Correlation between HIF-1? and CD44 with Radiotherapy Response in Stage IIB-IIIB Cervical Squamous Cell Carcinoma

Cervical cancer is the fourth most commonly malignancy in women worldwide and one of the most common malignancies in Indonesian women. Radiotherapy is one of the therapeutic modalities of cervical carcinoma. On the other hand, radioresistance can cause failure in this treatment. Under certain circumstances, reoxygenation can ensure the successfulness of radiotherapy. HIF-1 and CD44 are proteins markers that play role in hypoxia condition and stemness of cancer cells which has correlation with radiotherapy resistance. The aim of this study is to find the correlation between HIF-1 and CD44 immunoexpression with radiotherapy response in stage IIB-IIIB cervical squamous cell carcinoma. A retrospective case control analysis design has been used in this study, using secondary data of patients stage IIB-IIIB cervical squamous cell carcinoma at the Department of Anatomical Pathology of Dr Hasan Sadikin Hospital, Bandung. There are 64 samples consist of 32 radiotherapy sensitive cases and 32 radiotherapy resistant cases. Immunohistochemical staining of HIF-1 and CD44 were performed to all samples. The result of this study shows a statistically significant correlation between HIF-1 (p=0.0001) and CD44 (p=0.011) immunoexpression with radiotherapy response respectively, with Odd Ratio (OR) 27.35 and 4.78 respectively. In conclusion, radiotherapy response in Cervical squamous cell carcinoma is influenced by hypoxia condition and stem cell status. Immunoexpression of HIF-1 and CD44 can be used to predict radiotherapy response. Increase of HIF-1 and CD44 immunoexpression has a positive correlation with the possibility of radiotherapy resistance.