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Abstrak :
ABSTRACT
Sel tumor adalah sel yang terbentuk akibat kegagalan beberapa protein dalam mengatur siklus sel. Protein TP53 berperan penting dalam mengatur siklus sel, khususnya dalam menekan perkembangan sel tumor. Perubahan pada gen TP53 ditemukan dalam lebih dari setengah kasus tumor pada manusia. Protein lain yang berhubungan dengan protein TP53 juga ditemukan terlibat dalam proses pembentukan kanker. Analisis interaksi protein TP53 dengan melakukan clustering jaringan interaksi protein (PPI) TP53 adalah hal penting dalam membantu mengatasi sel tumor. Jaringan PPI dinyatakan sebagai graf dengan protein dan interaksinya masing-masing sebagai simpul dan busur pada graf. Spectral clustering adalah metode graph clustering yang menggunakan eigenvector dari matriks Laplacian.

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ABSTRACT
Fuzzy random walk adalah metode fuzzy clustering yang menggunakan probabilitas transisi dari random walk pada data. Dua metode tersebut akan digabungkan dan diimplementasikan pada penelitian ini. Menggunakan data PPI protein TP53 dari STRING database, didapat gabungan kedua metode tersebut mampu menghasilkan cluster yang fuzzy dan robust di mana setiap cluster dapat menjelaskan bagian tertentu dari fungsi protein TP53. Tumor cell is formed as a result of malfunctioning of some proteins that regulates the cell cycle. TP53 protein plays an important role in managing cell cycle, especially in tumor cell suppression. An alteration of TP53 gene is found in more than half cases of human tumor. Moreover, TP53-related proteins are also found involved in the carcinogenesis process. Therefore, it is important to analyze the interactions of TP53 protein by clustering protein-protein interactions (PPI) network of TP53. PPI networks are usually represented as a graph network with proteins and interactions as vertices and edges respectively. Spectral Clustering is a graph clustering algorithm based on eigenvector of the graph Laplacian. Fuzzy Random Walk is a fuzzy clustering method based on transition probability from a random walk on a dataset. In this paper, we combine both Spectral Clustering and Fuzzy Random Walk. Using PPI datasets of TP53 obtained from the STRING database, we found the combined algorithm is proven to produce both robust and fuzzy clusters with each cluster explains one of TP53 proteins functionality.

Abstrak :
ABSTRAK
Latar belakang: Fibroadenoma dan tumor filodes jinak merupakan tumor fibroepitelial dengan gambaran histopatologik yang tumpang tindih. Saat ini banyak pengambilan jaringan tumor payudara secara core biopsy, termasuk pada tumor fibroepitelial. Jumlah jaringan yang sedikit dan gambaran histopatologik yang tumpang tindih sering menyulitkan Dokter Spesialis Patologi Anatomik dalam menentukan diagnosis fibroadenoma dan tumor filodes jinak. Penelitian ini bertujuan untuk mengetahui gambaran histopatologik apa saja yang bermakna untuk mendiagnosis fibroadenoma dan tumor filodes jinak dan untuk menguji apakah diagnosis fibroadenoma dan tumor filodes jinak pada core biopsy dengan menggunakan sistem skoring lebih baik dibandingan tanpa skoring. Bahan dan cara: Penelitian ini merupakan suatu uji diagnostik. 57 kasus fibroadenoma dan tumor filodes jinak yang memiliki slaid core biopsy dan mastektomi/lumpektomi/eksisi dinilai ulang tanpa sistem skoring dan menggunakan skoring. Gambaran histopatologik yang dinilai pada sistem skoring adalah selularitas stroma, atipia inti, fragmentasi jaringan, infiltrasi lemak, mitosis dan heterogenitas stroma. Kemudian dilakukan analisis statistik, uji diagnostik dan uji kappa. Hasil: Selularitas stroma, heterogenitas stroma dan fragmentasi jaringan lebih sering ditemukan pada tumor filodes jinak dan berbeda bermakna (p=0,001; p=0,000; p=0,021). Spesifisitas pada sistem skoring meningkat sebesar 17,9%. Nilai duga positif dan nilai duga negatif pada sistem skoring meningkat sebesar 11,9% dan 5,1%. Area under curve (AUC) meningkat 8,9%. Uji Cohen?s kappa antara diagnosis core biopsy tanpa dan dengan skoring bernilai rendah (0,545). Kesimpulan: Adanya peningkatan spesifisitas, nilai duga positif dan AUC menunjukkan bahwa penilaian core biopsy sistem skoring lebih baik dibandingkan tanpa skoring dan dapat menjadi acuan untuk diagnosis fibroadenoma dan tumor filodes jinak. ABSTRACT
Background: Fibroadenoma and benign phyllodes tumor are kinds of fibroepithelial tumor which have overlapping histopathological features. Recently, core biopsy is commonly performed to determine breast tumor, including fibroepithelial tumor. Small amount of tissue and overlapped histopathological features often complicate the Pathologist in diagnosing both. This study aims to describe the histopathological appearance which needed to diagnose fibroadenoma and benign phyllodes tumor and to verify if the diagnosis of fibroadenoma and benign phyllodes tumor in core biopsy using scoring system is more accurate than without scoring system.

Method: This study was a diagnostic test, in which 57 cases of fibroadenoma and benign phyllodes tumor which had undergone core biopsy and mastectomy/excision were re-assessed using and without using scoring system. Histopathologic features which assessed using scoring system were stromal cellularity, nuclear atypia, tissue fragmentation, fat infiltration, mitotic figure, stromal heterogeneity. Analytical statistic, diagnostic test, accuracy test and Kappa test were done.

Results: Stromal cellularity, stromal heterogeneity and tissue fragmentation mostly found in benign phyllodes tumor and significantly different (p=0,001; p=0,000; p=0,021).There were significant differences between stromal cellularity (p=0,001), stromal heterogeneity (p=0,000), and tissue fragmentation (p=0,021) in diagnosis of benign phyllodes tumor. Specificity in scoring system increased by 17,9 %. Positive predictive value, negative predictive value and accuracy increased in scoring system (11,9% and 5,1%). Area under curve (AUC) increased by 8,9%. Cohen's Kappa test between core biopsy diagnosis without using and using scoring system had low result(0,545).

Conclusion: The increasing of specificity, positive predictive value, accuracy and AUC proved that core biopsy with scoring system is more accurate than without scoring. This can be used as reference to diagnose fibroadenoma and benign phyllodes tumor.;Background: Fibroadenoma and benign phyllodes tumor are kinds of fibroepithelial tumor which have overlapping histopathological features. Recently, core biopsy is commonly performed to determine breast tumor, including fibroepithelial tumor. Small amount of tissue and overlapped histopathological features often complicate the Pathologist in diagnosing both. This study aims to describe the histopathological appearance which needed to diagnose fibroadenoma and benign phyllodes tumor and to verify if the diagnosis of fibroadenoma and benign phyllodes tumor in core biopsy using scoring system is more accurate than without scoring system.

Method: This study was a diagnostic test, in which 57 cases of fibroadenoma and benign phyllodes tumor which had undergone core biopsy and mastectomy/excision were re-assessed using and without using scoring system. Histopathologic features which assessed using scoring system were stromal cellularity, nuclear atypia, tissue fragmentation, fat infiltration, mitotic figure, stromal heterogeneity. Analytical statistic, diagnostic test, accuracy test and Kappa test were done.

Results: Stromal cellularity, stromal heterogeneity and tissue fragmentation mostly found in benign phyllodes tumor and significantly different (p=0,001; p=0,000; p=0,021).There were significant differences between stromal cellularity (p=0,001), stromal heterogeneity (p=0,000), and tissue fragmentation (p=0,021) in diagnosis of benign phyllodes tumor. Specificity in scoring system increased by 17,9 %. Positive predictive value, negative predictive value and accuracy increased in scoring system (11,9% and 5,1%). Area under curve (AUC) increased by 8,9%. Cohen's Kappa test between core biopsy diagnosis without using and using scoring system had low result(0,545).

Conclusion: The increasing of specificity, positive predictive value, accuracy and AUC proved that core biopsy with scoring system is more accurate than without scoring. This can be used as reference to diagnose fibroadenoma and benign phyllodes tumor.;Background: Fibroadenoma and benign phyllodes tumor are kinds of fibroepithelial tumor which have overlapping histopathological features. Recently, core biopsy is commonly performed to determine breast tumor, including fibroepithelial tumor. Small amount of tissue and overlapped histopathological features often complicate the Pathologist in diagnosing both. This study aims to describe the histopathological appearance which needed to diagnose fibroadenoma and benign phyllodes tumor and to verify if the diagnosis of fibroadenoma and benign phyllodes tumor in core biopsy using scoring system is more accurate than without scoring system.

Method: This study was a diagnostic test, in which 57 cases of fibroadenoma and benign phyllodes tumor which had undergone core biopsy and mastectomy/excision were re-assessed using and without using scoring system. Histopathologic features which assessed using scoring system were stromal cellularity, nuclear atypia, tissue fragmentation, fat infiltration, mitotic figure, stromal heterogeneity. Analytical statistic, diagnostic test, accuracy test and Kappa test were done.

Results: Stromal cellularity, stromal heterogeneity and tissue fragmentation mostly found in benign phyllodes tumor and significantly different (p=0,001; p=0,000; p=0,021).There were significant differences between stromal cellularity (p=0,001), stromal heterogeneity (p=0,000), and tissue fragmentation (p=0,021) in diagnosis of benign phyllodes tumor. Specificity in scoring system increased by 17,9 %. Positive predictive value, negative predictive value and accuracy increased in scoring system (11,9% and 5,1%). Area under curve (AUC) increased by 8,9%. Cohen's Kappa test between core biopsy diagnosis without using and using scoring system had low result(0,545).

Conclusion: The increasing of specificity, positive predictive value, accuracy and AUC proved that core biopsy with scoring system is more accurate than without scoring. This can be used as reference to diagnose fibroadenoma and benign phyllodes tumor.;Background: Fibroadenoma and benign phyllodes tumor are kinds of fibroepithelial tumor which have overlapping histopathological features. Recently, core biopsy is commonly performed to determine breast tumor, including fibroepithelial tumor. Small amount of tissue and overlapped histopathological features often complicate the Pathologist in diagnosing both. This study aims to describe the histopathological appearance which needed to diagnose fibroadenoma and benign phyllodes tumor and to verify if the diagnosis of fibroadenoma and benign phyllodes tumor in core biopsy using scoring system is more accurate than without scoring system.

Method: This study was a diagnostic test, in which 57 cases of fibroadenoma and benign phyllodes tumor which had undergone core biopsy and mastectomy/excision were re-assessed using and without using scoring system. Histopathologic features which assessed using scoring system were stromal cellularity, nuclear atypia, tissue fragmentation, fat infiltration, mitotic figure, stromal heterogeneity. Analytical statistic, diagnostic test, accuracy test and Kappa test were done.

Results: Stromal cellularity, stromal heterogeneity and tissue fragmentation mostly found in benign phyllodes tumor and significantly different (p=0,001; p=0,000; p=0,021).There were significant differences between stromal cellularity (p=0,001), stromal heterogeneity (p=0,000), and tissue fragmentation (p=0,021) in diagnosis of benign phyllodes tumor. Specificity in scoring system increased by 17,9 %. Positive predictive value, negative predictive value and accuracy increased in scoring system (11,9% and 5,1%). Area under curve (AUC) increased by 8,9%. Cohen's Kappa test between core biopsy diagnosis without using and using scoring system had low result(0,545).

Conclusion: The increasing of specificity, positive predictive value, accuracy and AUC proved that core biopsy with scoring system is more accurate than without scoring. This can be used as reference to diagnose fibroadenoma and benign phyllodes tumor.

Abstrak :
ABSTRAK
Latar belakang: Sarkoma Ewing merupakan suatu small round cell tumor yang ditandai dengan fusi gen EWSR1/FLI1 pada 85 kasus. Diagnosis akurat diperlukan karena memiliki respon baik terhadap protokol kemoterapi spesifik. Baku emas diagnosis sarkoma Ewing adalah deteksi translokasi spesifik dengan RT-PCR atau FISH, namun pemeriksaan tersebut belum tersedia di institusi kami, sehingga dilakukan upaya lain untuk mempertajam diagnosis. Secara morfologi, sarkoma Ewing sering overlapping dengan small round cell tumor lainnya. Pulasan CD99 merupakan penanda yang sangat sensitif untuk mendiagnosis sarkoma Ewing, namun juga sering overlapping dengan small round cell tumor lainnya. Beberapa penelitian mengemukakan FLI1 dapat digunakan sebagai penanda diagnosis sarkoma Ewing. Tujuan penelitian ini adalah menilai ekspresi FLI1 untuk membantu menegakkan diagnosis sarkoma Ewing pada small round cell tumor yang memberikan hasil positif terhadap CD99, terutama pada kasus biopsi.Bahan dan cara: Penelitian ini menggunakan desain potong lintang. Sampel terdiri atas 36 kasus sarkoma Ewing dan 18 kasus small round cell tumor yang sudah dilakukan pulasan imunohistokimia CD99 di RSCM dari Januari 2011 sampai Mei 2018. Dilakukan pulasan FLI1 dan penilaian menggunakan H-score.Hasil: Titik potong H-score pada ekspresi FLI1 didapatkan 226.1 75 dengan sensitivitas 81.6 dan spesifisitas 94.4 . Ekspresi FLI1 tinggi didapatkan pada 31 kasus sarkoma Ewing, sedangkan pada 18 kasus small round cell tumor umumnya memiliki ekspresi FLI1 yang rendah ABSTRACT
Background: Ewing 39;s sarcoma is a small round cell tumor characterized by EWSR1 / FLI1 gene fusion in 85 of cases. Accurate diagnosis is necessary because it has a good response to a specific chemotherapy protocol. The gold standard of Ewing 39;s sarcoma diagnosis is the detection of specific translocation with RT-PCR or FISH, but the examination is not yet available at our institution, so another attempt is made to sharpen the diagnosis. Morphologically, Ewing 39;s sarcoma is often overlapping with other small round cell tumor. CD99 is a very sensitive marker for diagnosing Ewing 39;s sarcoma, but also often overlapping with other small round cell tumors. Several studies have suggested that FLI1 can be used as a marker of Ewing rsquo;s sarcoma. The purpose of this study was to assess the FLI1 expression to help establish the diagnosis of Ewing rsquo;s sarcoma in small round cell tumors that gave CD99 positive results, especially in the biopsy cases. Materials and methods: This was a cross-sectional study with 36 cases of Ewing rsquo;s sarcoma and 18 cases of other small round cell tumor that had been performed CD99 immunohistochemistry at RSCM from January 2011 to May 2018. All cases stained by FLI1 antibody and evaluated using H-score. Results: The H-score cut-off point on FLI1 expression was obtained at 226.1 75 with 81.6 sensitivity and 94.4 specificity. The high FLI1 expression was obtained in 31 cases of Ewing rsquo;s sarcoma, while in 18 cases of small round cell tumor were generally had low expression of FLI1 p