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Biomedical Science Doctorate Researches Biomarkers That Can Predict the Risk of Colorectal Cancer Spread
Biomedical Science Doctorate Researches Biomarkers That Can Predict the Risk of Colorectal Cancer Spread
Held in the Meeting Room on the Third Floor of the Postgraduate Building of Udayana University, Jl. PB Sudirman, Denpasar, Bali, the Biomedical Science Doctoral Study Program, Faculty of Medicine, Udayana University, held an open doctoral promotion defense with candidate Dr. I Nyoman Sasputra, M.Biomed., Sp.PA., for the dissertation "High Expression of Transforming Growth Factor-Β (Tgf-Β), Fibronectin (Fn), and Programmed Death-Ligand 1 (Pdl1) as a Risk Factor for Metastasis in Colorectal Adenocarcinoma." (July 15, 2026)
Colorectal adenocarcinoma is the third most common malignancy and the leading cause of death among gastrointestinal cancers. The risk of death in colorectal adenocarcinoma patients increases if metastasis has occurred. The use of biomarkers to determine risk factors for colorectal adenocarcinoma metastasis has been less than satisfactory, so research is needed to identify more robust biomarkers for determining metastasis risk factors. This study aims to demonstrate the risk of metastasis in patients with high TGF-β, fibronectin, and PD-L1 protein expression compared to those with low TGF-β, fibronectin, and PD-L1 protein expression.
This study used a nested case-control design. The sample size for this study was 84 colorectal adenocarcinoma patients from the Anatomical Pathology Laboratory of Prof. Dr. I G.N.G. Ngoerah General Hospital, Denpasar, from June 1, 2021, to July 1, 2024. A total of 42 non-metastatic colorectal adenocarcinoma patients served as controls, and 42 metastatic colorectal adenocarcinoma patients served as cases. TGF-β, fibronectin, and PD-L1 protein expression were assessed using immunohistochemistry, chi-square test, odds ratio, and logistic regression analysis with a significance level of p< 0.05.
The risk of metastasis was higher in colorectal adenocarcinomas with high TGF-β protein expression (RR=2.9; 95% CI: 2.074–4.081; p< 0.001), high PD-L1 protein expression by 22 times (OR=22.0; 95% CI: 7.065–68.505; p< 0.001), while all fibronectin protein expression was categorized as high. Multivariate logistic regression analysis showed high PD-L1 protein expression with a positive regression coefficient (B = 4.213; p< 0.001) and an odds ratio of 67.557 (95% CI: 11.366–401.562).
The study concluded that high TGF-β and PD-L1 protein expression are significant risk factors for colorectal adenocarcinoma metastasis. The risk of metastasis cannot be assessed from fibronectin expression. Fibronectin expression was equally high in colorectal adenocarcinoma with and without metastasis.
This examination was led by the Vice Dean for General Affairs and Finance, Faculty of Medicine, Udayana University, Prof. Dr. dr. I Made Muliarta, S.Ked., M.Kes., with the following examiners:
1. Prof. Dr. dr. I Gusti Ayu Sri Mahendra Dewi, Sp.PA., Subsp.O.G.P.(K) (Promoter)
2. Dr. dr. Gede Wirya Kusuma Duarsa, Sp.U, Subsp.Ped., M.Kes., MARS (Co-Promoter I)
3. Dr. dr. Ni Putu Sriwidyani, Sp.PA., Subsp.S.M.(K) (Co-Promoter II)
4. Prof. Dr. dr. I Made Jawi, M.Kes
5. Prof. Dr. dr. I Wayan Putu Sutirta Yasa, M.Si
6. Prof. Dr. Drs. I Ketut Sudiana, M.Si
7. Dr. dr. Ida Ayu Ika Wahyuniari, M.Kes
8. Dr. dr. I Kadek Swastika, S.Ked., M.Kes
9. Dr. dr. I Gusti Agung Gede Utara Hartawan, Sp.An-TI., MARS., SH
By academic invitation:
1. Dr. dr. I Wayan Sugiritama, M.Kes
2. Dr. dr. I Gusti Lanang Ngurah Agung Artha Wiguna, S.Ked., Sp.OT(K)..
3. Dr. dr. I Wayan Juli Sumadi, Sp.PA., Subsp.M.S(K)
4. Dr. dr. Ni Wayan Armerinayanti, M.Biomed., Sp.PA
5. Dr. dr. I Wayan Lolik Lesmana, M.Biomed., Sp.THT-BKL., Subsp.Onk(K)
During this examination, Dr. dr. I Nyoman Sasputra, M.Biomed., Sp.PA., was declared the 499th graduate of the Doctoral Program in Biomedical Sciences, Faculty of Medicine, Udayana University, with a Very Satisfactory Grade.
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