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"ABSTRACTAlthough basal cell carcinoma (BCC) is a common skin tumor, very rare cases of BCC arising from upper vermilion mucosa of lip have been reported previously. This tumor basically, originates from pillar structures and the involvement of the vermilion lip contrasts this concept so it is devoid of hair follicles and sweat glands. The exact pathogenesis of vermilion lip BCC is not clear but it has been postulated that the neoplasm originates from the pluripotential epithelial cells of the oral mucosa and epidermis. On the other hand, some authors consider their origin from ectopic sebaceous glands. Herein, we report a 34- year-old man with an asymptomatic ulcerated lesion on the upper left lip vermilion mucosa .The diagnosis of BCC was confirmed with histopathological examination after incisional biopsy of the mucosal neoplasm. After surgery of lip lesion, no recurrency was seen after 3 months follow-up the patient."

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Pendahuluan: Karsinoma rongga mulut adalah keganasan tersering ke-6 di Asia. Mayoritas pasien karsinoma sel skuamosa rongga mulut (KSSRM) di RSCM datang dalam kondisi lanjut. Namun belum ada studi yang meneliti mengenai kesintasan penyakit ini di Indonesia. Penelitian ini bertujuan untuk menilai kesintasan KSSRM di RSCM berdasarkan stadium klinis AJCC ke-8.

Metode: dilakukan studi analisis kesintasan secara retrospektif dengan menggunakan data pasien KSSRM yang didiagnosis di Divisi Bedah Onkologi RSCM pada tahun 2014-2018. Luaran pasien didapatkan dari rekam medis dan menghubungi pasien via telepon. Data dianalisis menggunakan metode Kaplan-Meier.

Hasil: Mayoritas pasien adalah laki-laki (perbandingan laki-laki:perempuan adalah 1,03:1) dengan rerata usia  51,12±13,821 tahun. Tumor ditemukan paling banyak di daerah lidah (72,8%) dan kebanyakan pasien didiagnosis pertama kali pada stadium IV (83,4%). Kesintasan keseluruhan satu dan dua tahun adalah 58,6% dan 43,1%, dengan kesintasan spesifik-penyakit adalah 66,9%. Kesintasan satu dan dua tahun terendah adalah pada kelompok stadium IV (53,5% dan 36,1% secara berurutan). Namun tidak terdapat hubungan yang bermakna secara statistik antara kesintasan dan stadium klinis pada studi ini.

Simpulan:  Kesintasan KSSRM yang rendah di RSCM menunjukan tingginya patient delay. Penapisan dan edukasi mengenai penyakit ini dibutuhkan untuk meningkatkan angka kesintasan.

 

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Introduction: Oral cancer carcinoma is the 6^th most frequent malignancy in Asia. In Cipto Mangunkusumo Hospital, most patient comes in late stage. Yet, there is no survival study available for this disease in our country.

Objectives: This study aims on revealing the survival rate oral squamous cell carcinoma (OSCC) patients in Cipto Mangunkusumo based on the 8^th AJCC staging.

Methods: We performed a retrospective survival analysis study from a database of OSCC patients diagnosed at Cipto Mangunkusumo Hospital in 2014-2018. Follow-up details were updated from medical record and by phone calls. Data was analysed using the Kaplan-Meier method.

Results: Majority of the patients were male (male-to-female ratio was 1.03:1) with the mean age was 51,12±13,821 years old. Tumors occurred mostly in the tongue (72,8%), and most patients were initially diagnosed as stage IV (83,4%). The one and two year overall survival rate were 58,6% and 43,1%, with a disease-specific survival rate was 66,9%. The worst one and two year survival rate was found constantly in the stage IV group (53,5% and 36,1%, consecutively). Though there was no statistically significant association between overall survival and clinical staging in this study (p>0,05).

Conclusion: The low OSCC survival rate in Cipto Mangunkusumo Hospital indicated a high level of patient delay. Screening and education regarding this disease are needed to increase the survival rate.

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"Latar Belakang: Karsinoma sel skuamosa rongga mulut (KSSRM) menempati urutan keenam dari keganasan yang paling sering terjadi di Asia. Kebanyakan pasien datang berobat dalam kondisi stadium lanjut sehingga KSSRM memiliki mortalitas yang tinggi. Angka kesintasan KSSRM satu tahun dan dua tahun di RSCM adalah 58,6% dan 43,1%; angka kesintasan spesifik penyakit adalah 66,9%. Studi ini bertujuan untuk mencari faktor-faktor yang memengaruhi kesintasan KSSRM.Metode: Studi ini merupakan kohort retrospektif berdasarkan data rekam medis pasien. Variabel yang diteliti adalah usia, jenis kelamin, lokasi tumor, stadium klinis, derajat diferensiasi sel tumor, derajat invasi tumor, dan batas sayatan. Analisis kesintasan menggunakan Kaplan-Meier dan uji log-rank. Analisis bivariat dan multivariat menggunakan regresi Cox untuk mendapatkan hazard ratio (HR).Hasil: Ada 169 subjek yang menderita KSSRM dan diterapi di RSCM tahun 2014 – 2018. Mayoritas pasien merupakan laki-laki (51,5%) dengan usia di atas 50 tahun (55,6%). Lokasi tumor paling banyak dijumpai di lidah (72,8%) diikuti mukosa bukal (13%). 82,2% pasien datang pada stadium IV, 60,4% memiliki diferensiasi baik, dan 53,8% memiliki grade rendah. Berdasarkan analisis bivariat, didapatkan bahwa ukuran dan ekstensi tumor (T), keterlibatan kelenjar getah bening regional (N), stadium klinis, dan batas sayatan memengaruhi kesintasan KSSRM (p <0,05). Keterlibatan KGB (HR: 1,212; 95% CI: 0,997-1,474; p <0,05) dan stadium klinis (HR: 1,749; 95% CI: 1,261-2,425; p <0,05) memengaruhi mortalitas secara signifikan.Kesimpulan: Faktor-faktor yang memengaruhi kesintasan KSSRM adalah stadium klinis dan keterlibatan kelenjar getah bening regional (N).

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Background: Oral squamous cell carcinoma (OSCC) is the sixth most common malignancy in Asia. Most patients were diagnosed in advanced stage; thus, the mortality rate is high. The one-year and two-year overall survival rate in Cipto Mangunkusumo Hospital are 58.6% and 43.1%, the disease-specific survival rate is 66.9%. This study is aimed to investigate the prognostic factors correlated with OSCC.

Methods: A retrospective cohort study was done on OSCC patients diagnosed and treated in Cipto Mangunkusumo Hospital from 2014 to 2018. Data regarding age, gender, site of the primary lesion, clinical stage of the disease, tumor differentiation, invasion, and surgical margins were collected. Prognostic variables were identified with bivariate analysis using Kaplan-Meier curves and log-rank testing for comparison.

Results: One hundred and sixty nine patients were included. Majority of patients were male (51.5%), age above 50 years old (55.6%). The most prevalent tumor site was the tongue (72.8%) followed by buccal mucosa (13%). 82.2% of patients had advanced (clinical stage IV) disease at diagnosis. Majority of patients had well-differentiated tumor (60.4%) and low-grade tumor (53.8%). Bivariate analysis showed that tumor size (T), nodal status (N), clinical stage, and marginal status significantly affected the overall survival (p <0.05). Nodal status (HR: 1.212; 95% CI: 0.997-1.474; p <0.05) and clinical stage (HR: 1.749; 95% CI: 1.261-2.425; p < 0.05) were independently associated with the risk of death.

Conclusion: Clinical stage and lymph node involvement are the most significant prognostic factors of OSCC."

"Tujuan Pemeriksaan: Membuktikan bahwa KSB tipe agresif menunjukkan ekspresi Ki-67 lebih tinggi dibandingkan dengan yang non-agresifi. Material dan Metode: Pada penelitian ini didapatkan sampel sebanyak 46 blok parafin jaringan KSB tipe agresif dan non-agresif di Insta1asi Patologi Anatomi RS Kanker ?Dharmais? yang memenuhi kritcria inklusi mulai tahun 1995 - 2008 serta dapat dilacak rekam mcdiknya untuk dapat diperiksakan ekspresi Ki-67 secara imunohistokimiau Analisa data karakteristik pasien dari sampel tersebut dilakukan secara bivariat berdasarkan kelompok umur, jenis kelamin, jenis histopatologi. Hasil: Rerata umur 61.30 i 11,97 tahun dengan median 61.50 tahun, pasien termuda berumur 24 tahun dan tertua 84 tahun. Berdasarkan kelompok umur didapatkan hasil sebanyak 16 pasien ( 34,8%) berumur kurang dari 60 tahun dan 30 pasien ( 65,2%) bcmmur lebih atau sama dengan 60 tahun. Pembagian berdasarkan jenis kelamin dari 46 pasiqn, laki-laki berjumlah 14 (30,4%) dan perempuan 32 (69,6%)Ekspresi Ki-67 positif pada KSB sebanyak 29 (63%) dari 46 pasien dan ekspresi negatif 17 (37%) dari 46 pasien, dengan pcmbagian pada tipe agresif terdapat 23 (50%) dari 46 pasien dan tipe non agresif 12 (26%) dari 46. Ekspresi Ki-67 negatif pada tipe agresif scbanyak 6 (13%) dari 46 pasien dan 5 (11%) dari 46 pasien tipe non-agresif. KSB tipe agresif menunjukkan ekspresi Ki-67 Iebih tinggi 79,31% dibandingkan dengan KSB tipe non agresif 70,59%. Kesimpulan: KSB tipe agresif menunjukkan ekspresi Ki-67 lebih tinggi 79,31% dibandingkan dengan KSB tipe non agresif 70,59%. Hasil uji statistik diperoleh p value 0.097. Ada perbedaan proporsi kejadian KSB antara yang negatif dengan posititf Dari hasil analisis diperoleh OR l.597, artinya KSB agrcsif mempunyai peluang 1.597 kali dibanding dengan KSB non agresif.

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Purposed: To prove that aggressive type basal cel carcinoma shows Ki-67 expression higher than non aggressive type.

Method: In this study obtained samples of 46 paraffin blocks of Dharmais Cancer Center that the criteria of inclusion from the year 1995-2008 to be assessed Ki-67 expression in histochemistry. Patient characteristics of the data analysis was performed by bivariate sample based on age groups, types of sex, type of histopathology.

Result: Rcrata age ot`61 .30 += 11.97 years with a median of 61.50 years, Patient 24 years old the youngest and the oldest 84 years. Based on the results obtained ages of 16 Patient (34.8%) aged less than 60 years and 30 Patient (65.2%) aged more than or equal to 60 years. Distribution based on the type of sex from 46 Patient, 14 men (30.4%) and 32 women (69.6%). The results of expression of Ki-67 negative on aggressive type of 6 (13%) of 46 patients and 5 (11%) of 46 patients with non-aggressive type. Aggressive type of BCC, Ki-67 expression is higher by 79.31% compared to non-aggressive type of BCC 70.59%.

Conclusion: Aggressive type of BCC, Ki-67 expression is higher by 79.31% compared to non-aggressive type of BCC 70.59%. Results obtained by statistical test p value of 0097. There is a difference between the proportion of negative events with BCC positive. The results of analysis OR 1597, that means aggressive BCC has chance BCC 1.597 times compared with non-aggressive."

"Angka kematian kanker serviks masih tinggi karena banyak pasien datang berobat pada tahap lanjut. Respons terapi radiasi pada pasien kanker serviks stadium lanjut bervariasi walau dengan faktor klinikopatologi yang sama seperti stadium, massa tumor, jenis histopatologi, derajat diferensiasi, invasi limfovaskular, reaksi limfosit dan nekrosis. Oleh karena itu dipikirkan faktor prognosis lain seperti faktor apoptosis-survivin, telomerase dan sitokrom c. Penelitian ini bertujuan untuk mengetahui peran survivin, telomerase, dan sitokrom c sebagai prediktor respons terapi radiasi pada kanker serviks stadium lanjut khususnya stadium IIIB.Studi ini bersifat prospektif menggunakan metode nested case control. Pengambilan data dilakukan di Poliklinik Onkologi Departemen Obstetri dan Ginekologi RSCM serta Departemen Patologi Anatomi FKUI pada bulan Januari 2016 hingga Mei 2017. Pada subjek penelitian dilakukan wawancara, pemeriksaan histopatologi dan pemeriksaan biokimia secara ELISA untuk mengetahui kadar survivin, telomerase, sitokrom c, dan MRI pra-radiasi serta pasca-radiasi. Dari 90 subjek penelitian didapatkan rerata usia pasien 50 tahun, rerata massa tumor 6,7 cm dan sebagian besar berkeratin 84,4 , berdiferensiasi baik 81,1 , reaksi limfosit negatif 75,6 dan nekrosis 74,4 . Rerata faktor apoptosis-survivin, telomerase dan sitokrom c adalah 591,2 pg/mL, 5.223,2 pg/mL dan 191,3 ng/mL. Dari analisis bivariat didapatkan variabel yang berhubungan dengan respons terapi secara independen adalah massa tumor p = 0,1 , diferensiasi p = 0,17 , kadar survivin p = 0,01 , kadar telomerase p = 0,08 dan kadar sitokrom c p = 0,47. Hasil analisis multivariat didapatkan hubungan kadar survivin dan kadar telomerase dengan respons terapi radiasi p = 0,01 dan p = 0,07 . Tidak terdapat hubungan kadar sitokrom c dengan respons terapi radiasi p = 0,64 . Dengan model cox regresi survival didapatkan hazard ratio subjek dengan kadar survivin tinggi dan kadar telomerase tinggi terhadap respons terapi radiasi negatif adalah 4,20 dan 1,97.Simpulan: kadar survivin dan telomerase tinggi berhubungan dengan respons terapi radiasi negatif.

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Cervical cancer mortality rate is still high mostly due to patients seeking for help in advanced stage of the disease. Even with the same clinicopathologic features such as stage of the diseases, size of the tumor, histopathological types, level of differentiation, lymphocyte reaction and tumor necrosis, the radiotherapy outcomes still vary from patient to patient. Therefore, we thought another predictive factors like apoptosis inducing factors i.e. survivin, telomerase and cytochrome c as a new predictor of therapeutic resp onses on patients with stage IIIB squamous cell carcinoma of cervix.

This is a prospective study with nested case control method. Data collection was conducted in Oncology Polyclinic, Department of Obstetrics and Gynecology RSCM and Department of Pathological Anatomy of FKUI from January 2016 to May 2017. Subjects were interviewed, conducted histopathological and biochemical examination with ELISA to determine levels of survivin, telomerase, cytochrome c, and patients undergo pre and post radiation MR imaging.

There were 90 patients in this study with the mean of ages was 50 years, mean of tumor size was 6.7 cm and most subjects were keratinizing 84.4 , well differentiated 81.1 , negative lymphocyte reaction 75.6 and tumor necrosis 74.4 . The mean levels of apoptosis inducing factors survivin, telomerase and cytochrome c were 591.2 pg mL, 5,223.2 pg mL, and 191.3 ng mL.

Bivariate analysis showed the independent association between tumor size, level of differentiation, levels of survivin and telomerase p 0.1, p 0.17, p 0.01, p 0.08 . Multivariate analysis showed the correlation between levels of survivin and telomerase with radiation therapeutic response p 0.01 and p 0.07 and there was no association with level of cytochrome c p 0.64 With the survival cox regression models, the hazard ratio of subjects with high levels of survivin and telomerase on the negative radiation therapy responses were 4.20 and 1.97.Conclusion there were association between high levels of survivin and telomerase on the negative radiation therapy response. "

"Latar Belakang. Pentingnya peranan protektif keratinized mucosa (KM) yang adekuat (>2mm) di sekitar implan sebagai soft tissue seal dalam menjaga barrier terhadap penetrasi bakteri yang dapat menyebabkan penyakit peri-implant masih menjadi perdebatan karena adanya inkonsistensi hasil. Tujuan. Untuk mengetahui hubungan lebar mukosa berkeratin di sekitar implan dengan brushing discomfort (BD) dan kesehatan jaringan peri-implan secara klinis dan radiografis. Metode. Penelitian cross-sectional ini mengevaluasi 17 pasien dengan 31 implan di klinik spesialis periodonsia RSKGM FKG UI. Sampel di bagi menjadi kelompok KM adekuat dan inadekuat. Pasien di periksa secara klinis dengan skor mPI, DI dan GI pada bagian bukal permukaan implan, radiografis periapkcal untuk mendapatkan data marginal bone level (MBL). BD di nilai menggunakan visual analogue scale (VAS). Hasil. Perbandingan antar dua kelompok dengan skala numerik di uji dengan independent t-test. Terdapat perbedaan skor mPI (0,01), DI (0,03) dan GI (0,05) di antara dua kelompok. Sedangkan untuk brushing discomfort (0,88) dan MBL (0,46) tidak terdapat perbedaan yang signifikan. Kesimpulan. Inadekuat KMberkaitan dengan peningkatan akumulasi plak, debris dan inflamasi mukosa di sekitar implan.

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Background. The importance of the protective role of adequate keratinized mucosa (KM) around an implant as a soft tissue seal in maintaining a barrier against bacterial penetration that can cause peri-implant disease is still being debated due to inconsistentresults. Aim. To determine the relationship between the width of the keratinized mucosa around the implant with brushing discomfort and peri-implant tissue clinically and radiographically. Method. This cross-sectional study evaluates 17 patients (31implants) at the periodontic specialist clinic, RSKGM FKG UI. The sample group was divided into adequate and inadequate KM groups. Patients were clinically examined using score mPI, DI and GI on the buccal site of the implant, and periapical radiographs were taken to evaluate marginal bone level (MBL). Brushing discomfort was assessed using a visual analogue scale (VAS). Results. The comparison between the two groups with a numerical scale was tested using an independent t-test. There were significant differences in (0.01), DI (0.03), and GI (0.05) between the two groups. However, there was no significant difference for brushing discomfort (0.88) and MBL (0.46). Conclusion. Inadequate KM is associated with increased accumulation of plaque,debris, and mucosal inflammation around the implant."

"Dari 428 kasus yang didiagnosa di FKUI/RSCM sejak tahun 1985 hingga tahun 1993, diperoleh 38 kasus KSB yang mengalami residif. Sedangkan yang representetif dan dapat diteliti dari kasus yang residif hanya 30 kasus dengan jenis pertumbuhan sebagai berikut yaitu Nodular Infiltratif (5 kasus), Infiltratif Sklerosing (9 kasus), InfiItratif Non Sklerosing (14 kasus) dan Multilokal. (2 kasus). Dalam penelitian ini digunakan teknik pulasan Perak Kolloidal untuk melihat gambaran morfologik dan menghitung jumlah butir Nukleolar Organizer Region (NOR). Jumlah absolut NOR per inti memberikan gambaran distribusi yang berlainan pada setiap kasus. Jumlah rata-rata AgNOR oleh dua pemeriksa secara terpisah adalah NI 8.02 (SD 1.36)v IS 8.39 (SD 1.73), INS 9.36 (SD 1.78), dan MF 9.91 (SD 2.02>. Analisa statistik data dengan menggunakan test Studant, memberikan hasil tidak berbeda bermakna antara pemeriksa I dan pemeriksa II, juga jumlah rata-rata AgNOR dapat menunjukkan nilai yang bermakna untuk timbulnya residif. Nilai AgNOR pada NI berbeda bermakna dengan INS maupun MF, juga nilai AgNOR pada IS bermakna makna dengan INS maupun MF. Sedangkan antara NI dengan IS, juga antara INS dengan MF tidak terdapat perbedaan yang bermakna untuk timbulnya residif. Peneliti menyimpulkan bahwa pada penelitian kuantitatif AgNOR secara retrospektif dapat memberikan informasi yang memungkinkan digunakan petunjuk adanya asidif pada beberapa jenis pertumbuhan KSB sehingga dapat membantu dalam menentukan prognosis."

"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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"Indonesian Journal of Dentistry 2006; Edisi Khusus KPPIKG XIV:239-242Oral squamous cell carcinorna ( OSCC ) is the most common malignant tumor of the oral cavity, and its account for 80-90% of all malignancies in oral cavity. The aim of this study was to detemine the presenceof p53 mutations and to associate these mutations with the histopathological type of OSCC such as well differentiated and poorly differentiated. Analitycal observational comparative study by cross sectional design was used. Forty untreated well and poorly differentiated OSCC biopsy sample and normal tissue biopsy material taken from 16 normal patients were analyzed for the presence of mutation in the conserved region of the p53 gene especially in exon 5 by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP). The results of this study showed that p53 gene mutations were detected in exon 5; 11/40 (27,5%) with heterozygous mutation 9/11 (81,8%). The incidence in exon 5 of p53 gene mutation was significantly accociated with well differentiated 2/20 (l0%) and poorly diferentiated 9/20 (45%) OSCC(P=0,013). This study concludes that 1) mutation in exon 5 of p53 gene occured frequently in OSCC; 2) exon 5 of the p53 gene could be one of the the specific targets for histopathological grade of OSCC; 3) mutation in exon 5 of p53 gene could be important prognostic factor in OSCC."

"Indonesian Journal of Dentistry 2006; Edisi Khusus KPPIKG XIV: 7-11Mucous membrane pemphigoid (MMP) is an autoimmune mucocutaneous blistering disease characterized by autoantibodies to components within the basement membrane zone. The lesions may produce risk of scarring of the canthus (symblepharon), inversion of the eyelashes (entropion) and trauma to the cornea (trichiasis). We reported a case of MMP in a 56-year old female with diabetes mellitus and hypertension whose ocular involvement has lead to blindness of the right eye. The diagnosis MMP was base on the history and clinical findings in oral medicine department. Management of this patient inclueded the administration of antifungal, corticosteroid ; diaminodiphenylsulfone, nutritional supplementation. oral hygiene promotion and consultation to internal medicine specialist and opthalmologis. The improvement of oral lesions progressed well within five months. we conclude that optimal improvement can be reached by comprehesieve management with controlling systemic factors and good cooperation between medical team and patient. and patien"