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"Kanker kolorektal terus menyumbang jumlah kasus kanker dan kematian yang tinggi setiap tahunnya. Salah satu metode diagnosis progresi kanker ini adalah dengan interpretasi biopsi dari ahli patologi anatomi. Akan tetapi, seringkali terjadi misinterpretasi antar patolog karena lesinya yang kurang spesifik. Maka dari itu, perlunya ada alat bantu yang dapat menunjang pekerjaan ahli patologi anatomi dalam menginterpretasi progresi kanker kolorektal. Penelitian ini bertujuan untuk melihat kemampuan spektrofotometer untuk mengklasifikasikan jaringan kolorektal mencit. Data jaringan mencit yang sudah diklasifikasikan menurut ahli PA diuji menggunakan cahaya tampak dan akan dibaca oleh spektrofotometer reflektansi. Hasil dari spektrofotometer kemudian akan dibaca oleh Theremino Spectrophotometer. Semua data kemudian diuji normalitas menggunakan uji Saphiro Wilk, dilanjutkan dengan uji ANOVA atau Kruskal-Wallis, kemudian uji Post Hoc atau Mann-Whitney. Data juga dianalisis menggunakan supervised dan unsupervised machine learning. Dari uji hipotesis hanya didapatkan 2 panjang gelombang yang dapat membedakan jaringan normal dan prekanker secara signifikan (696,7 dan 699.8 nm). Sedangkan yang lainnya kurang dapat membedakan jaringan normal, radang, dan prekanker. Hasil dari machine learning menunjukkan sensitivitas, spesifisitas, AUC, akurasi, dan presisi yang rendah. Maka dari itu, dapat disimpulkan dari penelitian ini bahwa metode spektrofotometri reflektans cahaya tampak kurang cocok digunakan untuk membedakan jaringan kolon normal, radang, dan prekanker pada sediaan preparat mencit.

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Colorectal cancer continues to account for a high number of cancer cases and deaths every year. The gold standard of diagnosing this cancer progression is by interpretation of a biopsy from an anatomical pathologist. However, there is often misinterpretation among pathologists due to their unspesific lesions. Therefore, it is required to have a tool that can support the work of anatomical pathologists in interpreting the progression of colorectal cancer. This study aims to see the ability of the spectrophotometer to classify the colorectal tissue of mice. Mice tissue data that has been classified according to PA experts was tested using visible light and would be read by a reflectance spectrophotometer. The results of the spectrophotometer will then be read by the Theremino Spectrophotometer. All data were then tested for normality using the Saphiro Wilk test, followed by the ANOVA or Kruskal-Wallis test, then the Post Hoc or Mann-Whitney test. Data were also analyzed using supervised and unsupervised machine learning. From the hypothesis test, only 2 wavelengths were found that could significantly differentiate normal and precancerous tissue (696.7 and 699.8 nm). While others are less able to distinguish normal, inflammatory, and precancerous tissue. The results from machine learning show low sensitivity, specificity, AUC, accuracy, and precision to distinguish between the three categories. Therefore, it can be concluded from this research that the visible light reflectance spectrophotometric method is not suitable for distinguishing normal, inflammatory, and precancerous colonic tissue in mice preparations."

"Latar belakang: Menurut Global Cancer Statistics 2020 (GLOBOCAN), kanker kolorektal masih menduduki posisi ke-3 pada penyebab kanker tersering di dunia, dan posisi ke-2 pada penyebab kematian tersering akibat kanker (9.4%). Evaluasi histopatologi dari hasil biopsi jaringan kolorektal yang merupakan baku emas dalam diagnosis saat ini pun masih memiliki berbagai keterbatasan. Penentuan derajat keparahan dari kanker kolorektal, dilakukan secara subjektif oleh ahli patologi anatomik melalui observasi mikroskop, sehingga data yang dimiliki bersifat kualitatif. Studi menggunakan prinsip spektrofotometri sudah pernah dilakukan dalam upaya diagnostik kanker sebelumnya. Namun, hingga saat ini masih belum ada studi yang menggunakan spektrofotometer reflektansi VIS-NIR sebagai metode diagnostik kuantitatif dan objektif untuk kanker kolorektal.Tujuan: Penelitian ini adalah studi pendahuluan untuk mengetahui potensi dan kemampuan dari spektrofotometer reflektansi VIS-NIR dalam membedakan jaringan normal, prekanker, dan radang pada blok parafin jaringan kolon mencit.Metode: Penelitian ini memiliki desain eksperimental yang menggunakan sampel blok parafin jaringan kolorektal mencit Mus musculus. Sampel diklasifikasikan oleh ahli patologi anatomi menjadi tiga kategori berdasarkan derajat lesinya, yaitu normal, radang, dan prekanker. Sebanyak 30 sampel tersebut diukur intensitas cahaya reflektansinya pada 454 panjang gelombang berbeda yang termasuk dalam spektrum VIS-NIR. Hasil pengukuran dianalisis dengan perangakat lunak SPSS 26.0 untuk uji komparatif dan perangkat lunak Orange Data Mining untuk pengujian machine learning dalam pegelompokan sampel berdasarkan derajat lesinya.Hasil dan Pembahasan: Hasil uji komparatif membuktikan bahwa 429 dari 454 panjang gelombang cahaya VIS-NIR memiliki perbedaan intensitas cahaya reflektansi yang bermakna antarkelompok derajat lesi (p<0.05). Machine learning yang terbaik dalam pengelompokan sampel menurut derajat lesi berdasarkan data intensitas cahaya reflektansi adalah model SVM dengan nilai Area under the Curve (AUC) 98.3%, Classification Accuracy (CA) 86.7%, Skor F1 0.862, Precision 86.9%, Recall 86.7%, sensitivitas 70-100%, dan spesifisitas 90-95%.Kesimpulan: Spektrofotometri Reflektansi VIS-NIR dapat membedakan jaringan normal, radang dan prekanker kolorektal pada mencit Mus musculus dengan sensitivitas dan spesifisitas yang baik

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Background: According to the Global Cancer Statistics 2020 (GLOBOCAN), colorectal cancer is still the 3rd most common cause of cancer in the world and the 2nd most common cause of cancer death (9.4%). Histopathological evaluation of colorectal tissue biopsy results, which is currently still the gold standard in colorectal cancer diagnosis, has its limitations. Determining the severity of colorectal cancer is done subjectively by anatomical pathologists through microscopic observation. Results from this evaluation are qualitative data which can contribute to the high level of false positive and negatives of the diagnosis. Studies using spectrophotometric principles have been carried out in previous diagnostic efforts. However, to date, there are still no studies using the VIS-NIR reflectance spectrophotometer as a quantitative and objective diagnostic tool for colorectal cancer.

Objective: This is a pilot study to determine the potential and ability of the VIS-NIR reflectance spectrophotometer in differentiating normal, precancerous, and inflammatory parrafin-block of mouse colorectal tissues.

Method: This experimental study uses paraffin-block samples of colorectal tissue from Mus musculus mice. Samples were classified by anatomical pathologists into three categories based on the degree of lesion, namely normal, inflammatory, and precancerous. A total of 30 samples were measured by their light intensity reflectance at 454 different wavelengths included in the VIS-NIR spectrum. Results are evaluated using SPSS 26.0 for comparative testing and Orange Data Mining for machine learning to evaluate their competence in differentiating samples based on the degree of lesion.

Results and Discussion: Comparative test results proved that 429 of the 454 wavelengths in the VIS-NIR light spectrum had a significant difference in light intensity reflectance between the three degree groups of lesion (p<0.05). The best machine learning in differentiating samples according to the degree of lesions based on light reflectance intensity is the SVM model with the value of Area Under the Curve (AUC) 98.3%, Classification Accuracy (CA) 86.7%, F1 score 0.862, Precision 86.9%, Recall 86.7%, sensitivity 70-100%, and specificity 90-95%.

Conclusion: VIS-NIR Reflectance spectrophotometry can distinguish normal, inflammatory, and precancerous colorectal tissue in Mus musculus mice with good sensitivity and specificity."

"Kanker kolorektal adalah kanker yang berlokasi dibagian kolon atau rektum dengan indikasi awal adalah keberadaan polip non-kanker. Kanker kolorektal menempati urutan ketiga sebagai kanker ganas dan urutan kedua dengan tingkat mortalitas tertinggi di tingkat dunia. Peningkatan morbiditas kanker kolorektal tercatat pada orang dewasa berusia 30-40 tahun. Prevalensi dan urgensi deteksi dini kanker kolorektal diperlukan untuk mendapatkan hasil diagnosis kanker sebagai solusi pengobatan kanker. Gen MDR1 sebagai gen penghabisan obat membentuk resistensi terhadap pengobatan yang menyebabkan kegagalan dalam kemoterapi. Penelitian ini bertujuan untuk mengetahui ekspresi gen MDR1 pada kanker kolorektal. Penelitian ini menggunakan metode qPCR yang bersifat spesifik dan sensitif pada satu target. Berdasarkan hasil qPCR diperoleh di antara 10 penderita kanker kolorektal terdapat 6 penderita yang positif terdeteksi gen MDR1 dan 4 penderita tidak mengekspresikan gen MDR1. Khususnya, ekspresi mRNA tertinggi diamati pada penderita yang telah mengalami metastasis terutama menuju hepar. Secara statistik, pengujian menggunakan Shapiro-Wilk (0,049 < 0,05) menyatakan data tidak terdistribusi normal antara kelompok jaringan normal dan kanker kolorektal. Sedangkan, pada uji Mann Whitney U (0,065 > 0,05) tidak terdapat perbedaan signifikan antara jaringan normal dan jaringan kanker kolorektal. Rekomendasi selanjutnya adalah dengan menggunakan sampel lebih banyak untuk melihat pola ekspresi gen.

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Colorectal cancer is cancer located in the colon or rectum with the initial indication is the presence of non-cancerous polyps. Colorectal cancer ranks third as a malignant cancer and ranks second with the highest mortality rate in the world. The increase in colorectal cancer recorded in adults aged 30-40 years. The prevalence and urgency of early detection of colorectal cancer is obtained to get the results of a cancer diagnosis as a cancer treatment solution. The MDR1 gene as a drug efflux forms resistance to treatment causes failure in chemotherapy. This study aims to determine the expression of the MDR1 gene in colorectal cancer. This study uses the qPCR method which is specific and sensitive to one target. Based on the qPCR results, it was found that among 10 patients with colorectal cancer, there were 6 patients who were positive for the MDR1 gene and 4 patients were negative the MDR1 gene. In particular, the highest mRNA expression was observed in patients who had metastasized mainly to the liver. Statistically, the Shapiro-Wilk test (0.049 < 0.05) stated that the data were not normally distributed between the normal tissue groups and colorectal cancer. Meanwhile, the Mann Whitney U test (0.065 > 0.05) means that there is no significant difference between normal tissue and colorectal cancer tissue. The next recommendation is to use more samples to see the pattern of gene expression."

"ABSTRAK Latar Belakang :Karsinoma kolorektal (KKR) merupakan penyebab kematian kedua di dunia dari seluruh jeniskanker. KKR dapat disebabkan oleh defek dari MMR DNA. Microsatellite instability (MSI)adalah penanda defek MMR DNA. KKR MSI-H memiliki gambaran karakteristik tertentu.Tumor-infiltrating-lymphocyte (TIL) merupakan faktor prognosis. Hilangnya ekspresi PMS2 danMSH6 dapat sebagai penanda MSI. Penelitian ini bertujuan untuk menilai terjadinya MSI padaKKR di sisi kiri dan sisi kanan kolon melalui Hilangnya ekspresi PMS2 dan MSH6, sertamengetahui hubungan antara TIL dengan MSI-H.Bahan dan Metode :Dilakukan pulasan IHK PMS2 dan MSH6, serta penghitungan TIL. Penilaian dilakukan denganmenghitung hilangnya ekspresi PMS2 dan MSH6 pada inti sel dan dikelompokkan ke dalamkelompok mutasi dan tidak mutasi .Penghitungan TIL juga dikelompokkan ke dalam TIL tinggidan rendah, berdasarkan nilai titik potong Hasil : Didapatkan 27,8% kasus menunjukkan hilangnya ekspresi PMS2 dan MSH6 dengan 14,4%kasus di distal kolon. TIL terbanyak di distal kolon 30% kasus. Tidak terdapat perbedaanbermakna antara mutasi PMS2 dan MSH6 dengan lokasi (p=0,829) dan TIL (p=0,187). Terdapatperbedaan bermakna antara usia dan lokasi (p=0,020) serta peningkatan ekspresi PMS2 denganMSH6 (p=0,06).Kesimpulan :MSI-H ditemukan pada 27,8% kasus. Penggunaan PMS2 dan MSH6 pada penelitian ini belumdapat menggantikan 4 panel IHK. Terdapat kecenderungan dimana adenokarsinoma NOSmemiliki frekuensi mutasi lebih tinggi dari adenokarsinoma musinosum.ABSTRACT Background : Colorectal carcinoma (CRC) is the world second leading cause of death from all types of cancer.CRC can be caused by a defect of MMR DNA. Microsatellite instability (MSI) is a marker ofDNA MMR defect. CRC MSI-H has a certain characteristic figures. Tumor-infiltratinglymphocytes (TIL) isone of prognostic factor. Loss expression of the PMS2 and MSH6 can beuse as a marker of MSI. This study aims to assess the occurrence of MSI in CRC on the left sideand the right side of the colon through the loss of expression of PMS2 and MSH6, anddetermine the relationship between TIL with MSI-H. Materials and Methods :Immunohistochemical staining using two marker, there is PMS2 and MSH6. We also countingthe number of TIL. Assessment by calculating the loss expression of PMS2 and MSH6 in the cellnuclei and divided into two groups, the mutations and non mutations . TIL result also groupedinto high and low, based on the cutoff point. Result :There are 27.8% of cases showed loss of expression of PMS 2 and MSH6 with 14.4% of cases inthe distal colon. About 30% TIL cases located in distal colon. There were no significantdifferences between PMS2 and MSH6 mutation with the location (p = 0.829) and TIL (p =0.187). There are significant differences between age and location (p = 0.020) and increasedexpression of PMS2 with MSH6 (p = 0.06). \ Conclusion :MSI-H was found in 27.8% of cases. The use of PMS2 and MSH6 in this study have not beenable to replace 4 panels of IHC. There is a tendency where the adenocarcinoma NOS have ahigher mutation frequency than mucinous adenocarcinoma. ;Background :Colorectal carcinoma (CRC) is the world second leading cause of death from all types of cancer.CRC can be caused by a defect of MMR DNA. Microsatellite instability (MSI) is a marker ofDNA MMR defect. CRC MSI-H has a certain characteristic figures. Tumor-infiltratinglymphocytes (TIL) isone of prognostic factor. Loss expression of the PMS2 and MSH6 can beuse as a marker of MSI. This study aims to assess the occurrence of MSI in CRC on the left sideand the right side of the colon through the loss of expression of PMS2 and MSH6, anddetermine the relationship between TIL with MSI-H. Materials and Methods :Immunohistochemical staining using two marker, there is PMS2 and MSH6. We also countingthe number of TIL. Assessment by calculating the loss expression of PMS2 and MSH6 in the cellnuclei and divided into two groups, the mutations and non mutations . TIL result also groupedinto high and low, based on the cutoff point. Result :There are 27.8% of cases showed loss of expression of PMS 2 and MSH6 with 14.4% of cases inthe distal colon. About 30% TIL cases located in distal colon. There were no significantdifferences between PMS2 and MSH6 mutation with the location (p = 0.829) and TIL (p =0.187). There are significant differences between age and location (p = 0.020) and increasedexpression of PMS2 with MSH6 (p = 0.06). \ Conclusion :MSI-H was found in 27.8% of cases. The use of PMS2 and MSH6 in this study have not beenable to replace 4 panels of IHC. There is a tendency where the adenocarcinoma NOS have ahigher mutation frequency than mucinous adenocarcinoma. ;Background :Colorectal carcinoma (CRC) is the world second leading cause of death from all types of cancer.CRC can be caused by a defect of MMR DNA. Microsatellite instability (MSI) is a marker ofDNA MMR defect. CRC MSI-H has a certain characteristic figures. Tumor-infiltratinglymphocytes (TIL) isone of prognostic factor. Loss expression of the PMS2 and MSH6 can beuse as a marker of MSI. This study aims to assess the occurrence of MSI in CRC on the left sideand the right side of the colon through the loss of expression of PMS2 and MSH6, anddetermine the relationship between TIL with MSI-H. Materials and Methods :Immunohistochemical staining using two marker, there is PMS2 and MSH6. We also countingthe number of TIL. Assessment by calculating the loss expression of PMS2 and MSH6 in the cellnuclei and divided into two groups, the mutations and non mutations . TIL result also groupedinto high and low, based on the cutoff point. Result :There are 27.8% of cases showed loss of expression of PMS 2 and MSH6 with 14.4% of cases inthe distal colon. About 30% TIL cases located in distal colon. There were no significantdifferences between PMS2 and MSH6 mutation with the location (p = 0.829) and TIL (p =0.187). There are significant differences between age and location (p = 0.020) and increasedexpression of PMS2 with MSH6 (p = 0.06). \ Conclusion :MSI-H was found in 27.8% of cases. The use of PMS2 and MSH6 in this study have not beenable to replace 4 panels of IHC. There is a tendency where the adenocarcinoma NOS have ahigher mutation frequency than mucinous adenocarcinoma. "

"Kaitannya dengan ekspresi protein MLH1, MSH2, dan SMAD4, dan membandingkannya dengan pasien kanker kolorektal usia di atas 60 tahun.Metode: Data rekam medis pasien kanker kolorektal usia di bawah 40 tahun dan usia di atas 60 tahun , dikumpulkan dari 3 rumah sakit: Jakarta, Makasar, dan Bandung. Kelompok etnis dipilih dari suku bangsa Jawa, Makasar (Sulawesi Selatan, dan Minangkabau (Sumatera Barat) yang dikonfirmasi berdasarkan kuesioner. Pada spesimen tumor dilakukan pemeriksaan histopatologi, gradasi tumor, serta pemeriksaan imunohistokimia untuk penentuan ekspresi protein MLH1 dan MSH2 untuk menilai mutasi instabilitas mikrosatelit. Ekspresi protein SMAD4 diperiksa untuk memastikan bahwa jaringan tumor tidak berasal dari instabilitas mikrosatelit.Hasil: Telah dikumpulkan 121 penderita kanker kolorektal dari etnis Sunda, Jawa, Makasar, dan Minangkabau. Derajad keganasan antara pasien muda dan pasien tua berbeda secara bermakna (p = 0.001). Pewarnaan imunohistokimia untuk protein MSH2 dan MLH1 yang dilakukan pada masing-masing 92 dan 97 pasien, menunjukkan tidak terdapat perbedaan bermakna dalam hal ekspresi MLH1 dan MSH2 dan gradasi tumor, yang berarti tidak ada hubungan antara instabilitas mikrosatelit dan derajad tumor.Kesimpulan: Karakter kliniko patologi kanker kolorektal pada penduduk asli Indonesia, tidak berbeda antara pasien usia muda (< 40 tahun) dan pasien usia tua (>60 tahun) pada kelompok etnis yang sama. Juga tidak terdapat perbedaan dalam ekspresi protein MSH2 dan MLH1, yang merupakan indikator instabilitas mikrosatelit.

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Aim: To obtain clinicopathological characteristics of colorectal cancer among young native Indonesians and to assess MLH1, MSH2, and SMAD4 protein expressions, comparing them with a matched population of colorectal cancer patients aged 60 years old and older.

Methods: Medical records of colorectal cancer patients aged 40 years or younger and 60 years or older from several hospitals in three Indonesian cities ? Jakarta, Makassar, and Bandung - were reviewed. The ?native? ethnic groups were selected from those originating from Java, Makassar (South Celebes), Miinangkabau (West Sumatra). Ethnicity of 121 colorectal carcinoma patients was confirmed by fulfilling requirements in a questionnaire. Tumor specimens of those patients underwent evaluation for histopathology, tumor grading as well as immunohistochemical analysis to assess MLH1, MSH2 protein expressions to detect microsatellite instability mutation pathway and SMAD4 protein expression to reconfirm that the specimens were not microsatellite instability origin.

Results: There were 121 colorectal carcinoma cases of Sundanese, Javanese, Macassarese and Minangkabau ethnic group. This study indicated that colorectal cancer has statistically different grade (p = 0.001) between the young and the older patients. Immunohistochemical staining for MSH2 protein and MLH1 were done for 92 and 97 specimens respectively. There was no significant difference between the expressions of MLH1 and MSH2 on tumor grading, indicated there was no correlation between microsatellite instability and tumor grading in this study.

Conclusion: Colorectal cancer in young native Indonesian patients (40 years old or less) was not different in clinicopathological characteristics compared to older patients (60 years old or more) in similar ethnic groups. There was also no difference in MSH2 and MLH1 protein expressions, important indicators of microsatellite instability."

"Latar belakang: Kanker kolorektal menduduki peringkat tiga sebagai kanker terbanyak di dunia, dan peringkat kedua sebagai kanker dengan angka mortalitas tertinggi, yaitu 862,000 kematian pada tahun 2018. Dalam alur penatalaksanaan kanker kolorektal, pemeriksaan histopatologi memiliki peranan penting dalam menentukan progresivitas kanker yang secara tidak langsung menentukan jenis terapi pada pasien. Subjektivitas dalam pemeriksaan patologi berpotensi untuk menjadi suatu masalah karena dapat menyebabkan diagnosis yang tidak tepat. Hal ini diakibatkan sifat pemeriksaan patologis yang operator dependent yang perlu diminimalkan agar pemeriksaan lebih objektif. Spektroskopi telah digunakan sebagai metode untuk membantu mengkuantifikasikan diagnosis kanker mulai dari quantitative mass sepctrometry, atau quantitative spectroscopic imaging. Namun penggunaan spektroskopi berbasis cahaya tampak belum banyak ditemukan.Tujuan: Studi ini bertujuan untuk mengetahui intensitas cahaya reflektansi dari spektrofotometer reflektans sederhana untuk membedakan jaringan kolon normal, prekanker, dan kanker, serta akurasinya dalam membedakan jaringan. Metode: Studi ini mengukur reflektansi pada jaringan kanker kolon dari mencit (Mus musculus) pada 126 panjang gelombang mulai dari 435-712.6 nm. Data reflektansi dianalisis menggunakan Uji Saphiro Wilk, Uji Kruskal Wallis, dan Uji One Way ANOVA. Kemudian Principle Component Analysis (PCA) dilakukan pada data, lalu dilanjutkan dengan 5-fold cross validation menggunakan algoritma machine learning. Pengukuran parameter akurasi kemudian dilakukan pada model yang dibuat menggunakan machine learning yang mencakup CA (Classification Accuracy), precision, recall, sensitivitas, dan spesifisitas. Hasil: Dalam membedakan 3 kelompok jaringan (normal, prekanker, dan kanker), ditemukan 41 panjang gelombang dengan setidaknya 2 kelompok berbeda bermakna, dan spektrofotometer memiliki akurasi yang rendah (CA 0.429-0.464, precision 0.446-0.481, recall 0.429-0.464). Untuk membedakan jaringan normal dan jaringan abnormal (prekanker dan kanker), ditemukan 57 panjang gelombang dengan perbedaan bermakna, dan spektrofotometer memiliki akurasi dengan skor CA 0.821-0.857, precision 0.819-0.60, recall 0.821-0.857, sensitivitas 88.8-100%, dan spesifisitas 50-70%.Simpulan: Studi ini menyimpulkan bahwa terdapat perbedaan reflektansi antara 3 kelompok jaringan. Spektrofotometer reflektans sederhana dapat membedakan jaringan normal dan jaringan abnormal (prekanker dan kanker) dengan cukup baik, namun tidak dapat untuk membedakan 3 kelompok jaringan.

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Bakcground: Colorectal cancer is the third most prevalent cancer worldwide and is the second place for cancers with the highest mortality (862,000 deaths in 2018. In the guidelines for colorectal cancer therapy, histopathological evaluations plays a major role in determining the progression of the cancer thus indirectly determining the therapy for each patient. Subjectivity in pathological evaluation might lead to problems which would resulted in misdiagnosis. This is due to the operator-dependent characteristic of pathological evalutaion that should be minimalized to increase its objectivity. Spectroscopy have been researched and used as a method to help to quantify cancer diagnosis such as quantitative mass spectroscopy and quantitative spectroscopic imaging. The usage of visible light spectroscopy is limited for now. Objectives: This study aims to evaluate the reflectance measured using simple reflectance spectrophotomoeter in order to differentiate normal colon, precancer lesion, and colon cancer tissue, and its accuracy in differentiating tissues.Methods: This study measures the reflectance of the Mus musculus rodents' colon tissue in 127 wavelength from 435-712.6 nm. The reflectance then analyzed using Saphiro Wilk test, One Way ANOVA, and Kruskal Wallis. PCA is conducted, then a 5-fold cross validation is done using machine learning algorithms. A accuracy testing including CA (Classification Accuracy), precision, recall, sensitivity, and specificity is done to the models made by machine learning algorithm.Results: In differentiating 3 tissue category (normal, precancer, and cancer) 41 wavelengths are identified with a p-value of <0.05. To differentiate 3 tissue category, simple spectrophotometer have low accuracy (CA 0.429-0.464, precision 0.446-0.481, recall 0.429-0.464. In differentiating abnormal tissue (precancer and cancer) from normal tissue, 57 wavelengths are identified with a p-value of <0.05. To differentiate these 2 categories, simple reflectance spectrophotometer have an accuracy with CA score equals 0.821-0.857, precision equals 0.819-0.60, recall equals 0.821-0.857, sensitivity equals 88.8-100%, and spesificity equals 50-70%.Conclusion: This study concludes that there is a significant difference in reflectance from 3 tissue samples. Simple reflectance spectrophotometer could differentiate normal and abnormal (precancer and cancer) tissue well but it is unable to differentiate normal, precancer, and cancer tissue to 3 different categories."

"Kecemasan merupakan perasaan yang tidak jelas tentang keprihatinan dan kekhawatiran karena ancaman pada sistem nilai atau pola keamanan seseorang.Kanker kolorektal dapat dideteksi dengan beberapa pemeriksaan dan salah satunya adalah dengan kolonoskopi. Tindakan kolonoskopi menimbulkan keoemasan yang diakibatkan karena takut akan hasil dari kolonoskopi dan hasil patologi anatomi. Peneiitian deskripsi sederhana terhadap 33 responden ditujukan untuk mengetahui faktor-faktor yang mempengaruhi tingkat kecemasan pasien yang akan dilakukan kolonoskopi pada deteksi dini kanker kolorektal.Berdasarkan hasil kuesioner yang didapat, peneliti memperoleh hasil yang tinggi terhadap kecemasan karena takut akan hasil kolonoskopi dan kecemasan karena takut akan hasii patologi anatomi. Hasil penelitian menunjukkan bahwa faktor terbanyak yang mempengaruhi tingkat kecemasan pasien yang akan dilakukan kolonoskopi pada deteksi dini kanker kolorektal adalah nasil koionoskopi dan hasil patotogi anatomi. Kesimpulan yang diperoleh dari penelitian ini adalah kecemasan karena takut akan hasil kolonoskopi 90.9% dan kecemasan karena takut akan hasil patologi anatomi 9O,9%."

"[ABSTRAKPendahuluan : Kanker kolorektal termasuk salah satu morbiditas terbanyak di Indonesia dengan hasil terapi yang cenderung memprihatinkan untuk stadium lanjut lokal. Oleh karena itu diperlukan kemoradiasi neoajuvan yang merupakan terapi standar sesuai guideline untuk kanker rektum stadium lanjut lokal, meskipun demikian espons yang dihasilkan sangat bervariasi dan dipengaruhi oleh berbagai faktor, termasuk hipoksia jaringan. Osteopontin adalah penanda hipoksia endogen yang berkorelasi signifikan dengan tekanan oksigen tumor. Osteopontin juga merupakan penanda hipoksia kronis yang lebih akurat dibandingkan Carbonic Anhydrase IX (CAIX), Glucose Transporter 1 (GLUT1), dan Lactate Dehydrogenase A (LDH A) tetapi belum pernah dilakukan penelitian yang mengukur kadar OPN secara kuantitatif pada jaringan kanker rektum serta mengkorelasikannya dengan respons pengecilan tumor pada kemoradiasi neoajuvan.Metode dan Materi: Dilakukan skrining data pasien dari Rekam Medis Departemen Radioterapi. Empat belas pasien yang memenuhi kriteria inklusi dan eksklusi dianalisis retrospektif dari bulan Februari sampai dengan bulan Mei 2015. Pencitraan radiologi pasca kemoradiasi dibandingkan dengan sebelum kemoradiasi, sementara jaringan rectum didapatkan dari blok parafin yang didapatkan dari biopsi sebelum kemoradiasi. Evaluasi radiologi diukur menggunakan kriteria RECIST 1.1. Kadar OPN diperiksa menggunakan metode ELISA dan diukur menggunakan spektrofometer.Hasil : Rerata kadar OPN adalah 0.5678 ± 0.26 ng/mL. Terdapat korelasi berbanding terbalik yang kuat (r= -0.630, p= 0.016) antara kadar OPN dan pengecilan tumor. Nilai ambang batas OPN ≥0.538 ng/mL memprediksikan ketidakresponsifan terhadap kemoradiasi neoajuvan dengan tingkat sensitivitas 100% dan spesifisitas 81,8%. Meskipun demikian, tidak terdapat korelasi antara kadar OPN dengan Hemoglobin.Kesimpulan : Penelitian ini menunjukkan bahwa hipoksia terdapat pada pasien dengan kanker rektum stadium lanjut lokal dan merupakan karakter yang menandai turunnya respons pengecilan tumor terhadap kemoradiasi neoajuvan. Kadar OPN yang makin tinggi menunjukkan kondisi hipoksia yang lebih buruk dan respons yang lebih buruk untuk pengecilan tumor.

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ABSTRACTIntroduction: Colorectal carcinoma is one of the common cancer in Indonesia with concerned clinical outcome for locally advanced stage, therefore neoadjuvant chemoradiation (CRT) is needed. Neoadjuvant CRT is the mainstay treatment for locally advanced rectal carcinoma, however the response is varied due to many factors, including tissue hypoxia. Osteopontin (OPN) is an emerging endogen hypoxic marker with significant correlation with tumor pO2, also more accurate chronic hypoxic marker compared to Carbonic Anhydrase IX (CAIX), Glucose Transporter 1 (GLUT1), and Lactate Dehydrogenase A (LDH A) but there's no research that measured OPN quantity in rectal cancer tissue and correlate it with tumor shrinkage response in neoadjuvant CRT.Methods and Materials: Patients? data was screened from Radiotherapy Department Medical Record Archieves. Fourteen patients that meet the inclusion and exclusion criteria were analyzed retrospectively from February to May 2015. Radiology imaging post CRT compared to the imaging pre CRT, while the rectum tissue obtained from Formalin-Fixed Paraffin Embedded (FFPE) tissue from biopsy sampling before CRT. Radiology evaluation was measured using RECIST 1.1. OPN level was conducted using ELISA method and measured with spectrophotometry.Results: The mean OPN concentration is 0.5678 ± 0.26 ng/mL. There was a significant strong negative correlation (r = -0.630, p= 0.016) between the OPN level and tumor shrinkage. OPN cut off value ≥0.538 ng/ml predicts non-responsiveness of neoadjuvant CRT with 100% sensitivity and 81.8% specificity. However, there is no correlation between OPN concentration and Hemoglobin concentration.Conclusion: This study showed that hypoxia occurs in patients with locally advanced rectal carcinoma, and characterizes decreasing tumor shrinkage response in neoadjuvant CRT. Higher level of OPN suggests worse level of hypoxic condition and worse response of tumor shrinkage., Introduction: Colorectal carcinoma is one of the common cancer in Indonesia with concerned clinical outcome for locally advanced stage, therefore neoadjuvant chemoradiation (CRT) is needed. Neoadjuvant CRT is the mainstay treatment for locally advanced rectal carcinoma, however the response is varied due to many factors, including tissue hypoxia. Osteopontin (OPN) is an emerging endogen hypoxic marker with significant correlation with tumor pO2, also more accurate chronic hypoxic marker compared to Carbonic Anhydrase IX (CAIX), Glucose Transporter 1 (GLUT1), and Lactate Dehydrogenase A (LDH A) but there’s no research that measured OPN quantity in rectal cancer tissue and correlate it with tumor shrinkage response in neoadjuvant CRT. Methods and Materials: Patients’ data was screened from Radiotherapy Department Medical Record Archieves. Fourteen patients that meet the inclusion and exclusion criteria were analyzed retrospectively from February to May 2015. Radiology imaging post CRT compared to the imaging pre CRT, while the rectum tissue obtained from Formalin-Fixed Paraffin Embedded (FFPE) tissue from biopsy sampling before CRT. Radiology evaluation was measured using RECIST 1.1. OPN level was conducted using ELISA method and measured with spectrophotometry. Results: The mean OPN concentration is 0.5678 ± 0.26 ng/mL. There was a significant strong negative correlation (r = -0.630, p= 0.016) between the OPN level and tumor shrinkage. OPN cut off value ≥0.538 ng/ml predicts non-responsiveness of neoadjuvant CRT with 100% sensitivity and 81.8% specificity. However, there is no correlation between OPN concentration and Hemoglobin concentration. Conclusion: This study showed that hypoxia occurs in patients with locally advanced rectal carcinoma, and characterizes decreasing tumor shrinkage response in neoadjuvant CRT. Higher level of OPN suggests worse level of hypoxic condition and worse response of tumor shrinkage.]"

"Angka kejadian kanker rektal sekarang ini semakin meningkat. Semakin dini kasus ini dapat didiagnosis, maka prognosis pasien dengan kanker rektal akan semakin baik. Keterlibatan jaringan mesorektal yang ditemukan pada CT Scan abdomen-pelvis merupakan indikasi adanya metastasis pada kelenjar getah bening regional. Keterlibatan jaringan mesorektal pada CT Scan abdomen-pelvis mempengaruhi stadium dan penatalaksanaan pasien kanker rektal. Penelitian ini dilakukan untuk mengetahui hubungan keterlibatan jaringan mesorektal yang ditemukan pada Computed Tomography abdomen-pelvis pasien kanker rektal dengan metastasis kelenjar getah bening regional. Hasil penelitian ini menunjukkan tidak adanya hubungan antara keterlibatan jaringan mesorektal dengan metastasis pada kelenjar getah bening regional (pN) pada pasien kanker rektal.

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The incidence of rectal cancer is now increasing. The earlier cases can be diagnosed, the prognosis of patients with rectal cancer are better. Mesorektal tissue involvement were found in the abdominal-pelvic CT scan is an indication of the presence of metastases in regional lymph nodes. Mesorektal tissue involvement on CT scan of the abdomen-pelvis affect stage and management of rectal cancer patients. This study was conducted to determine the relationship of tissue involvement mesorektal found on abdominal-pelvic computed tomography rectal cancer patients with metastatic regional lymph nodes. The results of this study showed no correlation between tissue involvement mesorektal with metastasis in regional lymph nodes (pN) in patients with rectal cancer."

"Kanker kolorektal (KKR) menempati urutan ketiga sebagai kanker penyebab kematian tertinggi di dunia. Diperkirakan sekitar 63% kematian akibat KKR terjadi karena kurangnya screening dan keterlambatan diagnosis. Saat ini metode standar yang digunakan dalam diagnosis KKR adalah kolonoskopi dan biopsi jaringan. Namun metode tersebut memiliki risiko yang tinggi, besifat invasif, serta tidak efisien untuk monitoring perkembangan tumor. Gen Epidermal Growth Factor Receptor (EGFR) telah umum digunakan sebagai marka prognostik KKR, salah satunya melalui studi ekspresi gen pada Circulating Tumor Cells (CTCs). Namun CTC memiliki beberapa kelemahan, seperti konsentrasi yang rendah dan heterogenitas yang beragam. Di sisi lain, serum darah penderita kanker mengandung cell-free Nucleic Acid (cfNA) yang membawa informasi genetik dari jaringan tumor asal. Hal tersebut menjadikan cfNA berpotensi untuk dikembangkan sebagai salah satu metode alternatif untuk diagnosis dan monitoring KKR. Penelitian ini bertujuan untuk mendeteksi gen EGFR dari CTC dan serum darah penderita KKR menggunakan metode quantitative PCR with Melting Curve Analysis (qPCR MCA). Penelitian dilakukan terhadap 4 pasien KKR dengan karakteristik dan stadium kanker yang bervariasi. Hasil penelitian menunjukkan gen EGFR terdeteksi pada seluruh sampel serum dan hanya terdeteksi pada 1 sampel CTC. Oleh karena itu, dapat disimpulkan bahwa deteksi biomarker EGFR pada serum memiliki efektivitas yang lebih baik dibandingkan CTC.<

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Colorectal cancer (CRC) ranks as the third leading cause of cancer death in the world. It is estimated that around 63% of deaths from CRC occur due to lack of screening and delay in diagnosis. Currently, the standard methods used in the diagnosis of CRC are colonoscopy and tissue biopsy. However, this method has a high risk, invasive, and inefficient for tumor monitoring. The Epidermal Growth Factor Receptor (EGFR) has been commonly used as a prognostic marker for CRC through gene expression analysis of Circulating Tumor Cells (CTCs). However, CTC have some limitations such as heterogeneity and low concentrations. On the other hand, the blood serum of cancer patients contains cell-free Nucleic Acid (cfNA) which carries genetic information from the original tumor tissue. Hence, cfNA have great potential to be developed as an alternative method for CRC diagnosis and monitoring. This study aims to detect the EGFR gene from CTC and blood serum of CRC patients using the quantitative PCR with the Melting Curve Analysis (qPCR MCA). The study was conducted on 4 CRC patients with various characteristics and stages of cancer. The results showed that the EGFR gene was detected in all serum samples and only in 1 CTC sample. Therefore, the results suggest that the detection of EGFR biomarkers in serum has better effectiveness than CTC."