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"ABSTRAKKarsinoma sel ginjal terhitung sekitar 3% dari kanker pada orang dewasa dan 85% dari semua keganasan primer ginjal. Tumor ini biasanya tidak memberikan gejala hingga penyakit sudah berada pada stadium lanjut. Metastasis pada kelenjar getah bening dan metastasis jauh diketahui merupakan faktor prognostik yang penting pada karsinoma sel ginjal. Parameter klinis diperlukan untuk memprediksi metastasis sebelum operasi. Penelitian ini merupakan penelitian prospektif dengan mengambil data dari rekam medis dari Januari 1995 hingga Desember 2015 di Rumah Sakit Cipto Mangunkusumo. Penelitian ini mengevaluasi faktor prediktif klinis untuk kejadian metastasis pada karsinoma sel ginjal.

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ABSTRACTRenal cell carcinoma (RCC) accounts for about 3% of cancers in adults as well as 85% of all primary malignancies arising from the kidney. RCC is commonly large at presentation and symptoms may not occur until relatively late in the disease. Lymph node and distant metastases were known as the prognostic factor in renal cell carcinoma. Clinical parameters are needed to predict the metastases preoperatively. This is a prospective-analytic using medical record data from January 1995 - December 2015 at Cipto Mangunkusumo Hospital. This study evaluate clinical predictive factors for metastatic renal cell carcinoma incidence;"

"ABSTRAKLatar belakang: Penentuan faktor risiko metastasis kelenjar getah bening dan prognosis pasien Karsinoma Sel Skuamosa (KSS) penis tidak sebanyak KSS pada organ lain. Penggunaan parameter patologik, ekpresi p53 dan Ki67 dapat digunakan sebagai variabel penentu prognosis maupun terapi KSS penis namun masih diperlukan data yang lebih banyak. Penelitian ini bertujuan untuk menjelaskan hubungan antara ekspresi p53 dan Ki67 terhadap parameter histopatologik yang mempengaruhi risiko metastasis.Bahan dan Cara: Penelitian ini merupakan studi potong lintang dengan melakukan pulasan imunohistokimia p53 (Novocastra DO-7) dan Ki67 (Biocare CRM 325) pada 25 sampel KSS penis.Hasil: Ekspresi p53 positif ditemukan pada 48% KSS penis dan ekspresi Ki67 tinggi ditemukan pada 52% kasus. Tidak temukan hubungan yang bermakna antara ekspresi p53 dan parameter-parameter histopatologik. Didapatkan hubungan bermakna antara ekspresi Ki67 terhadap derajat diferensiasi tumor dan adanya invasi uretra.Kesimpulan: Ekspresi p53 tidak dapat digunakan sebagai faktor prediktif risiko metastasis KSS penis. Ekspresi Ki67 secara sebagian berhubungan dengan faktor risiko metastasis KSS penis.

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ABSTRACTBackground: Determination of lymph node metastasis risk factors and prognosis of patients with Squamous Cell Carcinoma(SCC) of the penis is not as much as SCC in other organs. Pathological parameters, expression of p53 and Ki67 could be used as a determinants of prognosis and therapy in SCC of the penis but more data is still needed. This study aims to clarify the relationship between the expression of p53 and Ki67 to histopathological parameters that affect the risk of metastasis.Methode: This study was a cross-sectional study by using immunohistochemical staining of p53 (Novocastra DO-7) and Ki67 (Biocare CRM 325) in 25 samples of SCC of the penisResult: Expression of p53positive was found in 48% of SCC of the penis and higher expression of Ki67f was found in 52% of cases. No significant association between p53 expression and histopathologic parameters. Obtained significant correlation between the expression of Ki67 on the degree of tumor differentiation and invasion urethra.Conclusion: P53 expression can not be used as a predictive factor of risk metastatic in SCC of the penis. Ki67 expression is partially associated with risk factors for metastatic SCC of the penis."

"ABSTRAKTujuan: Menilai ekspresi protein Epidermal Growth Factor Receptor (EGFR) pada Karsinoma Sel Ginjal (KSG) serta kaitannya dengan faktor-faktor prediktor prognosis yang dinilai secara histopatologik (subtipe, staging histopatologik, derajat anaplasia inti Fuhrman)Metode: Studi potong lintang terhadap jaringan yang difiksasi formalin dan diletakkan di dalam parafin dari pasien-pasien dengan KSG, yang diwarnai menggunakan metode imunohistokimia terhadap protein EGFR. Hasil: Ekspresi EGFR pada membran ditemukan pada 46% dari keseluruhan kasus (N=41) dan ekspresi EGFR di sitoplasma ditemukan pada 49% dari keseluruhan kasus (N=41). Terdapat hubungan antara subtipe histopatologik dan derajat anaplasia inti Fuhrman dengan ekspresi EGFR di sitoplasma (nilai p 0,017 dan 0,014 dengan uji Fisher’s exact). Tidak ditemukan asosiasi antara staging histopatologik dengan ekspresi EGFR.Diskusi: Perlu dibuat penelitian lanjutan dengan membandingkan ekspresi EGFR terhadap angka kesintasan pasien serta dibandingkan dengan faktor prediktor prognosis yang lain. Kemaknaan lokasi ekspresi EGFR di sitoplasma juga memerlukan perhatian khusus dan pembuktian secara ilmiah.

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ABSTRACTObjective: To study the expression of Epidermal Growth Factor Receptor protein in Renal Cell Carcinoma (RCC) and its relationship with prognostic predictor factors evaluated histopathologically (subtype, histopathological staging, Fuhrman nuclear grading). Methods: This was a cross-sectional study on 41 formalin-fixated paraffin-embedded tissue of patients with RCC, stained using immunohistochemical method against EGFR protein. Result: Membranous EGFR expression was found in 46% of cases (N=41), while cytoplasmic EGFR expression was found in 49% of cases. There was a significant association between histopathological subtype or Fuhrman nuclear anaplasia grading and cytoplasmic expression of EGFR (p value 0,017 and 0,014, respectively, using Fisher’s exact test). No significant association was found between histopathological staging and EGFR expressionDiscussion: A further study on the association EGFR expression and survival, and its comparison to other prognostic factors is necessary. The significance of EGFR expresion in the cytoplasm requires special attention and further scientific evidence."

"ABSTRAK Latar belakang Prevalen metastasis kelenjar getah bening KGB pada karsinoma tiroid papiler KTP dan angka rekurensi regional yang berkaitan dengannya cukup tinggi Masih terdapat pro dan kontra terhadap diseksi kompartemen sentral yang dipandang dapat mengatasi masalah tersebut Oleh sebab itu diperlukan seleksi pasien yang akan mendapatkan diseksi kompartemen sentral Pengetahuan mengenai faktor prediktor metastasis kompartemen sentral dipandang dapat membantu seleksi pasien tersebut Penelitian ini bertujuan mengetahui faktor faktor prediktor klinikopatologis metastasis KGB kompartemen sentral pada pasien KTP cN0 di RSUPN dr Cipto Mangunkusumo RSCM Metode penelitian Studi retrospektif dilakukan pada 62 pasien KTP cN0 yang menjalani diseksi kompartemen sentral dalam kurun waktu Januari 2014 sampai Juli 2015 Pengambilan sampel dilakukan secara konsekutif Dilakukan analisis statistik menggunakan SPSS 20 0 untuk mencari hubungan antara faktor usia jenis kelamin ukuran tumor ekstensi ekstra tiroid metastasis jauh completeness of resection varian histopatologi dan invasi limfovaskular dengan metastasis KGB kompartemen sentral Kami menggunakan uji Chi square atau Fisher serta uji stratifikasi Signifikansi bila nilai p ABSTRACT Background Prevalence of lymph node metastases to central neck compartment in papillary thyroid carcinoma PTC and it rsquo s corelation with regional metastatic are high There are pros and cons on central neck dissection which is assumed can solve the problem Selection in which patient will undergo central neck dissection is necessary Predictive factors are useful for such selection This study aim is to identify the clinicipathologic predictive factors for metastases in central compartment in Cipto Mangunkusumo Hospital Method Data of 62 cN0 PTC patients who underwent central neck dissection were colected retrospectively and consecutively from medical record in Cipto Mangunkusumo Hospital The relationships between clinicopathology factors such as age gender tumor size extra thyroid extention distant metastasis completeness of resection histopathology variant lymphovascular invasion and central compartment metastases were analyzed using SPSS 20 0 Chi square Fischer exact and stratification test were used in our analsis Statistical significance was stated when p value "

"belakang: Karsinoma sel skuamosa rongga mulut (KSSRM) adalah salah satu kanker yang paling umum dijumpai dengan angka survival 52.0% yang tidak meningkat secara bermakna walaupun tatalaksana kanker ini terus berkembang. Cornulin merupakan protein spesifik untuk sel skuamosa yang penting dalam diferensiasi epitel. Penelitian sebelumnya menunjukkan bahwa rendahnya ekspresi cornulin berhubungan dengan gambaran klinikopatologi dan survival yang lebih buruk dibandingkan dengan ekspresi tinggi. Oleh karena sifatnya yang spesifik dan belum ada penelitian mengenai ekspresi cornulin sebagai faktor prognosis di Indonesia, maka penulis tertarik untuk mengetahui hubungan antara ekspresi cornulin dan survival pada pasien dengan KSSRM.Tujuan: Mengetahui potensi cornulin sebagai penanda biologis survival pada pasien dengan KSSRM.Metode: Penelitian ini menggunakan desain studi kohort retrospektif yang dilakukan dari periode Juni 2021 sampai dengan Mei 2022. Populasi penelitian ini merupakan pasien dengan diagnosis KSSRM yang ditegakkan dengan pemeriksaan histopatologis dan menjalani terapi di Divisi Bedah Onkologi Departemen Ilmu Bedah RSCM periode Januari 2015 – Mei 2020. Pemeriksaan imunohistokimia dilakukan untuk mengetahui ekspresi cornulin dan skor imunihistokimia ditentukan menggunakan immunoreactive score (IRS). Skor IRS < 6 berarti ekspresi rendah dan ≥ 6 berarti ekspresi tinggi. Analisis statistik univariat, bivariat, dan survival dilakukan menggunakan perangkat lunak SPSS.Hasil: Cornulin tidak memiliki hubungan yang signifikan secara statistik dengan survival pada pasien dengan KSSRM. T, N, dan stadium memiliki hubungan yang signifikan secara statistik dengan survival pada pasien dengan KSSRM dengan nilai p masing-masing adalah 0.001, 0.040, dan 0.001. T dan N memiliki hubungan yang bermakna secara statistik dengan ekspresi cornulin pada pasien dengan KSSRM, dengan nilai p masing-masing adalah 0.034 dan 0.030.Kesimpulan:Cornulin sebagai protein penanda biologis KSSM tidak dapat menjadi prediktor dari survival pasien dengan KSSM.

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Background: Oral squamous cell carcinoma (OSCC) is one of the most common cancers with a 52.0% survival rate which does not increase significantly even though the management of this cancer continues to develop. Cornulin is a specific protein for squamous cells that is important in epithelial differentiation. Previous studies have shown that low cornulin expression is associated with worse clinicopathological features and survival compared to high cornulin expression. Due to its specific nature and no research on cornulin expression as a prognostic factor has been done in Indonesia, the author is interested in knowing the relationship between cornulin expression and survival in patients with OSCC.

Objective: To determine the potential of cornulin as a biological marker for survival in patients with OSCC.

Methods: This study used a retrospective cohort study design that was conducted from June 2021 to May 2022. The population of this study were patients with OSCC diagnosis confirmed by histopathological examination and undergoing therapy at the Division of Surgical Oncology, Department of Surgery, RSCM for the period January 2015-May 2020. Immunohistochemical examination was performed to determine the expression of cornulin and the immunohistochemical score was calculated using the immunoreactive score (IRS). IRS score < 6 means low cornulin expression and ≥ 6 means high cornulin expression. Univariate, bivariate, and survival statistical analyses were performed using SPSS software.

Results: Cornulin did not have a statistically significant relationship with survival in patients with OSCC. T, N, and stage had a statistically significant relationship with survival in patients with SCC with p values ​​of 0.001, 0.040, and 0.001, respectively. T and N had a statistically significant relationship with cornulin expression in patients with OSCC, with p-values ​​of 0.034 and 0.030, respectively.

Conclusion: Cornulin as a biological marker protein of OSCC cannot be a predictor of the survival of patients with OSCC."

"Latar Belakang: Skrining kanker kulit dilakukan sebagai salah satu upaya dalam mengurangi morbiditas dan mortalitas yang ditimbulkan akibat kanker kulit. Karsinoma sel basal (KSB) merupakan salah satu kanker kulit yang paling sering ditemukan. KSB berpigmen seringkali menunjukkan fitur klinis yang menyerupai melanoma, sehingga kriteria klinis ABCDE diduga dapat menjadi salah satu pilihan dalam membantu penegakan diagnosis. Tujuan: Mengevaluasi kriteria klinis ABCDE sebagai alat bantu skrining KSB berpigmen dibandingkan dengan baku emas histopatologik.Metode: Penelitian potong lintang analitik ini dilakukan pada bulan Januari sampai dengan Juni 2023 di Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo (RSUPNCM). Pasien dengan lesi tumor kulit berpigmen dari tahun 2017 sampai dengan 2022 yang mempunyai data klinis, histopatologis, dan foto dokumentasi yang lengkap direkrut ke dalam penelitian secara konsekutif. Kriteria eksklusi mencakup lesi berukuran lebih dari 2 cm, ras kulit putih (tipe kulit Fitzpatrick 1-3), serta hasil pembacaan histopatologis lesi tumor sesuai dengan penyakit prakanker dan kanker kulit lainnya. Data diolah secara statistik menggunakan perangkat lunak Stata versi 16 (StataCorpTM) dan Medcalc diagnostic evaluation test calculator.Hasil: Sebanyak 84 pasien direkrut ke dalam penelitian dengan total 95 lesi yang mencakup 61 lesi KSB dan 34 lesi non-KSB. Median usia subjek KSB lebih tua dibandingkan dengan usia subjek non-KSB (p<0,001). Median ukuran lesi KSB lebih besar dibandingkan dengan ukuran lesi non-KSB (p<0,001). Lesi pada subjek KSB lebih banyak di wajah dibandingkan dengan subjek non-KSB (p=0,005). Proporsi kepositivan KSB berdasarkan kriteria klinis ABCDE adalah 87,5%. Kriteria klinis ABCDE menunjukkan sensitivitas 57,4% (interval kepercayaan [IK] 95% 44,0%–70,0%); spesifisitas 85,3% (IK 95% 68,9%–95,0%); nilai duga positif 87,5% (IK 95% 75,2%–94,2%); nilai duga negatif 52,7% (IK 95% 44,7%–60,6%); dan akurasi 67,4% (IK 95% 57,0%–76,6%) dalam mendiagnosis KSB berpigmen.Kesimpulan: Kriteria klinis ABCDE secara lengkap mempunyai nilai diagnostik yang kurang baik sebagai alat bantu skrining KSB berpigmen.

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Background: Skin cancer screening is performed as an effort to reduce the morbidity and mortality caused by skin cancer. Basal cell carcinoma (BCC) is one of the most common skin cancers. Pigmented BCC often shows clinical features resembling melanoma, so that ABCDE clinical criteria are thought to be a potential modality to help establishing the diagnosis of pigmented BCC.

Objective: To evaluate the ABCDE clinical criteria for the screening of pigmented BCC compared to histopathological examination as the gold standard examination.

Method: This analytical cross-sectional study was performed from January to June 2023 in dr. Cipto Mangunkusumo National Central General Hospital (RSUPNCM). Subjects with pigmented skin lesions visiting RSUPNCM from 2017 to 2022 whose clinical data, histopathological data, and photographs were documented completely were recruited to the study consecutively. Exclusion criteria included lesion’s size more than 2 cm, light skin (Fitzpatrick skin type 1-3), and histopathological diagnosis in line with precancerous lesion or other skin cancer. Data were analyzed with Stata software version 16 (StataCorpTM) and Medcalc diagnostic evaluation test calculator.

Results: A total of 84 subjects were recruited to the study with a total of 95 lesions consisting of 61 BCC lesions and 35 non-BCC lesions. Median age of the BCC subjects was older than that of non-BCC subjects (p<0.001). Median lesion’s size of the BCC lesions was larger than that of non-BCC lesions (p<0.001). The lesion location in BCC subjects was significantly prevalent on the face (p=0.005). The proportion of BCC positivity based on ABCDE clinical criteria was 87.5%. ABCDE criteria had sensitivity of 57.4% (95% Confidence Interval [CI] 44.0%–70.0%); specificity of 85.3% (95% CI 68.9%–95.0%); PPV of 87.5% (95% CI 75.2%–94.2%); NPV of 52.7% (95% CI 44.7%–60.6%); and accuracy of 67.4% (95% CI 57.0%–76.6%) in diagnosing pigmented BCC.

Conclusion: Fulfilling all ABCDE clinical criteria had poor diagnostic value for the screening of pigmented BCC."

"[ABSTRAKTujuan: Insiden kanker prostat secara global terus meningkat. Meskipun dapat dilakukan deteksi dini kanker prostat, perlu dipahami bahwa progresivitas penyakit ? menjadi metastasis ? berbeda untuk setiap pasien. Penelitian ini bertujuan untuk mengamati aspek-aspek yang mungkin berperan sebagai faktor prediktif metastasis pada kanker prostat tidak terpalpasi.Material dan Metode: Data dikumpulkan dari Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo dan Rumah Sakit Pusat Kanker Nasional Dharmais sejak tahun 1995-2013. Pasien dengan kanker prostat tidak terpalpasi kemudian dibagi menjadi dua kelompok: dengan metastasis dan tanpa metastasis. Usia, volume prostat, nilai prostate-spesific antigen (PSA), Gleason score sum group, stadium tumor, Karnofsky performance score (KPS), kadar hemoglobin, dan kadar kreatinin serum merupakan faktor yang dianalisis dalam penelitian ini. Data dianalisis menggunakan analisis bivariat dan uji regresi logistik. Hanya pasien dengan data lengkap yang dimasukkan dalam penelitian ini.Hasil: Didapatkan 91 pasien dengan data lengkap, 59 pasien (64,83%) tanpa metastasis dan 32 pasien (35,16%) dengan metastasis. Terdapat perbedaan statistik yang signifikan antara kelompok tanpa metastasis dan kelompok dengan metastasis, yakni untuk PSA (13.7ng / mL vs 71.5ng / mL; p = 0,001), kadar hemoglobin (13,60 g / dL vs 12,25 g / dL; p = 0,002), dan KPS (90 vs 90 ; p = 0,004). Perbedaan yang signifikan secara statistik juga didapatkan pada kelompok GSS (35 dan 24 pada kelompok tanpa metastasis vs 12 dan 20 pada kelompok dengan metastasis; p = 0,047). Usia, volume prostat, stadium tumor, dan kadar kreatinin antara kedua kelompok tidak memiliki perbedaan signifikan secara statistik (p> 0,05). Nilai pretreatment PSA adalah satu-satunya faktor prediktif untuk metastasis dengan odds ratio 1.014 (95% CI, 1,005-1,022; p = 0,002).Kesimpulan: Sebagian besar pasien kanker prostat tidak terpalpasi terdeteksi pertama kali tanpa metastasis. Nilai pretreatment PSA yang diperoleh pada kunjungan awal pasien dapat digunakan sebagai faktor prediktif metastasis di masa depan.

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ABSTRACTObjective: Prostate cancer incident is globally increasing. Despite early detection of prostate cancer, the progressivity of the disease itself toward metastatic disease remains different for each patient. The purpose of this study is to observe aspects that may have roles as predictive factors for metastasis in nonpalpable prostate cancer.Materials and Methods: Data was collected from National Hospital Cipto Mangunkusumo and Dharmais National Cancer Center Hospital from 1995-2013. Patients with nonpalpable prostate cancer then divided into two groups: metastasis-free group and metastasis group. Age, prostate volume, pretreatment Prostate-specific antigen (PSA) value, Gleason score sum group, tumor stadium, Karnofsky performance score (KPS), hemoglobin level, and serum creatinine level were factors that were analyzed in the study. The data was analyzed using bivariate analysis and logistic regression test. Only patients with complete data are included in the study.Results: There are 91 patients with complete data, 59 patients (64.83%) were patients without metastasis and 32 patients (35.16%) were with metastasis. There was significant statistical difference between no metastasis group with metastasis group for PSA (13.7ng/mL vs71.5ng/mL; p = 0.001), hemoglobin level (13.60 g/dL vs 12.25 g/dL; p = 0.002), and KPS (90vs90; p = 0.004). There was also significant statistical difference in GSS groups (35 and 24 in metastasis-free group vs 12 and 20 in metastasis group; p = 0.047). Age, prostate volume, tumor stadium, and creatinine level had no statistical difference between the two groups (p > 0.05). Pretreatment PSA value was the only predictive factor for metastasis with odds ratio 1.014 (95% CI, 1.005 to 1.022; p = 0.002).Conclusion: Most nonpalpable prostate cancer patients are first detected without metastasis. Pretreatment PSA value that was obtained at their initial visit might be used as predictive factor for metastasis for them in the future.;Objective: Prostate cancer incident is globally increasing. Despite early detection of prostate cancer, the progressivity of the disease itself toward metastatic disease remains different for each patient. The purpose of this study is to observe aspects that may have roles as predictive factors for metastasis in nonpalpable prostate cancer.Materials and Methods: Data was collected from National Hospital Cipto Mangunkusumo and Dharmais National Cancer Center Hospital from 1995-2013. Patients with nonpalpable prostate cancer then divided into two groups: metastasis-free group and metastasis group. Age, prostate volume, pretreatment Prostate-specific antigen (PSA) value, Gleason score sum group, tumor stadium, Karnofsky performance score (KPS), hemoglobin level, and serum creatinine level were factors that were analyzed in the study. The data was analyzed using bivariate analysis and logistic regression test. Only patients with complete data are included in the study.Results: There are 91 patients with complete data, 59 patients (64.83%) were patients without metastasis and 32 patients (35.16%) were with metastasis. There was significant statistical difference between no metastasis group with metastasis group for PSA (13.7ng/mL vs71.5ng/mL; p = 0.001), hemoglobin level (13.60 g/dL vs 12.25 g/dL; p = 0.002), and KPS (90vs90; p = 0.004). There was also significant statistical difference in GSS groups (35 and 24 in metastasis-free group vs 12 and 20 in metastasis group; p = 0.047). Age, prostate volume, tumor stadium, and creatinine level had no statistical difference between the two groups (p > 0.05). Pretreatment PSA value was the only predictive factor for metastasis with odds ratio 1.014 (95% CI, 1.005 to 1.022; p = 0.002).Conclusion: Most nonpalpable prostate cancer patients are first detected without metastasis. Pretreatment PSA value that was obtained at their initial visit might be used as predictive factor for metastasis for them in the future.;Objective: Prostate cancer incident is globally increasing. Despite early detection of prostate cancer, the progressivity of the disease itself toward metastatic disease remains different for each patient. The purpose of this study is to observe aspects that may have roles as predictive factors for metastasis in nonpalpable prostate cancer.Materials and Methods: Data was collected from National Hospital Cipto Mangunkusumo and Dharmais National Cancer Center Hospital from 1995-2013. Patients with nonpalpable prostate cancer then divided into two groups: metastasis-free group and metastasis group. Age, prostate volume, pretreatment Prostate-specific antigen (PSA) value, Gleason score sum group, tumor stadium, Karnofsky performance score (KPS), hemoglobin level, and serum creatinine level were factors that were analyzed in the study. The data was analyzed using bivariate analysis and logistic regression test. Only patients with complete data are included in the study.Results: There are 91 patients with complete data, 59 patients (64.83%) were patients without metastasis and 32 patients (35.16%) were with metastasis. There was significant statistical difference between no metastasis group with metastasis group for PSA (13.7ng/mL vs71.5ng/mL; p = 0.001), hemoglobin level (13.60 g/dL vs 12.25 g/dL; p = 0.002), and KPS (90vs90; p = 0.004). There was also significant statistical difference in GSS groups (35 and 24 in metastasis-free group vs 12 and 20 in metastasis group; p = 0.047). Age, prostate volume, tumor stadium, and creatinine level had no statistical difference between the two groups (p > 0.05). Pretreatment PSA value was the only predictive factor for metastasis with odds ratio 1.014 (95% CI, 1.005 to 1.022; p = 0.002).Conclusion: Most nonpalpable prostate cancer patients are first detected without metastasis. Pretreatment PSA value that was obtained at their initial visit might be used as predictive factor for metastasis for them in the future.;Objective: Prostate cancer incident is globally increasing. Despite early detection of prostate cancer, the progressivity of the disease itself toward metastatic disease remains different for each patient. The purpose of this study is to observe aspects that may have roles as predictive factors for metastasis in nonpalpable prostate cancer.Materials and Methods: Data was collected from National Hospital Cipto Mangunkusumo and Dharmais National Cancer Center Hospital from 1995-2013. Patients with nonpalpable prostate cancer then divided into two groups: metastasis-free group and metastasis group. Age, prostate volume, pretreatment Prostate-specific antigen (PSA) value, Gleason score sum group, tumor stadium, Karnofsky performance score (KPS), hemoglobin level, and serum creatinine level were factors that were analyzed in the study. The data was analyzed using bivariate analysis and logistic regression test. Only patients with complete data are included in the study.Results: There are 91 patients with complete data, 59 patients (64.83%) were patients without metastasis and 32 patients (35.16%) were with metastasis. There was significant statistical difference between no metastasis group with metastasis group for PSA (13.7ng/mL vs71.5ng/mL; p = 0.001), hemoglobin level (13.60 g/dL vs 12.25 g/dL; p = 0.002), and KPS (90vs90; p = 0.004). There was also significant statistical difference in GSS groups (35 and 24 in metastasis-free group vs 12 and 20 in metastasis group; p = 0.047). Age, prostate volume, tumor stadium, and creatinine level had no statistical difference between the two groups (p > 0.05). Pretreatment PSA value was the only predictive factor for metastasis with odds ratio 1.014 (95% CI, 1.005 to 1.022; p = 0.002).Conclusion: Most nonpalpable prostate cancer patients are first detected without metastasis. Pretreatment PSA value that was obtained at their initial visit might be used as predictive factor for metastasis for them in the future.;Objective: Prostate cancer incident is globally increasing. Despite early detection of prostate cancer, the progressivity of the disease itself toward metastatic disease remains different for each patient. The purpose of this study is to observe aspects that may have roles as predictive factors for metastasis in nonpalpable prostate cancer.Materials and Methods: Data was collected from National Hospital Cipto Mangunkusumo and Dharmais National Cancer Center Hospital from 1995-2013. Patients with nonpalpable prostate cancer then divided into two groups: metastasis-free group and metastasis group. Age, prostate volume, pretreatment Prostate-specific antigen (PSA) value, Gleason score sum group, tumor stadium, Karnofsky performance score (KPS), hemoglobin level, and serum creatinine level were factors that were analyzed in the study. The data was analyzed using bivariate analysis and logistic regression test. Only patients with complete data are included in the study.Results: There are 91 patients with complete data, 59 patients (64.83%) were patients without metastasis and 32 patients (35.16%) were with metastasis. There was significant statistical difference between no metastasis group with metastasis group for PSA (13.7ng/mL vs71.5ng/mL; p = 0.001), hemoglobin level (13.60 g/dL vs 12.25 g/dL; p = 0.002), and KPS (90vs90; p = 0.004). There was also significant statistical difference in GSS groups (35 and 24 in metastasis-free group vs 12 and 20 in metastasis group; p = 0.047). Age, prostate volume, tumor stadium, and creatinine level had no statistical difference between the two groups (p > 0.05). Pretreatment PSA value was the only predictive factor for metastasis with odds ratio 1.014 (95% CI, 1.005 to 1.022; p = 0.002).Conclusion: Most nonpalpable prostate cancer patients are first detected without metastasis. Pretreatment PSA value that was obtained at their initial visit might be used as predictive factor for metastasis for them in the future., Objective: Prostate cancer incident is globally increasing. Despite early detection of prostate cancer, the progressivity of the disease itself toward metastatic disease remains different for each patient. The purpose of this study is to observe aspects that may have roles as predictive factors for metastasis in nonpalpable prostate cancer.Materials and Methods: Data was collected from National Hospital Cipto Mangunkusumo and Dharmais National Cancer Center Hospital from 1995-2013. Patients with nonpalpable prostate cancer then divided into two groups: metastasis-free group and metastasis group. Age, prostate volume, pretreatment Prostate-specific antigen (PSA) value, Gleason score sum group, tumor stadium, Karnofsky performance score (KPS), hemoglobin level, and serum creatinine level were factors that were analyzed in the study. The data was analyzed using bivariate analysis and logistic regression test. Only patients with complete data are included in the study.Results: There are 91 patients with complete data, 59 patients (64.83%) were patients without metastasis and 32 patients (35.16%) were with metastasis. There was significant statistical difference between no metastasis group with metastasis group for PSA (13.7ng/mL vs71.5ng/mL; p = 0.001), hemoglobin level (13.60 g/dL vs 12.25 g/dL; p = 0.002), and KPS (90vs90; p = 0.004). There was also significant statistical difference in GSS groups (35 and 24 in metastasis-free group vs 12 and 20 in metastasis group; p = 0.047). Age, prostate volume, tumor stadium, and creatinine level had no statistical difference between the two groups (p > 0.05). Pretreatment PSA value was the only predictive factor for metastasis with odds ratio 1.014 (95% CI, 1.005 to 1.022; p = 0.002).Conclusion: Most nonpalpable prostate cancer patients are first detected without metastasis. Pretreatment PSA value that was obtained at their initial visit might be used as predictive factor for metastasis for them in the future.]"

"Latar Belakang: Karsinoma sel sebasea adalah keganasan yang cukup sering ditemukan pada populasi Asia dan bersifat agresif dengan tingkat rekurensi lokal dan metastasis jauh yang tinggi. Peningkatan ekspresi pulasan imunohistokimia (IHK) tumor suppressor gene p53 dan Ki-67 sebagai penanda aktifitas proliferasi pada tumor kepala dan leher menunjukkan adanya korelasi antara aktivitas proliferasi dengan buruknya prognosis.Tujuan: Menilai ekspresi p53 dan Ki-67 pada karsinoma sel sebasea yang dihubungkan dengan faktor prognostik klinis dan histopatologi pada karsinoma sel sebasea yaitu ukuran tumor, keterlibatan kelenjar getah bening (KGB), metastasis jauh, diferensiasi, penyebaran pagetoid, dan invasi perineural.Metode: Pulasan IHK menggunakan antibodi p53 dan Ki-67 dilakukan pada jaringan karsinoma sel sebasea di blok parafin yang berasal dari data rekam medis sejak Juni 2017 – Juni 2022 di RSCM. Penilaian ekspresi dilakukan pada nukleus dengan metode manual dan semi-kuantitatif pada 1 lapang pandang dengan minimal jumlah sel sebanyak 500 sel dari hasil foto dan diproses ke dalam peranti lunak Qupath. Hasil penilaian selanjutnya di cek silang dengan data klinis pasien yang sudah dicatat di tabel induk dan kemudian dianalisa secara statistik untuk mengetahui hubungan keduanya.Hasil: Total 34 pasien dengan ketersediaan blok parafin dianalisa berdasarkan data klinis dan ekspresi p53 dan Ki-67. Tidak ditemukan adanya hubungan yang signifikan secara statistik antara kategori ekspresi p53 dengan faktor prognosis klinis dan histopatologi (p>0.05). Ekspresi p53 pada hasil penelitian menunjukkan proporsi faktor prognosis buruk lebih banyak ditemukan pada ekspresi tinggi yaitu adanya metastasis, invasi perineural, dan penyebaran pagetoid. Tidak ditemukan adanya hubungan yang signifikan secara statistik antara kategori ekspresi Ki-67 dengan faktor prognosis klinis dan histopatologi (p>0.05). Ekspresi Ki-67 pada penelitian ini menunjukkan proporsi faktor prognosis buruk lebih banyak ditemukan pada ekspresi tinggi yaitu ukuran tumor yang lebih besar, metastasis, diferensiasi buruk, dan invasi perineural.Kesimpulan: Tidak terdapat hubungan yang bermakna secara statistik antara ekspresi Ki-67 dan p53 dengan faktor prognosis klinis dan histopatologi buruk pada karsinoma sel sebasea. Terdapat proporsi sampel dengan ekspresi Ki-67 tinggi yang lebih banyak dan nilai tengah yang lebih tinggi pada faktor prognosis ukuran tumor, metastasis, berdiferensiasi buruk, serta invasi perineural, meskipun hasil yang didapatkan tidak jauh berbeda dan secara statistik tidak bermakna. Pada pulasan p53 terdapat perbedaan yang cukup besar dalam hal proporsi pulasan dengan ekspresi tinggi serta nilai tengah yang lebih tinggi pada faktor prognosis ukuran tumor.

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Sebaceous cell carcinoma is a relatively common malignancy in the Asian population, characterized by aggressive behavior with high rates of local recurrence and distant metastasis. Increased expression of immunohistochemical marker such as tumor suppressor gene p53 and Ki-67, a proliferation marker, in head and neck tumors suggests a correlation between proliferation activity and poor prognosis.

Objective: This study aims to evaluate the expression of p53 and Ki-67 in sebaceous cell carcinoma and its association with clinical and histopathological prognostic factors, including tumor size, lymph node involvement, distant metastasis, cell differentiation, pagetoid spread, and perineural invasion.

Methods: Immunohistochemical staining using p53 and Ki-67 antibodies was performed on paraffin-embedded sebaceous cell carcinoma tissues obtained from medical records between June 2017 and June 2022 at RSCM. Expression assessment was conducted on nuclei using manual and semi-quantitative methods on 500 cells per field processed with Qupath software. The results were cross-checked with patients' clinical data recorded in a master table and statistically analyzed to determine their relationship.

Results: A total of 34 patients were analyzed based on clinical data and p53 and Ki-67 expression. There was no statistically significant association between p53 expression and clinical and histopathological prognostic factors (p>0.05). However, high p53 expression was associated with a higher proportion of poor prognostic factors, such as metastasis, perineural invasion, and pagetoid spread. Similarly, there was no statistically significant association between Ki-67 expression categories and clinical and histopathological prognostic factors (p>0.05). High Ki-67 expression was more frequently observed in cases with larger tumor size, metastasis, poor differentiation, and perineural invasion.

Conclusion: This study found no significant statistical association between Ki-67 and p53 expression with poor prognostic factors in sebaceous cell carcinoma. Nonetheless, a higher proportion of samples with high Ki-67 expression and higher median values were observed in cases with bigger tumor size, metastasis, poor differentiation, and perineural invasion, although these differences were not statistically significant. For p53 expression, significant differences were found in terms of proportion and median values concerning tumor size prognostic factors.

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"Latar belakang: Pasien kanker paru berpotensi mengalami infeksi oportunistik yang dapat memperburuk luaran klinis, bahkan kematian. Salah satu penyebab infeksi oportunistik itu adalah jamur Aspergillus sp. Diagnosis dini masih menjadi tantangan, tetapi sangat penting dilakukan agar tata laksana dapat dioptimalkan. Tujuan: Penelitian ini bertujuan untuk mengetahui korelasi klinis dengan hasil kultur jamur Aspergillus pada pasien kanker paru karsinoma bukan sel kecil (KPKBSK) di RSUP Persahabatan serta uji kepekaannya terhadap vorikonazol. Metode: Studi potong lintang ini dilakukan pada pasien KPKBSK yang memenuhi kriteria inklusi. Prosedur biakan jamur dari sputum induksi dilakukan pada medium Agar Sabouraud Dekstrosa (ASD) menggunakan metode high volume. Identifikasi spesies dilakukan dengan pemeriksaan mikroskopik, dilanjutkan dengan uji kepekaan Aspergillus menggunakan metode difusi cakram. Data klinis pasien diperoleh dari rekam medis. Hasil: Dari 70 pasien KPKBSK yang memenuhi kriteria inklusi, terdapat pasien laki-laki 61,4%, dengan rerata usia 59,83  9,18 tahun. Profil klinis lain menunjukkan jenis adenokarsinoma 74,3%, stadium lanjut kanker paru 78,6%, tampilan status 1 40%, perokok aktif 60%, dan indeks brinkman berat 31,4%. Gejala klinis berupa sesak napas 81,4%, nyeri dada 71,4%, berat badan turun 71,4%, batuk 45,7%, hemoptisis 28,6%, dan demam 8,6%. Riwayat komorbid berupa diabetes melitus 18,6%, bekas tuberkulosis 12,9%, dan asma/penyakit paru obstruktif kronik 1,4%. Proporsi Aspergillus yang diisolasi dari sputum induksi didapatkan pada 43 pasien (61,4%), dengan 67 isolat. Distribusi spesies Aspergillus terdiri atas Aspergillus niger 22,1%, Aspergillus fumigatus 17,9%, dan Aspergillus flavus 7,9%. Analisis statistik menunjukkan terdapat hubungan bermakna antara jenis kelamin laki-laki, gejala klinis batuk dan demam dengan hasil kultur Aspergillus (p<0.05). Uji kepekaan 59 isolat Aspergillus sp. terhadap vorikonazol menunjukkan hasil sensitif 57,6%, intermediet 34,6%, dan resisten 19,3%. Simpulan: Pada penelitian ini terdapat hubungan bermakna antara jenis kelamin laki-laki, gejala klinis batuk, dan demam dengan hasil kultur Aspergillus (p<0.05). Tiga puluh sembilan dari 59 isolat Aspergillus spp. masih sensitif terhadap vorikonazol.

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Background: Lung cancer patients have the potential to experience opportunistic infections that can worsen clinical outcomes, even death. One of the causes of opportunistic infection is the fungus Aspergillus sp. Early diagnosis remains a challenge, but it is necessary for optimal management.

Objective: This study aims to determine the clinical correlation with the results of Aspergillus culture in patients with non-small cell lung carcinoma (NSCLC) at Persahabatan Hospital and their susceptibility to voriconazole.

Methods: This cross-sectional study was carried out on NSCLC patients who met the inclusion criteria. The procedure of fungal culture from induced sputum was performed on Sabouraud Dextrose Agar (SDA) medium using the high volume method. Species identification was conducted with microscopic examination, followed by Aspergillus susceptibility test using the disc diffusion method. Patients’ clinical data obtained from medical records.

Results: Out of 70 NSCLC patients who met the inclusion criteria, there were male patients 61.4%, with a mean age of 59.83 ± 9.18 years. Clinical profiles of NSCLC patients were adenocarcinoma 74.3%, advanced lung cancer 78.6%, performance status 1 40%, active smokers 60%, and severe Brinkman index 31.4%. Clinical symptoms of shortness of breath 81.4%, chest pain 71.4%, weight loss 71.4%, cough 45.7%, hemoptysis 28.6%, and fever 8,6%. A history of comorbid diabetes mellitus 18.6%, former tuberculosis 12.9%, and asthma/chronic obstructive pulmonary disease 1.4%. The proportion of Aspergillus isolated from induction sputum was found in 43 patients (61.4%), as many as 67 isolates. The distribution of Aspergillus species consisted of Aspergillus niger 22.1%, Aspergillus fumigatus 17.9%, and Aspergillus flavus 7.9%. Statistical analysis showed that there was a significant relationship between male gender, clinical symptoms of cough, and fever with the results of Aspergillus culture (p <0.05). Susceptibility test for 59 isolates of Aspergillus sp. to voriconazole showed sensitivity of 57.6%, intermediate 34.6%, and resistance 19.3%.

Conclusion: In this study, there was a significant relationship between male gender, clinical symptoms of cough, and fever with Aspergillus culture results (p <0.05). Thirty-nine out of 59 Aspergillus spp. isolates were still sensitive to voriconazole."

"Latar belakang: Trikloroetilen merupakan bahan kimia yang masih digunakan di industri sampai dengan saat ini. Pajanan terhadap trikloroetilen dipercaya dapat menyebabkan berbagai gangguan kesehatan. Tujuan dari laporan kasus berbasis bukti ini adalah untuk memberi bukti adanya risiko terjadinya karsinoma ginjal pada pekerja dengan pajanan trikloroetilen. Metode: Pencarian literature dilakukan melalui Pubmed dan Google Scholar dengan kriteria inklusi jenis literature adalah RCT dan ulasan sistematis, kelompok yang diteliti adalah pekerja dengan pajanan trikoloetilen dari pekerjaan. Artikel yang ditemukan kemudian dievaluasi kritis dengan menggunakan kriteria The Oxford Center for Evidence-based Medicine. Hasil: Berdasarkan kriteria pencarian ditemukan tiga artikel yaitu artikel meta-analisis yang telah diproses secara sistematik dan kuantitatif oleh Scott, et al. yang menyatakan bahwa adanya hubungan sebab-akibat yang kuat antara pajanan trikloroetilen dengan terjadinya karsinoma ginjal dengan ringaksan risiko relatif (RRm) dari 15 studi adalah 1.27 (95% CI: 1.13-1.43). Artikel yang kedua merupakan studi kohort retrospektif yang dilakukan oleh Henschler, et al. menemukan bahwa terjadi peningkatan risiko karsinoma ginjal akibat pajanan trikloroetilen dibandingkan dengan kelompok kontrol maupun pada populasi umum dengan rasio insiden terstandarisasi sebesar 7.97 (95% CI: 2.59-18.59). Artikel yang terakhir merupakan suatu studi kasus-kontrol yang dilakukan di Perancis (Arve Valley) oleh Charbotel, et al. yang menemukan bahwa merokok meningkatkan risiko terjadinya karsinoma ginjal pada pekerja yang terpajan trikloroetilen dengan OR 3.27 (95% CI:1.48-7.19). Kesimpulan dan saran: Pajanan trikloroetilen dapat menyebabkan terjadinya karsinoma ginjal yang risikonya dipengaruhi oleh dosis pajanan serta faktor risiko lainnya seperti merokok. Pengendalian risiko perlu dilakukan secara berkesinambungan untuk industri yang menggunakan trikloroetilen dalam proses produksinya. Background: Trichloroethylene is a chemical that is still used in the industry today. Exposure to trichlorethylene is believed to cause various health problems. The purpose of this evidence-based case report is to provide evidence of the risk of kidney carcinoma in workers with trichlorethylene exposure. Method: Literature searches carried out through Pubmed and Google Scholar with literature type inclusion criteria were RCTs and systematic reviews, the groups studied were workers with tricholoethylene exposure from work. Articles found are then critically evaluated using the Oxford Center for Evidence-based Medicine criteria. Results: Based on the search criteria found three articles, namely article meta-analysis that has been processed systematically and quantitatively by Scott, et al. which states that there is a strong causal relationship between exposure to trichlorethylene and the occurrence of renal carcinoma with a relative risk (RRm) of 15 studies is 1.27 (95% CI: 1.13-1.43). The second article is a retrospective cohort study conducted by Henschler, et al. found that there was an increased risk of renal carcinoma due to trichlorethylene exposure compared to the control group and in the general population with a standardized incidence ratio of 7.97 (95% CI: 2.59-18.59). The last article is a case-control study conducted in France (Arve Valley) by Charbotel, et al. who found that smoking increased the risk of kidney carcinoma in workers exposed to trichlorethylene at OR 3.27 (95% CI: 1.48-7.19). Conclusions and recommendations: Trichloroethylene exposure can cause kidney carcinoma, the risk of which is affected by exposure doses and other risk factors such as smoking. Risk control needs to be carried out continuously for industries that use trichlorethylene in their production processes."