Doctor of Medicine Proves Risk Factors for Metastasis in Breast Cancer

Taking place in the Postgraduate Meeting Room, Denpasar Postgraduate Building, a Doctoral Promotion exam was held with the promovenda candidate, dr. Ni Putu Yenny Kendarini, M.Biomed, Sp.B, FINACS, with the dissertation title "Expression of Serum Cell-Free microRNA 373-3p, Ratio of Serum Levels Cluster Of Differentiation 44 Variant 6/Cluster of Differentiation 44 Standard Form and Vascular Endothelial Growth Factor As a Metastatic Risk Factor in Luminal Subtype Breast Cancer." (31/7/2023)

 

The metastatic process in breast cancer can occur before the discovery of macrometastases through conventional investigations. The metastatic process may actually have occurred microscopically long before the appearance of metastatic tissue in an organ. For this reason, exploration of biomarkers is needed to detect metastases. The term liquid biopsy or fluid biopsy developed, which is a predictor biomarker such as microRNA circulating in the blood that can target cancer stem cells such as cluster of differentiation (CD). So it is hoped that metastatic therapy can be started earlier.

 

The aim of this study was to prove the expression of serum cell-free microRNA 373-3p, serum levels of CD44v6, CD44S, CD44V6/CD44S ratio, VEGF as risk factors for metastasis and the correlation of CD44S with VEGF in luminal subtype metastatic breast cancer. A total of 38 samples consisting of 18 cases with metastases and 20 controls without metastases who had undergone surgery to remove the primary tumor and continued chemotherapy and/or hormone therapy.

 

Examination of CD44v6, CD44s and VEFG was taken from blood serum and then examined using an enzyme-linked immunosorbent assay (ELISA) with units of ng/mL. Determination of the relative expression of 373-3p microRNA from cell-free serum and examined using reverse transcription quantitative real-time PCR (RT-qPCR).

 

MicroRNA 373-3p was not detected or negative, but microRNA 16 as an endogenous control was detected in all samples. The points of intersection of the CD44v6, CD44S, VEGF values with the ROC curve were 4 ng/mL, 119.2 ng/mL, 340 ng/mL. In a cross-sectional study, CD44S had a strong positive correlation with VEGF, where the higher the VEGF level, the higher the CD44s level, and vice versa. It was found that a low CD44v6/CD44s ratio is a risk factor for metastasis. A low CD44v6/CD44s ratio (< 0.03) has a 7 times higher risk of experiencing metastases.

 

The novelty of this study is that researchers first found a low CD44v6/CD44s ratio as a risk factor for metastasis in Luminal subtype breast cancer, where previously there had been no reports of a CD44 ratio being a risk factor for breast cancer metastasis, especially in the Luminal subtype. The two researchers found a strong positive correlation of CD44s and VEGF in cases of Luminal subtype breast cancer. This correlation has never been reported in previous studies. The three researchers found that the 373-3p microRNA was not expressed in breast cancer cases of the luminal subtype group after undergoing cancer therapy and surgery.

 

The exam was led by the Dean of FK Unud Dr. dr. Komang Januartha Putra Pinatih, M.Kes., with the testing team:

1. Dr. dr. Tjokorda Gde Bagus Mahadewa, M.Kes.,Sp.BS (K)., Spinal, FICS. FINSS (Promoter)

2. Prof. Dr. dr. I.B. Tjakra Wibawa Manuaba, MPH., Sp.B(K)Onk, FinaCS (Co-promoter I)

3.Dr. dr. I Wayan Sudarsa, Sp.B (K) Onk (Co-promoter II)

4. dr. Sofia Mubarika Harjana, M.Med.Sc., Ph.D

5. Prof. Dr. dr. I Made Jawi, M. Kes

6. Dr. dr. I Wayan Putu Sutirta Yasa, M.Si

7.Dr. dr. I Made Sudarmaja, M. Kes

8.Dr. dr. Ni Putu Sriwidyani, Sp.PA(K)

9.Dr. err. nat. dr. Ni Nyoman Ayu Dewi, M.Sc

 

While academic invitations are:

1.Dr. dr. I Nyoman Golden, Sp.BS(K)

2.Dr. dr. Urged Made Wihandani, M.Kes

3.Dr. dr. Luh Putu Ratna Sundari, S.Ked., M.Biomed

4.Dr. dr. I Made Muliarta, S.Ked., M.Kes

5. dr. Ni Nengah Dwi Fatmawati, S.Ked., Sp.MK(K)., Ph.D

 

In this exam, Dr. dr. Ni Putu Yenny Kendarini, M.Biomed, Sp.B, FINACS, was declared the 394th Doctor Graduate of the Doctoral Degree, Faculty of Medicine, Udayana University with the title of With Praise (Cumlaude).