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Hasil Pencarian

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Jeremiah Suryatenggara
Abstrak :
Publikasi terakhir menunjukkan bahwa AFP menyebabkan disfungsi sel dendritik asal monosit MDDC sebagai antigen presenting cell APC . Disfungsi ini memiliki ciri seperti berkurangnya ekspresi beberapa molekul permukaan sel dan sitokin yang berperan penting dalam fungsi sebuah sel dendritik mature mDC . AFP juga, dalam peranannya sebagai faktor sel tumor, meningkatkan toleransi terhadap sel tumor dengan cara menginduksi fungsi regulatori dari sistem imun. Tujuan studi ini adalah untuk mendapatkan gambaran yang lebih jelas lagi tentang efek AFP terhadap DC dalam aktivasi respon imun antitumor dan induksi toleransi imun terhadap tumor. Metode: Sel monosit dikultur dalam medium yang mengandung GM-CSF dan IL-4 dan diinkubasi selama 6 hari agar berdiferensiasi menjadi DC immature imDC . AFP ditambahkan pada kelompok perlakuan di awal kultur. Di hari ke-6, dilakukan pengamatan kontak induksi antara LPS dan imDC dengan LPS binding assay menggunakan flow cytometry. DC mature mDC kemudian diperoleh dengan cara penambahan lipopolysaccharide LPS ke kultur dan inkubasi selama 48 jam. Di hari ke-8 dilakukan pengamatan molekul permukaan DC berdasarkan analisa ekspresi HLA-DR, CD11c, CD40, CD83, CD80, dan CD86 menggunakan flow cytometry. Di hari yang sama, juga dilakukan kuantifikasi sitokin TGF-? pada medium kultur dengan metode ELISA. Sel dendritik selanjutnya dikulturkan bersama dengan PBMC autolog dalam kultur MLR selama 5 hari. Di hari ke-13, proliferasi sel T naive CD4 yang diinduksi oleh DC diamati berdasarkan dilusi Carboxyfluorescein succinimidyl ester CFSE menggunakan flow cytometry. Hasil: Penambahan AFP pada awal kultur MDDC menurunkan jumlah kontak induksi antara LPS dan imDC, menurunkan ekspresi molekul fungsional HLA-DR, CD40, CD80, CD86, dan CD83 pada permukaan mDC, meningkatkan kuantitas sekresi sitokin TGF-? oleh DC, dan menurunkan jumlah proliferasi total sel T CD4 naive yang diinduksi oleh DC. Kesimpulan: AFP mempengaruhi karakteristik dan fungsi kerja DC melalui berbagai cara pada tahap yang berbeda-beda, yang secara garis besarnya menurunkan respon imun tipe efektor dan meningkatkan respon imun tipe regulator. Hal ini diyakini mengakibatkan toleransi terhadap antigen, yang bersifat mendukung survivabilitas sel tumor pada kasus HCC dengan kadar AFP tinggi. ...... Recent publications showed that AFP causes the dysfunction of monocyte derived dendritic cell MDDC as in its role as antigen presenting cell APC . This dysfunction is characterized by the lack of expression of several stimulator molecules and cytokines that play important roles in the function of mature dendritic cells mDC . AFP also, in its role as a tumor factor, promotes tolerance towards tumor cells by inducing regulatory functions of the immune system. The purpose of this study is to obtain a clearer picture regarding effects of AFP in the stimulation of antitumor immune response and the induction of immune tolerance towards tumor. Methods Monocytes was cultured in medium contains GM CSF 800 ng ml and IL 4 1000 ng ml and incubated for six days to generate immature DC imDC . AFP was added into the treatment group at the beginning of the culture. On the 6th day, induction contact between LPS and imDC was observed with LPS binding assay by flow cytometry. Mature DC mDC was generated by addition of lipopolysaccharide LPS into the culture and incubation for another 48 hours. On the 8th day, DC surface markers was observed based on the expression of HLA DR, CD11c, CD40, CD83, CD80, and CD86 by flow cytometry. On the same day, cytokine TGF in the medium was also quantified by ELISA method. Dendritic cells are then combined with autologous PBMC in MLR culture for 5 days. On the 13th day, the proliferation of DC induced naive CD4 T cells was observed based on CFSE dilution by flow cytometry. Results Addition of AFP in early MDDC culture decreases the induction contact between LPS and imDC, decreases the expressions of functional molecules HLADR, CD40, CD80, CD86, and CD83 on mDC surface, increases the quantity of cytokine TGF secretion by DC, and decreases the total proliferation of DC induced naive CD4 T cells. Conclusion AFP alters characteristics and functions of DC through various ways and within different phases, which decreases the effector immune responses and increases the regulatory immune response in overall. This allegedly leads to tolerance towards antigens and is supportive towards the survivability of tumor cells in cases of HCC patients showing high level of AFP.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013
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UI - Tesis Membership  Universitas Indonesia Library
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Abdurrahman Hadi
Abstrak :
Latar Belakang: Tumor sel germinal mediastinum merupakan kelompok neoplasma gonad yang sensitif terhadap kemoterapi, namun agresif dan memiliki prognosis buruk. Penegakkan diagnosis dini yang tepat adalah hal yang penting dan salah satunya adalah dengan penilaian penanda tumor alpha fetoprotein (AFP) dan beta human chorionic gonadotropin (ßHCG). Metode: penelitian ini dilakukan dengan desain uji diagnostik dengan pendekatan potong lintang terhadap pasien tumor sel germinal nonseminoma mediastinum di RSUP Persahabatan sejak Januari 2015 hingga Desember 2022 dengan mengukur kadar Alfa Fetoprotein dan Human Chorionic Gonadotropin serum dan dilakukan pemeriksaan histopatologi. Analisis data dilakukan untuk menguji sensitivitas, spesifisitas, nilai duga positif, nilai duga negatif, akurasi diagnostik, dan analisis kurva receiver operating characteristic (ROC). Hasil: Dari total 362 subjek yang memenuhi kriteria inklusi, dari kedua penanda tumor AFP dan ßHCG didapatkansensitivitas 90,77% (IK 95% 80,98% - 96,54%), spesifisitas 97,98% (IK 95% 95,65% - 99,26%), nilai duga positif 90,77% (IK 95% 81,61% - 95,61%), nilai duga negatif 97,98% (IK 95% 95,77% - 99,05%), rasio kekerapan positif 45,4 (IK 95% 20,27 – 99,58), rasio kekerapan negatif 0,09 (IK 95% 0,04 – 0,2), serta nilai akurasi diagnostik sebesar 96,69% (IK 95% 94,28% - 98,28%). Kesimpulan: Pemeriksaan kadar Alfa fetoprotein dan ßhuman chorionic gonadotropin memiliki akurasi 96,69%, sensitivitas 90,77% spesifisitas 97,98%, nilai duga positif 90,77%, nilai duga negatif = 97,98% dalam penegakkan diagnosis tumor sel germinal nonseminoma mediastinum ......Background: Mediastinal germ cell tumors are a group of gonadal neoplasms that are sensitive to chemotherapy, but very aggressive and have poor prognosis. Early and correct diagnosis is important, one of them is by measuring tumor markers in serum: alpha-fetoprotein (AFP) and beta human chorionic gonadotropin (βHCG). Method: This study was conducted with a diagnostic test with a cross sectional approach design on patients with mediastinal germ cell tumors at RSUP Persahabatan from January 2015 to December 2022, and also assessment of tumor markers alpha-fetoprotein (AFP) and beta human chorionic gonadotropin (βHCG) serum and histopathology examination. Data analysis was carried out to find the sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and receiver operating characteristic (ROC) Results: Of a total of 362 eligible subjects, the sensitivity was 90.77% (95% CI 80.98% - 96.54%), the specificity was 97.98% (95% CI 95.65% - 99.26%), the positive predictive value was 90.77% (95% CI 81.61% - 95.61%), the negative predictive value was 97.98% (95% CI 95.77% - 99.05%), the positive likelihood ratio was 45.4 (95% CI 20.27 - 99.58), the negative likelihood ratio was 0.09 (95% CI 0.04 - 0.2), and the diagnostic accuracy was 96.69% (95% CI 94.28% - 98.28%). Conclusion: the sensitivity was 90.77%, the specificity was 97.98%, the positive predictive value was 90.77%, the negative predictive value was 97.98%, and the diagnostic accuracy was 96.69%.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Tesis Membership  Universitas Indonesia Library
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Ani Retno Prijanti
Abstrak :
ABSTRAK Ruang lingkup dan cara penelitian: Telah dilakukan penelitian induksi kanker hati tikus dengan aflatoksin B1. Penelitian ini ingin melihat apakah asam sialat meningkat lebih dini dari AFP pada induksi kanker hati tersebut. 50 ekor tikus perlakuan diinduksi dengan intubasi lambung 42 x 20 ug aflatoksin B1 Sebagai kontrol, 50 ekor tikus diintubasi dengan sejumlah sama akuades. Pengamatan dilakukan dengan mengambil plasma dan jaringan hati setiap bulan selama 10 bulan pemeliharaan. Pada contoh uji dilakukan pengukuran kadar asam sialat, deteksi AFP plasma dan pengamatan histopatologis jaringan hati. Pengukuran kadar asam sialat dilakukan dengan cara spektrofotometri, sedangkan deteksi AFP dengan cara ELISA. Pengukuran AFP dengan teknik ELISA memerlukan antigen AFP dan antibodi anti AFP tikus, yang ternyata tidak tersedia dipasaran. Antibodi anti AFP dibuat dengan imunisasi kelinci menggunakan protein amnion. Setelah imunisasi ke 3 titer antibodi sebesar 1280, setelah imunisasi ke 5 sebesar 2560. Purifikasi antibodi dilakukan dengan kolom imunoafinitas AminoLink. Purifikasi AFP dari amnion dilakukan dengan kolom afinitas Cibacron Blue. Uji statistik yang dipakai untuk analisis hasil adalah analisis Marian dua arah, dengan batas kemaknaan p<0,05. Hasil dan kesimpulan: Hasil penelitian menunjukkan bahwa kadar asam sialat plasma kelompok tikus perlakuan berbeda bermakna dengan kelompok kontrol sejak bulan pertama (p<0,05). Deteksi AFP menunjukkan peningkatan AFP pada kelompok tikus perlakuan dan tidak pada kelompok tikus kontrol sejak bulan pertama (p<0,05). Pengamatan histopatologis menunjukkan adanya perubahan yang dapat menuju kearah keganasan. Dengan demikian hasil pengamatan petanda tumor pada tikus yang diinduksi kanker hati menunjukkan bahwa baik kadar AFP maupun asam sialat meningkat pada waktu dini, satu bulan setelah induksi dengan aflatoksin B1 .
ABSTRACT Determination of The Earliness of Rat Plasma α-Fetoprotein (AFP) and Sialic Acid Levels as Tumor Markers in the Process of Liver Carcinogenesis Induction By Aflatoxin B1 (AFB1) Scope and method of study: An experimental study of aflatoxin B1 induced liver carcinogenesis has been done. The aim oh this study was to prove the increase of plasma sialic acid level is earlier than the AFP level in liver carcinogenesis. Fifty rats that were treated with daily intubations of 20 gg for a period of 42 days. Fifty control rats were intubated with equal volumes of aquadest. Observation of the plasma and liver tissues were done every month, including measurement of plasma AFP, sialic acid level, and histopatology of the liver tissue. Sialic acid level was done by spectrophotometric technique, and ELISA technique was used for the detection of plasma AFP. The ELISA technique for rat AFP needs rat AFP antigen and antibody anti rat AFP which were not available from chemical suppliers. The antibody anti rat AFP was developed by immunization of rabbits with rat amniotic protein. After the 3rd immunization, rabbit antibody anti rat amniotic titter was 1280, and after the 5th immunization 2560. Antibody purification was done by immunoaffinity chromatography column (AminoLink). Purification of the rat AFP from amniotic fluid was done by affinity chromatography column (Cibacron Blue). The result were analyzed by Analysis of varians, with p<0,05. Results and conclusions: The results showed that the plasma sialic acid level of rats treated with aflatoxin B1 were significantly different from that of the control rats, p<0,05. Besides, plasma AFP was detected in the treated rats, but not in the control rats, from the first month. The histopathologic observation of the treated rat livers showed that there were changes that could lead to neoplastic livers. Both plasma and sialic acid levels were seen early, starting from the first month after induction of carcinogen by aflatoxin B1.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 1997
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UI - Tesis Membership  Universitas Indonesia Library
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Missy Savira
Abstrak :
ABSTRAK
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Karsinoma hepatoseluler (KHS) merupakan karsinoma primer tersering pada sel hati. Sebagian besar KHS disebabkan oleh virus hepatitis B (VHB) dan virus hepatitis C (VHC) yang memiliki patogenesis yang berbeda dalam menyebabkan KHS. Alfa-fetoprotein (AFP) sebagai penanda tumor pada KHS dan dipengaruhi oleh berbagai faktor, salah satunya status infeksi. Berbagai penelitian sudah dilakukan untuk mengetahui pengaruh pengaruh jenis virus penyebab KHS dengan kadar AFP namun hasilnya sangat beragam. Berdasarkan hal tersebut dan ditambah dengan belum adanya penelitian serupa yang menggunakan data pasien di Indonesia maka penelitian ini bertujuan untuk membandingkan kadar AFP pada pasien KHS terkait infeksi VHB terhadap VHC. Penelitian ini dilakukan dengan desain studi potong lintang menggunakan 199 data AFP pasien KHS yang terdiri dari 129 kasus KHS terkait VHB dan 70 kasus KHS terkait VHC. Dari penelitian ini didapatkan sebanyak 97% dan 87.3% pasien KHS terkait VHC dan VHB mengalami peningkatan kadar AFP secara berurutan. Nilai median kadar AFP pada pasien KHS terkait VHB adalah 419 IU/mL sedangkan pada pasien KHS terkait VHC sebesar 400 IU/mL. Perbedaan nilai tersebut memiliki nilai p = 0.97 dalam uji Mann-Whitney U sehingga disimpulan tidak ada perbedaan bermakna pada rerata kadar AFP antara pasien KHS terkait VHB dibanding dengan VHC.


ABSTRACT

Hepatocellular carcinoma (HCC) is the most primary common carcinoma in liver cells. Most HCC are caused by the hepatitis B virus and hepatitis C that have different pathogenesis in causing carcinoma. Alpha-fetoprotein as tumor marker in HCC is influenced by various factors, one of which is infection status. Various studies have been carried out to determine the influence of the types of viruses causing HCC with AFP levels but the results are very diverse. Based on this and coupled with the absence of similar studies using patient data in Indonesia, this study aims to compare AFP levels in HCC patients related to HBV and HCV. Using cross-sectional design, this study included 199 data of AFP in patient with HCC comprises of 129 cases of HCC related to HBV and 70 cases of HCC related to HCV. From this study, it was found that 97% and 87.3% of HCC patients related to HCV and HBV experienced an increase in AFP levels consecutively. The median value of AFP levels in HBV-related HCC patients was 419 IU / mL while in HCV-related HCC patients was 400 IU / mL. The difference in value has a p value = 0.97 in the Mann-Whitney U test thus it is concluded that there is no significant difference in AFP levels between HBV-related HCC patients compared with HCV-related HCC.

Depok: Fakultas Kedokteran Universitas Indonesia, 2018
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UI - Skripsi Membership  Universitas Indonesia Library