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Abstrak :
Angka kejadian kanker payudara yang ditemukan pads stadium dini meningkat, dilakukan Sentinel Lymph Node Biopsy (SLNB) untuk mendapatkan kontrol lokoregional yang balk dan morbiditas minimal. SLNB belum menjadi prosedur tetap di Indonesia, dasar SLNB adalah deteksi limfonodi sentinel sebagai prediktor status axilla. Penelitian ini adalah penelitian bersama bagian Radiologi dan Bedah FKUI - RSCM Jakarta dengan tujuan mengetahui akurasi metode radiokolloid (limfoskintigrafi dan gamma probe) serta blue dye dalam mendeteksi limfonodi sentinel pada kanker payudara stadium dini. Dilakukan uji diagnostik secara cross sectional, membandingkan akurasi metode radiokolloid dan blue dye dengan histopatologi sebagai baku emas pada 14 pasien dan didapatkan 163 limfonodi. Karakterikstik subyek: keseluruhan perempuan, usia 39 - 53 tahun, kebanyakan sudah menopause, multipara dan menyusui anaknya. Tumor primer mayoritas di kanan, kwadran lateral atas, 57,1% T2, basil histopatologi semuanya karsinoma duktal invasif, didapatkan emboli limfatik pada 71,4% kasus. Waktu injeksi sampai dilakukan operasi antara 4 sampai 24 jam. Deteksi limfonodi sentinel dengan limfoskintigrafi mempunyai akurasi 81,8%, sensitifitas 90,4%, spesifisitas 73,2%, NPV 98,1%, negatif palsu 1,8%, nilai kappa 0,37. Menggunakan gamma probe mempunyai akurasi 79%, sensitivitas 90,4%, spesifisitas 67,6%, NPV 97,9%, negatif palsu 2%, nilai kappa 0,31. Bila keduanya dilakukan mempunyai akurasi 83,6%, sensitivitas 90,4%, spesifisitas 76,8%, NPV 98,2%, negatif palsu 1,8%, nilai kappa 0,56. 14% limfonodi sentinel merupakan limfonodi mammaria interna. Akurasi metode blue dye tidak bisa dinilai pada penelitian ini, gambaran deteksi dengan metode blue dye 71,4% positif. Disimpulkan bahwa metode radiokolloid mempunyai akurasi dan kesesuaian yang tinggi dalam mendeteksi limfonodi sentinel pada kanker payudara stadium dini, terbukti metode radiokolloid dapat diaplikasikan sebagai dasar penggunaan SLNB.

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The incidence of breast cancer in the early stage increases, Sentinel Lymph Node Biopsy (SLNB) is conducted to obtain good locoregional and minimal morbidity. SLNB has not become the permanent procedure in Indonesia, the basic of SLNB is sentinel node detection as a axillary lymph node status predictor. This is a joint research of the Radiology and Surgery Department FKUI - RSCM Jakarta aiming to find out the accuracy of radiocolloid (lymphoscintigraphy and gamma probe) as well as blue dye method in detecting sentinel node in the early stage breast cancer. Diagnostic examination is conducted by means of cross sectional, comparing the accuracy of radiocolloid and blue dye methods with histopathology as the gold standard of 14 patients and gotten 163 nodes. Subject characteristics: all female, aged 39-53, mostly menopause, multipara and breast-feeding. Primary tumor mostly in the right, upper lateral quadrant, T2, histopathology result all carcinoma ductal invasife, emboli lymphatic found in 71,4% cases. The period of injection to surgery is between 4 until 24 hours. The detection of sentinel node with lymphoscintigraphy has 81,8% accuracy, sensitivity 90,4%, specificity 73,2%, NPV 98,1%, false-negative 1,8% and kappa value 0,37. Using gamma probe has 79% accuracy, sensitivity 90,4%, specificity 67,6%, NPV 97,9%, false-negative 2% and kappa value 0,31. When both are conducted, it has 83,6% accuracy, sensitivity 90,4%, specificity 76,8%, NPV 98,2%, false-negative 1,8% and kappa value 0,56. 14% sentinel node is internal mammary node. The accuracy of blue dye method cannot be calculated in this research, detection rate is 71,4%. It is concluded that radiocolloid method has high accuracy and suitability in detecting sentinel node in the early stage breast cancer, it is proven that radiocolloid method can be applied as the basic for using SLNB.

Abstrak :
Latar Belakang : Upaya untuk menurunkan kejadian kanker serviks dengan menemukan lesi pra-kanker serviks di negara-begara berkembang masih belum menunjukkan basil yang memuaskan. Kendala yang dihadapi antara lain adalah belum adanya program nasional yang berkesinambungan serta sumber daya yang terbatas, termasuk peralatan untuk melakukan pemeriksaan papsmear. Di banyak daerah ketidaktersediaan alkohol 95% sebagai larutan fiksasi menjadi salah satu alasan tidak dilakukannya pemeriksaan papsmear. Salah satu inovasi yang dapat dilakukan pada daerah dengan sumber daya terbatas adalah dengan menghilangkan keharusan tersedianya alkohol 95% sebagai larutan fiksasi dan menggantinya dengan melakukan rehidrasi menggunakan NaCl 0,9% pada sediaan papsmear yang telah dikeringkan di udara terbuka. Tujuan : Menguji mutu sediaan papsmear yang dibuat dengan metode "sediaan kering". Bahan dan Cara Kerja : Penelitian dilakukan di laboratorium sitologi Departemen Obstetri dan Ginekologi FKUT-RSCM Jakarta. Dibuat dua buah slide papsmear dari setiap pasien yang datang untuk melakukan pemeriksaan papsmear. Pada kelompok pertama sediaan diproses secara konvensional menggunakan alkohol 95% sebagai larutan fiksasi, sedangkan kelompok kedua sediaan papsmear dikeringkan di udara terbuka kemudian dilakukan rehidrasi menggunakan NaCl 0,9% sebelum dilakukan pewarnaan. Dilakukan perbandingan mutu sediaan ditinjau dad segi densitas seluler, adanya artefak akibat pengeringan di udara terbuka, serta ada tidaknya gangguan akibat latar belakang eritrosit dan latar belakang sel radang. Hasil : Didapatkan 210 pasang sediaan yang dapat dievaluasi. Teknik kering mempunyai adekuasi sediaan yang sama baiknya dengan teknik konvensional. Tidak didapatkan perbedaan bermakna pada kedua kelompok ditinjau dad segi densitas seluler, adanya artefak akibat pengeringan di udara terbuka, serta ada tidaknya gangguan akibat latar belakang eritrosit dan latar belakang sel radang. Kesimpulan : Papsmear sediaan kering dapat dipakai sebagai alternatif pembuatan sediaan sitologi serviks saat larutan alkohol 95% tidak tersedia sebagai larutan fiksasi.

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Background : In many developing countries there are still many obstacles in establishing optimal result on performing early detection of cervical cancer. Among those are lack of continous national programs and also limited resources. In many area, availability of alcohol 95% as a fixating agent is often less and emerge as one reason why people did not perform papsmear examination routinely. Rehydration of air-dried ("dry-prepared") papsmear could replace alcohol 95% as a simple method in preparing cervical cytologic examination. Objective : To evaluate the quality of dry-prepared papsmear Material and Methods : The study was held in Cytology laboratory , Department of Obstetry and Gynecology, Cipto Mangunkusumo Hospital, Jakarta. We took one pair papsmear slides from every patient who was going to perform papsmear examination. One slide was processed with dry-prepared method, i.e. the slide was air-dried and then rehydrated with saline before staining, and another slide was processed conventionally (fixated with alcohol 95%) as a control. We compared the quality of both slides in terms of its celuler density, occurrence of air-dried artifacts, and the presence of obscuring blood and inflamatory cells. Result : Two hundred and ten slides were available for evaluation. The dry-prepared papsmear had a similar adequacy compared with the conventional one. There were no differences found in terms of celluler density, occurrence of air-dried artifact, and the presence of obscuring blood and inflamatory cells. Conlusion : Dry-prepared papsmear can be one alternative method in processing cervical cytologic examination when alcohol 95% was not available.

Abstrak :
Sorafenib adalah tata laksana sistemik pertama pada hepatoseluler karisonoma. Resistensi HCC terhadap sorafenib dapat berkembang cepat dan melibatkan disregulasi apoptosis. Apoptosis diregulasi oleh protein anti-apoptosis dan pro-apoptosis seperti Bcl-2 dan Bax serta dimediasi oleh caspase. Alpha-mangostin telah ditemukan menginduksi apoptosis dengan meningkatkan rasio Bax/Bcl-2 serta caspases di sel kanker payudara serta mengembalikan resistensi doksorubisin di HCC. Tujuan dari penelitian ini adalah untuk mempelajari efek alpha-mangostin di sel HepG2 tahan terhadap sorafenib. Lini sel HCC, sel HepG2 dibagi menjadi 6 kelompok;.01% DMSO, alphamangostin 20μM, sorafenib 10μM, sorafenib 10μM + sorafenib 10μM, sorafenib + alpha-mangostin 20μM, and sorafenib 10μM + sorafenib 10μM + alpha-mangostin 20 μM. Sel diambil dan dihitung, serta RNA diisolasi diikuti dengan sintesis cDNA. Ekspresi dari Bcl-2, Bax, caspase-9, dan -3 diukur menggunakan q-RT PCR. Pemberian alfa-mangostin terhadap sel HepG2 tahan sorafenib secara signifikan meningkatkan ekspresi mRNA Bcl-2 dan Bax bersamaan, sedangkan perbedaan rasio Bax/Bcl-2 tidak ditemukan signifikan. Sementara, ekspresi dari mRNA caspase-9 juga tidak menunjukkan perubahan yang signifikan. Namun, ditemukan peningkatan yang signifikan pada ekspresi mRNA caspase-3, tetapi juga menurun signifikan setelah administrasi sorafenib dan alpha-mangostin bersamaan. Kesimpulan: Alfa-mangostin menginduksi apoptosis di sel HepG2 tahan sorafenib ditunjukkan dengan peningkatan caspase-3 pada pemberian. Namun, mekanisme apoptosis dapat tidak melibatkan jalur intrinsik yang diindikasikan oleh perubahan yang tidak signifikan pada rasio Bax/Bcl-2 dan caspase-9. ..... Sorafenib is the first-line systemic treatment in hepatocellular carcinoma. Sorafenib-resistance HCC may develop rapidly, which may involve apoptosis dysregulation. Apoptosis is regulated by anti-apoptotic and pro-apoptotic proteins such as Bcl-2 and Bax and mediated by caspases. Alpha-mangosin has been reported to induce apoptosis by increase Bax/Bcl-2 ratio and caspases in breast cancer cells as well as reverse doxorubicin resistance in HCC. The purpose of this research is to explore alpha-mangostin effect in sorafenib-surviving HepG2 cells. HCC cell line, HepG2 cells were divided into 6 groups; 0.01% DMSO, alphamangostin 20μM, sorafenib 10μM, sorafenib 10μM + sorafenib 10μM, sorafenib + alpha-mangostin 20μM, and sorafenib 10μM + sorafenib 10μM + alpha-mangostin 20 μM. The cells were taken and counted, and RNA was isolated followed with cDNA synthesis. The expression of Bcl-2, Bax, Bax/Bcl-2 ratio caspase-9 and -3 were measured using q-RT-PCR. The treatment of alpha-mangostin to sorafenib-surviving HepG2 cells significantly increase Bcl-2 and Bax mRNA expression concurrently. In the ratio of Bax/Bcl-2 mRNA, the change was not significant. Meanwhile, the expression of caspase-9 mRNA was neither found to significantly change. However, the expression of caspase-3 mRNA was found to be significant, yet significantly lower in the coadministration of sorafenib and alpha-mangostin. Conclusion: Alpha-mangostin induces apoptosis in sorafenib-surviving HepG2 cells due to increase of caspase-3 upon its administration. However, the mechanism may not be through the intrinsic pathway given the insignificant changes in Bax/Bcl-2 ratio and caspase-9 expression.

Abstrak :
Latar Belakang: Menurut data WHO World Health Organization pada tahun 2012, kanker menempati nomor dua penyebab kematian di negara maju setelah penyakit kardiovaskular dan menjadi penyakit nomor tiga penyebab kematian di negara berkembang setelah kardiovaskular dan penyakit infeksi. Saat ini, data mengenai profil kanker yang diperoleh dari kegiatan registrasi kanker di Indonesia belum ada. Profil kanker dengan metode pengumpulan dan pelaporan yang baik di wilayah DKI Jakarta diperlukan untuk pembentukan registrasi kanker berbasis populasi di Indonesia. Rumah Sakit Ciptomangunkusumo RSCM telah ditetapkan sebagai rumah sakit pengendali data beban kanker DKI Jakarta oleh Menteri Kesehatan Republik Indonesia. Penelitian ini bertujuan untuk memberikan gambaran profil kanker di Provinsi Jakarta tahun 2008 sampai tahun 2012 berdasarkan data di RSCM sebagai pusat pengendali registrasi kanker Provinsi DKI Jakarta. Metode: Penelitian ini bersifat deskriptif cross sectional dengan mengambil data dari registrasi kanker di RSCM untuk membetuk profil kanker di Provinsi DKI Jakarta tahun 2008 sampai tahun 2012. Hasil: Didapatkan 14.726 pasien kanker, dengan rasio laki-laki dan perempuan 1:1,8. Mayoritas berusia antara 45-54 tahun. Mayoritas pasien datang berobat pada stadium lanjut, yaitu stadium 3 atau 4, sebanyak 31,8. Domisili pasien terbanyak di Kota Jakarta Barat 27,5 diikuti Kota Jakarta Timur 25,5. Urutan lima kanker terbanyak pada kedua jenis kelamin adalah kanker payudara, kanker serviks, keganasan sistem hematopoetik dan retikuloendotelial, kanker paru dan bronkus, serta kanker nasofaring. Urutan lima kanker terbanyak pada laki-laki adalah kanker paru, kanker nasofaring, keganasan sistem hematopoetik dan retikuloendotelial, kanker hati, serta kanker kelenjar getah bening. Urutan kanker terbanyak pada perempuan adalah kanker payudara, kanker serviks, kanker ovarium, keganasan sistem hematopoetik dan retikuloendotelial, serta kanker kelenjar tiroid. Kesimpulan: Hasil pada penelitian ini sesuai dengan GLOBOCAN 2012 untuk Wilayah Asia Tenggara, namun cakupan datanya belum optimal karena belum semua fasilitas kesehatan di Provinsi DKI Jakarta mengumpulkan data pasien kanker. Saran: Diperlukan penelitian lebih lanjut dengan cakupan yamg lebih luas dengan melibatkan semua fasilitas kesehatan di Provinsi DKI Jakarta. ...... Background: According to WHO World Health Organization data in 2012, cancer occupies the second cause of death in developed countries after cardiovascular disease and become the third leading cause of death in developing countries after cardiovascular and infectious diseases. Currently, data on cancer profiles obtained from cancer registration activitie s in Indonesia does not exist. Cancer profiles with good collecting and reporting methods are required for the establishment of Indonesia population based cancer registry. The Minister of Health of Indonesia has designated Ciptomangunkusumo Hospital Rumah Sakit Cipto Mangunkusumo RSCM as a Cancer Registry Control Center of DKI Jakarta Province. This study aims to provide a description of cancer profile of DKI Jakarta Province in 2008 to 2012 based on data from RSCM as a control center for cancer registry of DKI Jakarta Province. Methods: This was a cross sectional descriptive study by collecting data from cancer registry at RSCM to establish cancer profile in DKI Jakarta Province in 2008 to 2012. Results: 14,726 cancer patients were found, with male and female ratio of 1 1.8. The majority of patients were between 45 54 years old. Most of patients came to the health care facility were in advanced stage, as many as 31.8. The number of patient was highest from West Jakarta 27.5 and followed by from East Jakarta 25.5. The five most frequent cancer found in both sexes were breast cancer, cervical cancer, hematopoietic and reticuloendothelial system malignancy, lung and bronchial cancer, and nasopharyngeal cancer. The five most common cancers in male were lung cancer, nasopharyngeal cancer, hematopoietic and reticuloendothelial system malignancy, liver cancer, and lymph node cancer. The five most common cancers in female were breast cancer, cervical cancer, ovarian cancer, hematopoietic and reticuloendothelial system malignancy, and thyroid gland cancer. Conclusion: The results of this study are similar with GLOBOCAN 2012 results for Southeast Asia region, but the data coverage was still not optimal because not all health care facilities in DKI Jakarta Province submitted cancer patient data. Suggestion: Further research is needed with broader coverage involving all health care facilities in the DKI Jakarta Province.

Abstrak :
Penyakit kanker merupakan salah satu penyebab kematian dengan angka mortalitas tertinggi. Penelitian ini melaporkan profil pasien kanker yang berdomisili di wilayah Jakarta Utara dan Kepulauan Seribu tahun 2008 ndash; 2012 dengan total 2185 penderita kanker, terdiri dari 740 laki-laki dan 1445 perempuan. Mayoritas pasien bekerja sebagai ibu rumah tangga. Distribusi stadium kanker terbanyak adalah pada stadium 3. Urutan lima kanker terbanyak adalah kanker payudara, kanker serviks, kanker nasofaring, keganasan sistem hematopoetik dan retikuloendotelial, dan kanker ovarium. Pada laki-laki kanker terbanyak adalah kanker nasofaring, sedangkan pada perempuan kanker terbanyak adalah kanker payudara. Distribusi usia pada lima kanker terbanyak adalah pada kelompok 45-54 tahun kecuali sistem hematopoetik dan retikuloendotelial kelompok usia terbanyak pada ...... Cancer is one cause of death with the highest mortality rate. This study reports the profile of cancer patients living in North Jakarta and the Thousand Islands of 2008 to 2012 with a total of 2185 cancer patients, consisting of 740 men and 1445 women. The majority of patients work as housewives. The highest stage of cancer distribution is in stage 3. The top five cancer sequences are breast cancer, cervical cancer, nasopharyngeal cancer, hematopoietic and reticuloendothelial system malignancy, and ovarian cancer. In males most cancer is nasopharyngeal cancer, whereas in most cancer women is breast cancer. The age distribution of the five most common cancers is in the 45 54 year group except the hematopoietic and reticuloendothelial system of the most age group at

Abstrak :
The book will provide an exhaustive and clear explanation of how statistics, mathematics and informatics have been used in cancer research. To do so, state-of-the-art biostatistics, biomathematics and bioinformatics methods will be described and discussed in detail through illustrative and capital examples taken from cancer research work already published.

Abstrak :
Systems biology in cancer research and drug discovery provides a unique collection of chapters, by world-class researchers, describing the use of integrated systems biology and network modeling in the cancer field where traditional tools have failed to deliver expected promise. This book touches four applications/aspects of systems biology, (i) in understanding aberrant signaling in cancer, (ii) in identifying biomarkers and prognostic markers especially focused on angiogenesis pathways, (iii) in unwinding microRNAs complexity, and (iv) in anticancer drug discovery and in clinical trial design. This book reviews the state-of-the-art knowledge and touches upon cutting edge newer and improved applications especially in the area of network modeling. It is aimed at an audience ranging from students, academics, basic researcher and clinicians in cancer research.

Abstrak :
Genetically-engineered mouse models for cancer research have become invaluable tools for studying cancer biology and evaluating novel therapeutic approaches. This volume focuses on state-of-the-art methods for generating, analyzing and validating such models for studying aspects of human cancer biology. Additionally, these models are emerging as important pre-clinical systems in which to test cancer prevention and therapeutic strategies in order to select compounds for testing in clinical trials.