Cluster of Differentiation as Predictor of Therapy Response to Neoadjuvant Chemotherapy in Advanced Stage Cervical Cancer
Author(s): Patiyus Agustiansyah, Rizal Sanif, Theodorus, Nana Nurmila
Abstract
Cervical cancer is the third leading cause of death of women worldwide and number one in developing countries. On the Gynecology Division of Oncology Dr. Mohammad Hoesin Hospital Palembang administration of neoadjuvan chemotherapy is used as a therapy in advanced stage cervical cancer. Decreased CD4 cell value in the human body indicates a decrease in white blood cells or lymphocytes that play a role in fighting infections that enter the human body. This study aims to determine the value of CD4 in advanced cervical cancer at Dr. Mohammad Hoesin Hospital, Palembang. A case series study was undertaken in January to September 2017 at Dr. Mohammad Hoesin Hospital Palembang. There were 30 patients with advanced cervical cancer who meets the inclusion criteria. The frequency and distribution of data are described in tabular form. The effectiveness of NAC was analyzed using Paired T Test/Wilcoxon. Assessment of CD4 as a predictor of NAC therapy response was seen from the values of sensitivity and specificity. Data analysis using SPSS version 18.0. In this study, there were 30 patients with advanced cervical cancer. Mean age was 47.93 ± 9.537 years with age range 32-72 years and the highest stage was 3B (63.3%). With statistical analysis, there were no differences in age, height, stage and type of therapy between patients with positive and negative treatment response (p > 0.05). In addition, there was difference in the value of mass (p = 0.000) and the mass width (p = 0.000) before and after NAC therapy. There was no difference in CD4 values before and after NAC therapy series I (p = 0.072) but there are difference in CD4 values after NAC series II therapy (p = 0.021) The CD4 values after NAC series I therapy had a sensitivity of 82.14% and a specificity of 100% while the CD4 values after NAC II series therapy had a sensitivity of 89.29% and a specificity of 100%. It can be concluded that the CD4 cell value of patients with advanced cervical cancer increasing with Neoadjuvant Chemotherapy (NAC) therapy and can be used as a predictor of treatment response in patients with advanced cervical cancer.
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