. Furthermore, our stratified analysis provides high confidence from real-world data that LMWH, when dosed appropriately, is as safe and effective as UFH.

Metastatic Medullary Thyroid Carcinoma Mimicking a Primary Soft Tissue Sarcoma of the Shoulder: A Case Report Syifa Azizah Putri; Kiki Akhmad Rizki; Rupita Endangena Sitanggang
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1495

Background: Medullary thyroid carcinoma (MTC) is a rare neuroendocrine malignancy accounting for 1-5% of thyroid cancers. While often presenting with cervical lymphadenopathy, distant metastasis to bone and soft tissue mimicking a primary sarcoma is exceptionally rare. This report details a case of MTC where the primary diagnostic challenge was a massive, destructive shoulder mass. Case presentation: A 58-year-old woman presented with a disabling, 20 cm mass in her left shoulder, progressively enlarging over two years. The patient also noted a 30-year history of a stable, asymptomatic neck lump. Magnetic Resonance Imaging (MRI) revealed a large, hypervascular, destructive mass obliterating the scapula and invading surrounding musculature, with a radiological differential diagnosis of a primary soft tissue sarcoma. Laboratory investigation, however, revealed a massively elevated serum calcitonin (>2000 pg/mL) and carcinoembryonic antigen (CEA) (180 ng/mL). A CT-guided core biopsy of the shoulder mass, initially suspected to be a sarcoma, was negative for all sarcoma markers. Instead, it was strongly positive for neuroendocrine (Synaptophysin, Chromogranin A) and thyroid-specific (TTF-1, PAX-8) markers, as well as definitive MTC markers (Calcitonin, CEA). This confirmed the diagnosis of metastatic MTC. Staging was completed as pT3a pN1b M1. The patient underwent total thyroidectomy with bilateral central and left modified radical neck dissection, followed by planned palliative resection of the shoulder metastasis and systemic therapy with a selective RET inhibitor. Conclusion: This case highlights a critical diagnostic pitfall. Metastatic MTC can present as a massive soft tissue neoplasm mimicking a primary sarcoma. In such cases, a systematic diagnostic approach combining serum biomarkers (Calcitonin, CEA) with a comprehensive immunohistochemical panel is essential to establish the correct diagnosis and initiate appropriate, life-extending targeted therapy.

Efficacy of the Full Mesenchymal Stromal Cell Secretome versus Purified Small Extracellular Vesicles in Preclinical Models of Erectile Dysfunction: A Systematic Review and Parallel Meta-Analysis Victor Jeremia Syaropi Simanjuntak; Ishak Andreas Soritua Lumban Gaol; Erlangga Pradipta H; Dimas Sindhu Wibisono
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1496

Background: Acellular therapies from Mesenchymal Stromal Cells (MSCs), including the full secretome (conditioned medium, CM) and purified small extracellular vesicles (sEVs), are promising restorative treatments for erectile dysfunction (ED). It remains unknown if the therapeutic benefit is driven by the complete secretome or if purified sEVs are the primary, sufficient component. This study aimed to systematically review and meta-analyze the preclinical evidence. Methods: We conducted a systematic review and parallel meta-analysis adhering to PRISMA guidelines. PubMed, Scopus, and Web of Science were searched from January 1st, 2014, to July 31st, 2025. Studies were eligible if they were preclinical ED models evaluating MSC-CM or purified sEVs against a control. Two parallel meta-analyses were performed using a random-effects model. Primary outcomes were erectile function (Intracavernous Pressure / Mean Arterial Pressure ratio; ICP/MAP) and histopathology (Smooth Muscle / Collagen ratio; SM/Col). Results: Our search yielded 1,942 records, with 87 full-text articles assessed. After applying strict PICO criteria, 7 primary studies were eligible for the meta-analysis (3 secretome, 4 sEVs). The overall risk of bias was moderate to high (0% allocation concealment). No studies directly compared secretome versus sEVs. The first meta-analysis (Secretome vs. Control, 3 studies, 4 data points, n=70) demonstrated a large, significant improvement in ICP/MAP (Standardized Mean Difference [SMD]: 2.40; 95% CI [1.65, 3.15]; p-value < 0.001), with extreme heterogeneity (I-squared=85%). The second meta-analysis (sEVs vs. Control, 4 studies, n=68) also showed a large, significant improvement (SMD: 2.75; 95% CI [1.90, 3.60]; p-value < 0.001), also with extreme heterogeneity (I-squared=88%). Conclusion: Both the full MSC secretome and purified sEVs demonstrate large, significant therapeutic effects. However, this quantitative conclusion is severely limited by the exceptionally small number of studies and the profound biomolecular heterogeneity (in cell source and purification) that invalidates direct comparison. The primary finding remains the total lack of comparative data.

Inadequate Preoperative Assessment and Its Clinicopathological Correlates in Patients Referred for Completion Thyroidectomy: A Tertiary Referral Center Analysis Munawar; R Maman Abdurrahman
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1497

Background: Completion thyroidectomy (CT) for differentiated thyroid carcinoma (DTC) is a high-risk procedure, frequently performed following an oncologically incomplete primary operation. This study characterizes the preoperative diagnostic assessment deficiencies in a cohort of DTC patients referred to a tertiary center for re-operation and identifies factors associated with residual disease. Methods: We conducted a retrospective, single-center analysis of all patients who underwent CT for DTC at Hasan Sadikin General Hospital, Indonesia, over a 30-month period (January 1st, 2023, to June 30th, 2025). Data on preoperative assessments at the referring hospitals (ultrasonography (US) quality, fine-needle aspiration biopsy (FNAB), hormonal tests), primary surgical indications, and clinicopathological outcomes from both operations were extracted and analyzed using descriptive and bivariate statistics (Fisher's Exact Test). Results: A total of 27 patients met the inclusion criteria. Analysis of their initial workup revealed significant omissions: 14/27 (51.9%) lacked FNAB, and 5/27 (18.5%) lacked hormonal testing. While 24/27 (88.9%) underwent a primary US, only 20.8% of these reports (5/24) were ATA-compliant staging examinations. Only 5/27 patients (18.5%) received a complete trimodal assessment. Upon re-operation, 10/27 (37.0%) had residual carcinoma. This finding was significantly associated with the omission of primary FNAB (57.1% vs. 15.4%, p = 0.027). Conclusion: In this cohort of referred patients, incomplete preoperative assessment was nearly universal and strongly associated with adverse pathological findings. These data highlight the urgent need for standardized, evidence-based preoperative protocols and strengthened referral systems to ensure patients receive the correct primary operation.

Loss of E-cadherin Expression Stratifies Aggressive versus Non-Aggressive Papillary Thyroid Carcinoma Dwi Yanti Fioni Putri; Yenita; Aswiyanti Asri; Tofrizal; Rony Rustam; Husna Yetti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1498

Background: Papillary thyroid carcinoma (PTC) is generally indolent, yet specific histological subtypes defined by the World Health Organization (WHO) are linked to aggressive behavior and poor prognosis. The loss of the cell-adhesion protein E-cadherin is a hallmark of the epithelial-to-mesenchymal transition (EMT), a process implicated in tumor aggression. However, its role in stratifying PTC subtypes versus its correlation with tumor stage remains a significant controversy in the literature. This study aimed to disentangle these two parameters by clarifying the relationship between E-cadherin expression and both histological phenotype and tumor stage. Methods: This was an observational, cross-sectional pilot study on 40 randomly selected, formalin-fixed, paraffin-embedded (FFPE) PTC cases from a 2024 cohort (N=74) at a tertiary hospital in Indonesia. All cases were re-evaluated and classified according to the WHO 5th Edition (2022) criteria as non-aggressive (n=34) or aggressive (n=6). E-cadherin expression was assessed by immunohistochemistry (IHC) using a standardized semi-quantitative scoring system (product of intensity and proportion) adapted from previous studies, with inter-rater reliability assessed (Cohen’s Kappa = 0.88). Scores were dichotomized as 'High' (n=25) or 'Low' (n=15). The association between E-cadherin expression and both histological subtype and AJCC 8th Edition tumor stage (Early: I/II [n=32] vs. Advanced: III/IV [n=8]) was analyzed using Fisher's Exact Test, with Odds Ratios (OR) and 95% Confidence Intervals (CI) calculated. Results: High E-cadherin expression was observed in 62.5% of cases. A statistically significant and strong association was found between E-cadherin expression and histological subtype (p=0.021; OR 12.0; 95% CI 1.2–118.9). Low E-cadherin expression was present in 83.3% (5 of 6) of aggressive-subtype tumors, versus only 29.4% (10 of 34) of non-aggressive subtypes. In contrast, no significant correlation was found between E-cadherin expression and advanced tumor stage (p=0.126; OR 3.67; 95% CI 0.7–18.6). Conclusion: Loss of E-cadherin expression is a significant biomarker associated with high-risk, aggressive histological phenotypes in PTC. Its lack of correlation with tumor stage, confirmed by an uncertain OR, suggests E-cadherin's role is indicative of an inherent tumor biological phenotype (aggressiveness) rather than a linear marker of tumor progression (stage). This dichotomy, likely reflecting EMT/MET plasticity, positions E-cadherin IHC as a powerful ancillary tool for pathological risk stratification.

The Oral-Skin Axis in Autoinflammation: A Case Report of Severe Refractory Generalized Pustular Psoriasis (GPP) Resolved by Comprehensive Periodontal Intervention Ni Putu Wina Widyastuti; Prima Sanjiwani Saraswati Sudarsa; Herman Saputra; Handelia Phinari; Luh Putu Venny Cempaka Sari; Kevin Jonathan Djuanda; Mario Korwa
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1499

Background: Generalized pustular psoriasis (GPP) is a severe, IL-36-driven autoinflammatory dermatosis, distinct from psoriasis vulgaris. Chronic periodontitis (CP) is a dysbiotic inflammatory disease sharing pathogenic pathways (IL-1, IL-17). An "oral-skin axis" has been hypothesized, but definitive clinical evidence of CP driving a GPP flare is scarce. Case presentation: We present a 37-year-old male with a history of plaque psoriasis who developed a severe, refractory GPP flare (GPPASI 35.8) with high-grade fever (38.9°C), profound neutrophilic leukocytosis (22.5 x 10³/µL), and markedly elevated CRP (150 mg/L). The flare was resistant to maintenance methotrexate. Workup revealed severe CP with multiple periapical abscesses, culture from which grew Porphyromonas gingivalis and Fusobacterium nucleatum. The patient underwent a comprehensive dental intervention, including emergency extractions and full-mouth debridement, with concurrent peri-operative Amoxicillin-Clavulanate therapy. This combined intervention led to a rapid resolution of fever, neutrophilia, and cutaneous pustulation within 72 hours, without any escalation of systemic immunomodulators. He achieved complete remission (GPPASI 1.0) at 3-month follow-up. Conclusion: This case provides a strong temporal association supporting the oral-skin axis, highlighting severe periodontitis as a potent trigger and amplifier for GPP. The rapid resolution following a combined surgical and antibiotic intervention suggests that targeting the oral inflammatory and microbial reservoir is a critical, actionable strategy. We strongly recommend consideration of a comprehensive dental/oral screening in patients with refractory GPP.

Angiofibroma Beyond the Nasopharynx: Diagnostic Challenges and Endoscopic Management of Two Atypical Cases Arising from the Ethmoid and Sphenoid Sinuses Dolly Irfandy; Bestari Jaka Budiman; Jihan Mudrika Rahmi; Auzy Yoana Khalisha; Hippocrates Kam
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1500

Background: Angiofibroma is a histologically benign but locally aggressive vascular neoplasm almost exclusively associated with the nasopharynx of adolescent males (Juvenile Nasopharyngeal Angiofibroma, JNA). Extranasopharyngeal angiofibroma (ENA) is an exceptionally rare variant that originates outside the sphenopalatine foramen, posing significant diagnostic and management challenges due to its atypical locations, age of presentation, and clinical mimicry of other sinonasal pathologies. Case presentation: We present two sophisticated cases of ENA managed at our tertiary center. Case 1: A 35-year-old male presented with unilateral nasal obstruction. Endoscopy and imaging revealed a hypervascular mass centered in the posterior ethmoid sinus, destroying the basal lamella and abutting the skull base. Histopathological analysis was initially confounded by features resembling a solitary fibrous tumor (SFT), requiring a comprehensive immunohistochemical panel (IHC) including STAT6 and nuclear beta-catenin to confirm the diagnosis of angiofibroma. Case 2: A 17-year-old male presented with symptoms and imaging (non-contrast CT) highly suggestive of a benign sphenochoanal polyp. An initial attempt at routine endoscopic removal was aborted due to unexpected, profuse hemorrhage. Subsequent advanced imaging (CTA/MRI) revealed a hypervascular sphenoid-based angiofibroma. Both patients underwent preoperative superselective embolization followed by successful, purely endoscopic tumor resection with no recurrence at 12 and 18-month follow-up, respectively. Conclusion: ENA is a critical, albeit rare, diagnostic consideration for any vascular sinonasal mass, regardless of patient age or tumor location. These cases underscore the unreliability of "classic" clinical and radiological signs, the diagnostic pitfalls of histopathological mimics like SFT and polyps, and the critical role of advanced IHC (nuclear beta-catenin) for definitive diagnosis. A modern, multidisciplinary approach combining preoperative embolization with endoscopic resection offers a safe and effective pathway to cure.

Divergent Inflammatory Trajectories: Independent Predictive Value of Admission Neutrophil-to-Lymphocyte and Lymphocyte-to-Monocyte Ratios for Acute Ischemic Stroke Severity in a Southeast Asian Cohort Kadek Kristian Dwi Cahya; I Ketut Sumada; Desie Yuliani; Ni Made Kurnia Dwi Jayanthi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1501

Background: Systemic sterile inflammation acts as a critical pathophysiological driver in the acute phase of ischemic stroke, mediating secondary brain injury through blood-brain barrier disruption and microvascular thrombosis. While the Neutrophil-to-Lymphocyte Ratio (NLR) and Lymphocyte-to-Monocyte Ratio (LMR) have emerged as potential biomarkers in Western populations, their independent prognostic utility and specific diagnostic thresholds within Southeast Asian populations remain under-explored. This region presents unique challenges due to potential variations in baseline hematological profiles driven by genetic polymorphisms and environmental factors. This study aims to elucidate the association between admission NLR and LMR levels and the severity of Acute Ischemic Stroke (AIS) and to determine optimal population-specific prognostic cut-offs. Methods: We conducted a retrospective cross-sectional comparative study involving 128 patients with confirmed AIS admitted to Wangaya Regional General Hospital, Indonesia, between January 2025 and August 2025. Patients were stratified based on admission National Institutes of Health Stroke Scale (NIHSS) scores into a Mild Group (NIHSS ≤ 6, n=64) and a Moderate-Severe Group (NIHSS > 6, n=64). Infection was strictly excluded using clinical and radiological criteria independent of admission leukograms to prevent circular bias. Receiver Operating Characteristic (ROC) curve analysis was performed to determine diagnostic accuracy and identify optimal cut-offs. To address potential multicollinearity between NLR and LMR, two separate multivariate binary logistic regression models were constructed to determine independent predictors of severity. Results: The study population had a mean age of 60.5 years. The Moderate-Severe Group exhibited significantly higher NLR (6.12 ± 3.41 vs. 2.85 ± 1.20; p < 0.001) and lower LMR (2.15 ± 0.92 vs. 4.22 ± 1.50; p < 0.001) compared to the Mild Group. ROC analysis identified optimal cut-offs of ≥ 4.82 for NLR (AUC: 0.782; Sensitivity: 76.6%) and ≤ 2.89 for LMR (AUC: 0.724; Sensitivity: 71.9%). In the multivariate analysis Model 1, NLR ≥ 4.82 remained an independent predictor of severity (Adjusted Odds Ratio [aOR]: 4.12; 95% CI: 1.78–9.54; p = 0.001). In the separate Model 2, LMR ≤ 2.89 was also confirmed as an independent predictor (aOR: 2.85; 95% CI: 1.24–6.55; p = 0.014). Conclusion: Elevated NLR and reduced LMR at admission are robust, independent indicators of stroke severity in this Indonesian cohort. These accessible hematological biomarkers reflect the divergent trajectories of post-ischemic neuroinflammation—innate immune hyperactivity and adaptive immune exhaustion. They provide a cost-effective method for risk stratification in resource-limited settings, warranting their integration into routine initial assessment protocols.

Therapeutic Plasma Exchange as Adjuvant Rescue Therapy for Weil’s Disease-Associated Acute Liver Failure in a Hemodialysis-Dependent Patient: A Case Report Ardana Tri Arianto; Aura Ihsaniar; Lichte Christian Purbono
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1502

Background: Weil’s disease, the severe form of leptospirosis, manifests as a triad of jaundice, renal failure, and hemorrhage. In patients with pre-existing end-stage renal disease (ESRD), the management of superimposed acute liver failure (ALF) is exceptionally challenging due to altered pharmacokinetics, fluid intolerance, and the inability of standard hemodialysis to clear protein-bound hepatic toxins. Case presentation: We present a 32-year-old anuric male with ESRD on maintenance hemodialysis who presented with fever, jaundice, and altered mental status following floodwater exposure. He developed severe metabolic encephalopathy (GCS E2V2M4), profound coagulopathy (INR 6.04), and hyperbilirubinemia (Total Bilirubin 18.31 mg/dL). Following the failure of broad-spectrum antibiotics and sustained low-efficiency dialysis (SLED) to halt clinical deterioration, two sessions of therapeutic plasma exchange (TPE) were initiated as salvage therapy. The intervention utilized 100% fresh frozen plasma (FFP) replacement to address hemostatic failure. TPE resulted in rapid biochemical clearance and clinical stabilization. Post-intervention, the INR decreased from 6.04 to 1.57 (74% reduction), Total bilirubin declined from 18.31 to 5.57 mg/dL (69.5% reduction), and platelet counts recovered from 45,000 to 142,000/µL. Neurological status normalized (GCS 15) within 48 hours of the second session. Conclusion: TPE served as an effective bridge to recovery by clearing albumin-bound toxins and restoring coagulation factors in a high-risk patient where standard renal replacement was insufficient.

Nuclear β-Catenin Accumulation Correlates with Poor Survival in Undifferentiated Nasopharyngeal Carcinoma: A Retrospective Cohort Study in an Endemic Region Ayu Aksara; Awal Prasetyo; Devia Eka Listiana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1503

Background: Nasopharyngeal carcinoma (NPC) is highly endemic in Indonesia, characterized by a prevalence of undifferentiated subtypes and late-stage presentation. While the Epstein-Barr virus (EBV) is a primary driver, the limitations of TNM staging in predicting individual outcomes necessitate the identification of molecular biomarkers. This study investigates the prognostic utility of aberrant Wnt/β-catenin signaling, specifically nuclear accumulation, in predicting overall survival (OS). Methods: A retrospective cohort study was conducted on 44 patients diagnosed with undifferentiated NPC at Dr. Kariadi General Hospital, Indonesia, between 2020 and 2024. Immunohistochemistry (IHC) for β-catenin was performed, with scoring specifically targeting nuclear and cytoplasmic reactivity (excluding physiological membranous staining) using the Allred system. Clinicopathological variables, including TNM staging (AJCC 8th edition), were analyzed. Survival analysis utilized Kaplan-Meier curves and multivariate Cox Proportional Hazards regression. Results: The cohort exhibited advanced disease, with 81.8% of patients presenting at Stage III or IV. Nuclear β-catenin overexpression (moderate-to-strong) was observed in 97.7% of cases. Strong nuclear expression was significantly associated with advanced T-stage (p=0.032) and distant metastasis (p=0.045). Kaplan-Meier analysis revealed a significant reduction in 5-year overall survival for the strong expression group (0%) compared to the weak/moderate group (p < 0.001). In multivariate analysis adjusted for age and TNM stage, strong β-catenin expression remained a significant predictor of mortality (Hazard Ratio: 2.15; 95% CI: 1.05–4.42; p=0.036), alongside Stage IV disease. Conclusion: Nuclear accumulation of β-catenin is a prevalent molecular event in Indonesian NPC and serves as a significant prognostic biomarker independent of tumor stage. These findings suggest potential utility for risk stratification and targeted Wnt-inhibitor therapies.

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Contact Name Rachmat Hidayat

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Editorial Address Jl. Sirna Raga no 99, 8 Ilir, Ilir Timur 3, Palembang

Location Kota palembang, Sumatera selatan INDONESIA

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Contact Name
Rachmat Hidayat

Contact Email
dr.rachmat.hidayat@gmail.com

Phone
+6281949581088

Journal Mail Official
editor.bioscmed@gmail.com

Editorial Address
Jl. Sirna Raga no 99, 8 Ilir, Ilir Timur 3, Palembang

Location
Kota palembang,

Sumatera selatan

INDONESIA