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"ABSTRAKA 30-year-old Javanese-Indonesian man was admitted with complaints of 3 months persistent fever, weight loss, and fatigue. He had never known his past history of unprotected HIV until the admission. His only risk factor is unsafe sex. The patient seemed well nourished. Physical examination revealed blood pressure 100/60 mmHg, pulse 100 beats per minute, respiratory rate 20 times per minute, and temperature 38.8°C. Multiple cervical and inguinal lymphadenopathies were also found. Electrocardiogram showed anterolateral ischemic finding, whereas chest X-ray were normal. Laboratory test results revealed pancytopenia with hemoglobin of 8.2 g/dL, leucocyte count 2000 cells/mm3, platelet 78000 cells/mm3, hematocrit 25.8%, AST 162 IU/L, ALT 81 IU/L, decreased albumin of 2.72 g/dL. The clinical differential diagnosis were lymphoma or tuberculosis lymphadenopathy."

"ABSTRAKLatar belakang: Osteosarkoma merupakan tumor tulang primer tersering. Untukmenegakkan diagnosis osteosarkoma, diagnosis tripel diperlukan. Fine NeedleAspiration Cytology (FNAC), salah satu tes patologi, sering digunakan untukmendiagnosis osteosarkoma. Dibandingkan dengan biopsi, FNAC invasif sedikit,lebih murah, dan lebih mudah untuk dilakukan. Namun masih banyak institusiyang menolak pendapat ini karena FNAC hanya memberikan gambaran sel.Beberapa mempercayai bahwa hal ini dapat menyebabkan kesalahan diagnosis.Tujuan dari peneltian ini adalah untuk menentukan akurasi FNAC dalammendiagnosis kasus osteosarkoma di Departemen Patologi Anatomi FKUI/RSCMMetode: Teknik yang digunakan dalam penelitian ini adalah consecutivesampling. Sampel diambil dari formulir registrasi pasien yang melakukan keduates FNAC dan histopatologi dan diduga osteosarkoma dari hasil tes klinik, FNAC,dan histopatologi. Sampel berasal dari tahun 2010 sampai Mei 2015. Ujidiagnostik akan dilakukan untuk menentukan akurasi FNAC dalam diagnosisosteosarkoma.Hasil: Terdapat 47 sampel yang dianalisis. Akurasi FNAC dalammengkonfirmasi keganasan pada pasien terduga osteosarkoma diketahui sebesar91.48% dengan sensitivitas sebesar 93.18% dan spesifisitas sebesar 66.67%.Untuk diagnosis definit osteosarkoma, akurasi diagnostik sebesar 80.85%.Kesimpulan: FNAC terbukti memiliki akurasi yang baik dalam mengkonfirmasikeganasan dan mendiagnosis osteosarkoma. FNAC bisa digunakan sebagai salahsatu prosedur diagnostik sebelum operasi dalam manajemen osteosarkoma.

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ABSTRACTBackground: Osteosarcoma accounts for the most frequent primary bone tumors.In order to make definite diagnosis, triple diagnosis approach is necessary. FineNeedle Aspiration Cytology (FNAC), which is one of pathological examination,has been widely used to diagnose osteosarcoma. Compared to biopsy, FNAC isminimally invasive, cheaper, and easier to conduct. However, many institutionsare still against this idea as FNAC only provides the view of cells. Some stillbelieves that it may lead to misdiagnosis. The aim of this study is to find out theaccuracy of FNAC in diagnosing osteosarcoma cases at Department ofAnatomical Pathology FKUI/RSCM.Method: The technique used in this research is consecutive sampling. Sampleswere obtained from registration forms of patients who undergo both FNAC andhistopathology examinations and are suspected of osteosarcoma from eitherclinical, FNAC, or histopathology examination. Samples taken are from 2010until May 2015. Diagnostic test will be conducted to determine the accuracy ofFNAC on osteosarcoma diagnosis.Results: There are 47 cases assessed. The overall accuracy of FNAC onmalignancy confirmation in suspected osteosarcoma patients is revealed to be91.48% with sensitivity of 93.18% and specificity of 66.67%. For the definitiveosteosarcoma diagnosis, the diagnostic accuracy is 80.85%.Conclusions: FNAC has proven to have good accuracy in confirming malignancyand diagnosing osteosarcoma. FNA can be applied as one of pre-operativediagnostic procedure in the management of osteosarcoma"

"ABSTRAKLatar belakang Fine Needle Aspiration Cytology FNAC adalah teknik yang cepat murah dengan komplikasi yang minimal untuk mendiagnosis tumor tulang FNAC memiliki kapasitas untuk membedakan lesi jinak dan ganas Namun masih banyak kontroversi tentang penggunaan FNAC sebagai salah satu alat diagnostik tumor tulang seperti keterbatasan FNAC di sisi teknik dan cara interpretasi Penelitian ini bertujuan untuk mengevaluasi akurasi FNAC sebagai salah satu prosedur preoperasi diagnosis tumor tulang Metode Sampel diambil dari arsip rekam medis pasien curiga tumor tulang yang diperiksa dengan FNAC dan histopatologi di Departemen Patologi Anatomi FKUI RSCM dari tahun 2011 sampai 2014 Uji diagnostik dilakukan untuk mengetahui sensitivitas spesifisitas PPV NPV dan akurasi dari FNAC Hasil Terdapat 78 pasien kasus curiga tumor tulang yang diperiksa dengan FNAC dan Histopatologi di Departemen Patologi Anatomi FKUI RSCM pada tahun 2011 ndash 2014 Empat puluh sembilan kasus dilaporkan tumor tulang ganas dengan 5 kasus diskrepansi subtipe ganas dan 20 kasus tumor tulang jinak dengan 1 kasus diskrepansi subtype jinak Selain itu terdapat 8 kasus negatif semu dan 1 kasus positif semu Secara keseluruhan hasil yang didapatkan adalah sensitivitas 86 spesifisitas 95 2 PPV 98 NPV 71 4 dan akurasi sebesar 88 5 Kesimpulan Penelitian ini menunjukkan bahwa FNAC memiliki kualitas yang baik untuk mendiagnosis tumor tulang dibuktikan dengan tingginya angka sensitivitas dan spesifisitas 86 dan 95 2 FNAC dapat memberikan diagnosis yang akurat jika diikuti dengan pengambilan spesimen yang baik data klinis dan radiologi yang lengkap

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ABSTRACTBackground Fine Needle Aspiration Cytology FNAC is a rapid inexpensive minimum invasive technique with less complication in diagnosing bone neoplasm FNAC is able to differentiate between neoplasm and non neoplasm cases However there are still many controversies regarding the usage of FNAC as a diagnostic approach of bone neoplasm such as the limitations of FNAC technique and interpretation This research aims to evaluate the accuracy of FNAC as one of diagnostic approach in preoperative or diagnosing bone neoplasm Method Samples were obtained from archives of medical records data of patients who clinically suspected of bone neoplasm and undergo FNAC Histopathology in Anatomical Pathology Department FKUI RSCM from 2011 to 2014 Following this the diagnostic test will be conducted in order to obtain the sensitivity specificity PPV NPV and accuracy of FNAC Results There are 78 patients of bone neoplasm were undergo Fine Needle Aspiration Cytology and Histopathology examination from the archives Anatomical Pathology Department in 2011 to 2014 Forty nine cases were reported as malignant bone neoplasm with 5 discrepancy type and 20 cases were benign with 1 discrepancy type Furthermore there were 8 false negative cases and 1 false positive case The sensitivity specificity positive predictive value PPV negative predictive value NPV accuracy were 86 95 2 98 71 4 and 88 5 respectively Conclusions FNAC shows a good quality as one of diagnostic approach in bone neoplasm as can be seen in a high sensitivity and specificity 86 and 95 2 in this study FNAC of bone neoplasm might give a highly accurate diagnosis if accompanied by a high quality of technique sampling adequate specimen clinical and radiologic assistance "

"ABSTRAKLatar belakang : Fine Needle Aspiration Cytology FNAC adalah teknik yang cepat, murah, dengan komplikasi yang minimal untuk mendiagnosis tumor tulang. FNAC memiliki kapasitas untuk membedakan lesi jinak dan ganas. Namun FNAC memiliki keterbatasan di sisi teknik dan cara interpretasi.Tujuan : mengevaluasi akurasi FNAC sebagai salah satu prosedur preoperasi diagnosis tumor tulang. Metode : Sampel diambil dari arsip rekam medis pasien curiga tumor tulang yang diperiksa dengan FNAC dan histopatologi di Departemen Patologi Anatomi FKUI/RSCM dari tahun 2011 sampai 2014. Uji diagnostik dilakukan untuk mengetahui sensitivitas, spesifisitas, PPV, NPV, dan akurasi dari FNAC. Hasil : Terdapat 78 pasien kasus curiga tumor tulang yang diperiksa dengan FNAC dan Histopatologi di Departemen Patologi Anatomi FKUI/RSCM pada tahun 2011 ndash; 2014. Empat puluh sembilan kasus dilaporkan tumor tulang ganas dengan 5 kasus diskrepansi subtipe ganas dan 20 kasus tumor tulang jinak dengan 1 kasus diskrepansi subtype jinak. Selain itu, terdapat 8 kasus negatif semu dan 1 kasus positif semu. Secara keseluruhan, hasil yang didapatkan adalah sensitivitas 86 , spesifisitas 95.2 , PPV 98 , NPV 71.4 , dan akurasi sebesar 88.5 .Kesimpulan : Penelitian ini menunjukkan bahwa FNAC memiliki kualitas yang baik untuk mendiagnosis tumor tulang, dibuktikan dengan tingginya angka sensitivitas dan spesifisitas 86 dan 95.2 .

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ABSTRACTBackground Fine Needle Aspiration Cytology FNAC is a rapid, inexpensive, minimum invasive technique with less complication in diagnosing bone neoplasm. FNAC is able to differentiate between neoplasm and non neoplasm cases. However, there are limitations of FNAC technique and interpretation.Aim to evaluate the accuracy of FNAC as one of diagnostic approach in preoperative or diagnosing bone neoplasm.Method Samples were obtained from archives of medical records data of patients who clinically suspected of bone neoplasm and undergo FNAC Histopathology in Anatomical Pathology Department FKUI RSCM from 2011 to 2014. The diagnostic test will be conducted in order to obtain the sensitivity, specificity, PPV, NPV, and accuracy of FNAC.Results There are 78 patients of bone neoplasm were undergo Fine Needle Aspiration Cytology and Histopathology examination from the archives Anatomical Pathology Department in 2011 to 2014. Forty nine cases were reported as malignant bone neoplasm with 5 discrepancy type and 20 cases were benign with 1 discrepancy type. Furthermore, there were 8 false negative cases, and 1 false positive case. The sensitivity, specificity, positive predictive value PPV , negative predictive value NPV , accuracy were 86 . 95.2 . 98 , 71.4 , and 88.5 respectively.Conclusions FNAC shows a good quality as one of diagnostic approach in bone neoplasm as can be seen in a high sensitivity and specificity 86 and 95.2 in this study. "

"Background: In many developing countries, like Indonesia, most patients with oral mass lesion, i.e. infection, inflammation, even cancer came to the hospital at late stage of the diseases. Some of them afraid of endure suffering a killer disease, either after a biopsy or even should undergo an operation. Fine needle aspiration (FNA) biopsy is a technique rarely used to diagnose oral and oropharyngeal lesion. This technique seems promise a convenience, painless, accurate, safe, and easy to use to help patients and surgeons, and have been demonstrated repeatedly. Objectives: This case report emphasized many advantages of FNA biopsy to examine oral mass lesions and its metastasis to lymph node. Materials and methods: Under a local anesthesia, incisional biopsy and FNA biopsy were done on four cases of oral mass lesions. All samples were prepared for microscopic examination with Hematoxylin-Eosin (HE) staning and with Diff-Quick or Papaniculaou staining. Results: Incisional biopsy showed features of malignancy asthe same as FNA biopsy. There were bigger cells with high ratio between cells and nucleus, hyperchromatic nucleoli, and mitotic cells that refers to Squamous cell carcinoma. FNA biopsy from the nearest lymph node showed clumps atypia cells, prominent nucleoli, nuclear hyperchromatic and pleomorphism. Conclusion: FNA biopsy could well diagnose on oral mass lesions and the adjacent lymph node. FNA biopsy has many advantages particularly its convenience, painless, ease to use, cost effectiveness, and accuracy."

"Latar belakang: Sitologi aspirasi jarum halus merupakan metode yang efektif dan aman dalam menilai lesi kelenjar liur. Gambaran morfologi yang bervariasi serta sitomorfologik yang saling tumpang tindih, mengakibatkan sulitnya dalam mendiagnosis lesi kelenjar liur. Penelitian ini bertujuan untuk mengetahui akurasi diagnostik dan menganalisa gambaran sitomorfologik aspirasi lesi kelenjar liur.Metode: Dilakukan penelusuran sediaan sitologik lesi kelenjar liur tahun 2005-2009 pada arsip Departemen Patologi Anatomik FKUI/RSCM. Didapatkan 107 kasus sitologi lesi kelenjar liur, dan dilakukan pemeriksaan ulang. Terdapat 7 kasus dieksklusi karena sediaan tidak layak baca. Dilakukan pula penelusuran sediaan histopatologiknya dan dikorelasikan dengan sediaan sitologik. Uji diagnostik diaplikasikan pada 39 kasus berpasangan sitologi-histopatologik.Hasil: Kasus lesi kelenjar liur dari tahun 2005-2009 berjumlah 100 kasus, diantaranya 27 kasus negatif, delapan kasus inkonklusif dan 65 kasus lesi neoplastik. Pada 39 kasus berpasangan, empat belas kasus diantaranya memiliki diagnosis berbeda, dengan 3 kasus negatif palsu, satu kasus positif palsu. Secara keseluruhan dalam membedakan lesi malignant atau non-malignant didapatkan sensitivitas 82,35%, spesifisitas 95,45%, NPV 87,5% dan PPV 93,34%.Kesimpulan: Penelitian ini menunjukkan bahwa akurasi diagnostik sitologi lesi kelenjar liur sangat bervariasi, dengan sensitivitas 82,35% dan spesifisitas 95,45% dalam membedakan lesi malignant atau non-malignant; sekalipun tidak dapat menegakkan diagnosis definitif, namun tetap dapat membantu klinisi dalam tata laksana kasus.

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AbstractBackground: Fine-needle aspiration (FNA) is an effective and safe procedure for analyzing salivary gland lesions. Various morphological and overlapping cytomorphology features can bring difficulty in diagnosis of the salivary gland lesions. This study aimed to evaluate the diagnostic accuracy of fine needle aspiration cytology of salivary glands lesions.Methods: There were 107 cases of cytology and 39 cases of histopathology of salivary gland lesions collected and reviewed from the archives of Anatomical Pathology Department, Faculty of Medicine, Universitas Indonesia / Cipto Mangunkusumo Hospital from 2005-2009. Seven cases of cytology were excluded, due to unsatisfactory specimens. Diagnostic test was applied to analyze the 39 pairs of cytology-histopathology cases.Results: There were 100 cases of salivary gland lesions cytology obtained, consisted of 27 negatives, eight cases inconclusive and 65 cases of neoplastic lesions. Of the 39 pair cases, fourteen cases showed result discrepancies between cytology and histopathology, with 3 false-negative cases and 1 false-positive case. The sensitivity and specificity of cytology analysis in differentiating malignant from non-malignant lesions were 82.35%, and 95.45% respectively, NPV 87.5% and PPV 93.34%.Conclusion: This study showed diagnostic accuracy of FNA cytology salivary gland lesions was varied, with 82.35% sensitivity and 95.45% specificity in differentiating malignant from non-malignant hence this information can still be used for case management."

"Latar belakang: Keganasan pankreas merupakan salah satu penyebab morbiditas dan mortalitas signifikan di dunia dengan 90% kasus adalah adenokarsinoma yang umumnya terdiagnosis stadium lanjut karena tidak memiliki gejala klinis spesifik dan keterbatasan dalam menegakkan diagnosis. Adenokarsinoma pankreas disebabkan oleh perubahan histologik dari neoplasma intraepitelial pankreas (PanIN) dan mutasi genetik antara lain aktivasi onkogen KRAS serta inaktivasi gen supresor tumor seperti CDKN2A/p16, p53, BRCA2 dan Small Mothers Against Decapentaplegic 4 (SMAD4) atau disebut juga Deleted in Pancreatic Cancer, locus 4 (DPC4). Mutasi DPC4 ditemukan pada 55% kasus dan relatif spesifik pada adenokarsinoma pankreas. Penelitian ini dilakukan untuk menilai ekspresi DPC4 pada adenokarsinoma pankreas dengan sampel fine-needle aspiration biopsy (FNAB) dengan tujuan meningkatkan akurasi diagnosis.Bahan dan cara: Penelitian ini menggunakan desain potong lintang. Sampel diambil dari data arsip Departemen Patologi Anatomik FKUI/RSCM terdiri atas kelompok data berpasangan dengan 9 kasus adenokarsinoma dan 5 kasus nonadenokarsinoma dari Januari 2012-Agustus 2018 serta kelompok data tidak berpasangan dengan 10 kasus adenokarsinoma dari Januari 2017-Agustus 2018. Dilakukan pulasan DPC4 pada sampel sitologi dan histopatologik. Penilaian mengunakan persentase cut off positif >50% sel tumor.Hasil: Ekspresi DPC4 negatif didapatkan pada 5 kasus adenokarsinoma dan 0 kasus nonadenokarsinoma data berpasangan, serta 5 kasus adenokarsinoma data tidak berpasangan. Uji Fisher s exact yang dilakukan mendapatkan hasil ekspresi DPC4 pada adenokarsinoma dan nonadenokarsinoma data berpasangan tidak berbeda bermakna dengan nilai p>0.05.Kesimpulan: Tidak didapatkan perbedaan yang bermakna antara ekspresi DPC4 pada adenokarsinoma dan nonadenokarsinoma.

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Background: Pancreatic malignancy is one of the causes of significant morbidity and mortality in the world with 90% of cases were adenocarcinomas which are generally diagnosed in advanced stages because there is no specific clinical symptom and limitation in making a diagnosis. Pancreatic adenocarcinoma is caused by histological changes of intraepithelial pancreatic neoplasms (PanIN) and genetic mutations including activation of KRAS oncogenes and inactivation of tumor suppressor genes such as CDKN2A/p16, p53, BRCA2 and Small Mothers Against Decapentaplegic 4 (SMAD4) or also called Deleted in Pancreatic Cancer, locus 4 (DPC4). DPC4 mutations is found in 55% of cases and relatively specific in pancreatic adenocarcinoma. This study was conducted to assess the expression of DPC4 in pancreatic adenocarcinoma using a fine-needle aspiration biopsy (FNAB) sample to increase diagnosis accuracy.

Materials and methods: This was a cross-sectional study. Samples were taken from archival data of the Anatomical Pathology Department of FKUI/RSCM consisting of paired data group with 9 cases of adenocarcinoma and 5 cases of nonadenocarcinoma from January 2012 to August 2018 and unpaired data group with 10 cases of adenocarcinoma from January 2017 to August 2018. All cytology and histopathologic samples were stained with DPC4 antibody and evaluated using a positive cut-off> 50% of tumor cells.

Results: Negative DPC4 expression was found in 5 cases of adenocarcinoma and 0 cases of nonadenocarcinoma in paired data group, and 5 cases of unpaired data group adenocarcinoma. The Fisher s exact showed no significant difference of DPC4 expression between adenocarcinoma and nonadenocarcinoma paired data group with p value> 0.05.

Conclusion: There was no significant difference in the expression of DPC4 between adenocarcinoma and nonadenocarcinoma."

"Keganasan tiroid dapat ditemukan sekitar 5% dari kasus dengan nodul tiroid. Untuk penatalaksanaan kasus nodul tiroid perlu membedakan kasus jinak dari yang ganas. Biopsi aspirasi jarum halus (BAJaH) dilakukan praoperasi sedangkan potong beku dilakukan pada saat operasi. Tujuan tulisan ini ialah mengevaluasi ketepatan diagnosis pemeriksaan BAJaH serta PB bersama sitologi imprint (PB+I) pada kasus-kasus nodul tiroid di Departemen Patologi Anatomik FKUI-RSCM. Penelitian ini merupakan uji diagnostik menggunakan data arsip klinikopatologik di Departemen Patologi Anatmik FKUI-RSCM selama tahun 1999-2003. Spesimen dengan kelengkapan data hasil pemeriksaan BAJaH; data hasil pemeriksaan potong beku disertai sediaan sitologi imprint, serta sediaan histologik terfiksasi formalin dari bahan biopsi / operasi tiroid yang sama, digunakan dalam penelitian ini. Sensitivitas, spesifisitas dan akurasi PB+I lebih tinggi daripada BAJaH (berturut-turut 86,8% vs 73,7% ; 99,0% vs 83,9% ; 94,8% vs 80,5%). Bila hasil BAJaH konkordan dengan hasil PB+I, akurasi gabungan ke dua pemeriksaan tersebut menjadi 95,1%. Evaluasi potong beku bersama sitologi imprint masih sangat bermanfaat, karena pemeriksaan ini secara bermakna menunjukkan akurasi yang tinggi dalam mendiagnosis keganasan tiroid. (Med J Indones 2007; 16:89-93).

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Thyroid malignancy can be found on 5% of thyroid nodules. In order to better managed of thyroid nodules, skills to differentiate benign from malignant cases were needed. Fine needle aspiration biopsy (FNAB) was done preoperatively while frozen section (FS) and imprint cytology (IC) should be done intra-operatively. The objective of this research paper is to evaluate the diagnostic accuracy of FNAB versus frozen section combined with imprint cytology (FS+IC) in thyroid nodules at the Anatomic-Pathology Department FMUI-CM Hospital, Jakarta. This diagnostic test, used data from clinico-pathological records in Anatomic Pathology Department, Faculty of Medicine University of Indonesia / Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia during 1999-2003. Specimens with complete data of FNAB results, data of FS and slides of IC. All formalin fixed`specimens were reevaluated and used as the golden standard. Sensitivity, spesificity and accuracy of FS+IC were higher than FNAB (86.8% vs 73.7% ; 99.0% vs 83.9% ; 94.8% vs 80.5% respectively). If the results of FNAB were concordant with the result of FS+IC, the combined examination yields accuracy of 95.1%. The evaluation of frozen section combined with imprint cytology is very useful, because this examination significantly showed high accuracy in diagnosing thyroid malignancy. (Med J Indones 2007; 16:89-93) ."

"Latar Belakang: Kanker pankreas merupakan penyakit dengan kesintasan rendah dan kesulitan untuk melakukan diagnosis. Pemeriksaan Computed Tomography (CT)-Scan abdomen dan Ca 19-9 merupakan modalitas yang murah, mudah, dan terjangkau dalam diagnosis kanker pankreas. Endoscopic Ultrasound Fine Needle Aspiration (EUS-FNA) merupakan pemeriksaan baku emas untuk diagnosis kanker pankreas tetapi belum banyak tersedia di fasilitas kesehatan di IndonesiaTujuan: Penelitian ini bertujuan untuk mengetahui kemampuan diagnostik CT-Scan abdomen dan Ca 19-9 dibandingkan dengan EUS-FNA dalam diagnosis kanker pankreas.Metode: Desain studi ini adalah potong lintang dengan melihat rekam medis 62 pasien dengan kecurigaan kanker pankreas di RSCM pada tahun 2015-2019. Diambil pasien-pasien yang memiliki data Ca 19-9 dan CT-Scan abdomen yang kemudian dilakukan EUS-FNA untuk penegakan diagnosis kanker pankreas.Hasil: Sensitivitas dan spesifisitas CT-Scan abdomen masing-masing 76,27% dan 100%, sedangkan Ca 19-9 masing-masing 67,8% dan 33,33%. Nilai duga positif (NDP), nilai duga negatif (NDN), rasio kemungkinan positif (RKP), rasio kemungkinan negatif (RKN), dan akurasi CT-Scan abdomen masing-masing adalah 100%, 17.65%, tidak dapat dinilai, 0,24 , dan 77,42%. Nilai duga positif, NDN, RKP, RKN, dan akurasi untuk Ca 19-9 masing-masing adalah 95.24%, 5%, 1,02, 0,97, dan 66,13%.Kesimpulan: Kombinasi pemeriksaan CT-Scan Abdomen dan Ca 19-9 memiliki sensitivitas yang tinggi untuk kanker pankreas. Computed Tomography abdomen dapat digunakan untuk diagnosis kanker pankreas dengan sensitivitas dan spesifisitas yang baik.

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Introduction: Pancreatic cancer is a disease with low survival rate and difficult to diagnose. Abdominal computed tomography (CT) and Ca 19-9 are diagnostic modalities which are easy, simple, and non-invasive in diagnosis of pancreatic cancer. Endoscopic Ultrasound Fine Needle Aspiration (EUS-FNA) is the gold standard for diagnosis of pancreatic cancer but it is not available in many health care facilities in Indonesia.Purpose: This study aims to know the diagnostic accuracy of abdominal CT and Ca 19-9 compared to EUS-FNA for diagnosis of pancreatic cancer.Methods: The design of this study is cross-sectional by searching medical record of 62 patients with clinical suspicion of pancreatic cancer in Cipto Mangunkusumo hospital from year 2015-2019. Patients who undergo EUS-FNA with clinical suspicion of pancreatic cancer and have abdominal CT and Ca 19-9 data is included.Results: The sensitivity and specificity of abdominal CT are 76.27% and 100%, respectively, and Ca 19-9 are 67.8% and 33.33%, respectively. Positive predictive value, NPV, positive likelihood ratio, negative likelihood ratio, and accuracy of abdominal CT are 100%, 17.65%, unmeasurable, 0.24 , and 77.42%, respectively. Positive predictive value, NPV, positive likelihood ratio, negative likelihood ratio, and accuracy of Ca 19-9 are 95.24%, 5%, 1.02, 0.97, and 66.13%, respectively.Conclusion: The combined sensitivity of abdominal CT and Ca 19-9 has high sensitivity to diagnose pancreatic cancer. Abdominal CT can be used to diagnose pancreatic cancer with good sensitivity and specificity."

"ABSTRAKLatar Belakang: Kanker tiroid merupakan keganasan endokrin yang paling sering ditemukan dan insidennya semakin meningkat. Meskipun metode biopsi aspirasi jarum halus memiliki sensitivitas yang baik dalam mendiagnosis nodul tiroid, sebanyak 10-40 masih memberikan hasil inkonklusif dalam penentuan keganasan. Hal ini sering merugikan pasien karena harus mengalami re-operasi apabila terdapat keganasan pada hasil histopatologi.Tujuan Penelitian: Mengetahui proporsi dan mendapatkan nilai diagnostik dari pemeriksaan mutasi BRAF, NRAS, dan promoter TERT pada spesimen BAJAH untuk meningkatkan akurasi diagnosis kanker tiroid.Metode Penelitian: Studi retrospektif dengan mengikutsertakan 50 pasien nodul tiroid yang memerlukan pembedahan. Spesimen diambil pada saat proses BAJAH atau pasca operasi. Deteksi mutasi BRAF, NRAS, dan promoter TERT menggunakan metode DNA sekuensing Sanger . Hasil mutasi akan dibandingkan dengan pemeriksaan baku emas histopatologi.Hasil: Dari 50 kasus yang ikut dalam analisis, terdapat 39 kasus 78 merupakan keganasan tiroid. Nilai proporsi mutasi BRAF, NRAS, dan pTERT berturut-turut sebesar 31 , 18 , dan 13 . Uji diagnostik mutasi BRAF menghasilkan sensitivitas, spesifisitas, nilai duga positif, dan nilai duga negatif berturut-turut 31 , 100 , 100 , 29 terhadap kanker tiroid. Untuk mutasi NRAS sebesar 18 , 100 . 100 , 26 . Sedangkan untuk mutasi pTERT sebesar 13 , 100 , 100 , 24 . Jika ketiga mutasi tersebut dikombinasikan, maka nilainya akan meningkat menjadi 49 , 100 , 100 , 35 . Kesimpulan: Pemeriksaan mutasi BRAF, NRAS dan promoter TERT pada kanker tiroid masing-masing memiliki spesifisitas yang tinggi. Jika ketiganya dikombinasikan maka akan meningkatkan sensitivitas untuk membantu dalam meningkatkan akurasi diagnosis keganasan tiroid.

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ABSTRACTBackground Thyroid cancer is the most common endocrine malignancy and it rsquo s incidence is on the rise. Although the fine needle aspiration biopsy FNAB has a good sensitivity in the diagnosis of thyroid nodules, as much as 10 40 still gives inconclusive results in malignant determination. This is often detrimental to patients having to undergo re surgery if there is a malignancy in the histopathologic outcome.Aim To establish the proportion and diagnostic value of BRAF, NRAS, and TERT promoter mutation detection on FNAB specimens to improve the accuracy of thyroid cancer diagnosis.Methods The retrospective study by involving 50 patients with thyroid nodules surgery. Specimens were taken during the FNAB or postoperative process. Detection of BRAF, NRAS, and TERT promoter mutation using DNA sequencing method Sanger . The mutation results will be compared with the histopathologic gold standard examination.Resuts Of the 50 cases involved in the analysis, there were 39 cases 78 of thyroid malignancies. The proportion of BRAF, NRAS, and pTERT mutations was 31 , 18 , and 13 , respectively. BRAF mutation diagnostic test results in sensitivity, specificity, positive predictive value, and negative predictive value were 31 , 100 , 100 , 29 respectively. For NRAS mutation were 18 , 100 . 100 , 26 . As for pTERT mutation were 13 , 100 , 100 , 24 . If the three mutations are combined, then the value will increase to 45 , 100 , 100 , 35 .Conclusion Detection mutations of BRAF, NRAS and TERT promoters in thyroid cancer have a high specificity. If all three are combined it will increase the sensitivity to improve the accuracy of the diagnosis in thyroid malignancy."