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"Telah diketahui bahwa estrogen dan reseptor estrogen sangat berpengaruh pada sistem reproduksi, perkembangan payudara dan pembentukan kanker pada wanita. Namun efek estrogen pada sistem reproduksi pria serta mekanisme estrogen pada terjadinya kanker pada pria, khususnya kanker prosat masih belum jelas. Dari sekumpulan penelitian didapatkan kemungkinan estrogen dan reseptor estrogen berperan pada terjadinya kanker pada pria, terutama kanker prosat Reseptor estrogen dapat ditemukan pada stroma dan sel epitel prostat.

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It is known that estrogen and estrogen receptors have a great influence on the reproductive system, breast development and the formation of cancer in women. However, the effect of estrogen on the male reproductive system and the mechanism of estrogen in the occurrence of cancer in men, especially prostate cancer, is still unclear. From a set of studies, it is possible that estrogen and estrogen receptors play a role in the occurrence of cancer in men, especially prostate cancer Estrogen receptors can be found in the stroma and epithelial cells of the prostate."

"[Pendahuluan: Sejak tahun 70-an hingga sekarang, skor Gleason merupakan parameter penting pada penatalaksanaan kanker prostat. Biopsi prostat yang umum dipakai untuk membedakan antara kondisi jinak dan ganas semakin menjadikan skor Gleason berperan penting dalam menentukan tatalaksana selanjutnya. Meskipun demikian, terdapat diskrepansi antara skor Gleason yang diambil secara biopsi dan paskaoperasi.Tujuan: Untuk menentukan perbedaan skor Gleason sebelum dan setelah dilakukan prostatektomi radikal, dan untuk mencari faktor-faktor yang berperan dalam peningkatan skor Gleason.Metode: Dilakukan evaluasi laporan patologi dari spesimen prostat yang didapatkan secara biopsi dan paska prostatektomi radikal antara Januari 2004 sampai Desember 2013. Kriteria eksklusi dari studi ini adalah laporan-laporan yang tidak mencantumkan skor Gleason ataupun diagnosis selain adenokarsinoma prostat.Hasil: Studi ini menginklusikan 36 subjek dengan adenokarsinoma prostat yang telah menjalani prostatektomi radikal. Skor Gleason 6 merupakan skor tersering yang dilaporkan pada biopsi, sedangkan skor Gleason 7 merupakan skor tersering yang dilaporkan pada spesimen prostatektomi radikal. Diantara subjek, 58,3% (n=21) memiliki perbedaan antara skor Gleason biopsi dan prostatektomi radikal; 11,1% (n=4) memiliki penurunan dan 47,2% (n=17) mengalami peningkatan. Dengan menggunakan analisis statistik dijumpai bahwa rendahnya densitas PSA (PSAD) memiliki korelasi dengan likelihood peningkatan (r=0,658, p=0,006).Kesimpulan: Sebagian besar pasien memiliki perbedaan antara skor Gleason hasil biopsi dan paskaoperasi dimana terlihat kecenderungan peningkatan dibandingkan dengan penurunan skor. PSAD merupakan faktor yang berkorelasi dengan peningkatan skor Gleason., Introduction: Since its introduction in mid 70 until now, Gleason Score is an important parameter in the treatment of prostate cancer. The common practice of prostate biopsy to differentiate between malignant and benign condition of the prostate, hence makes Gleason score plays important role in determine the next step of treatment. Still there is a discrepancy between Gleason score taken from biopsy and postoperatively.Aim: To determine the Gleason score difference before and after radical prostatectomy, and to find factors that has a role in the upgrading of Gleason score.Methods: We evaluated pathology reports of prostate specimens obtained from biopsy and after radical prostatectomy between January 2004 until December 2013. Exclusion criteria of this study were reports that failed to mentioned Gleason score or a diagnosis apart from adenocarcinoma of the prostate.Results: This study enrolled 36 subjects with adenocarcinoma of the prostate who underwent radical prostatectomy. Gleason score 6 was the most reported score in initial biopsy while Gleason score 7 was the most reported in radical prostatectomy specimen. Among the subjects 58.3% (n=21) had diferrences of Gleason score between biopsy and radical proistatectomy; 11.1% (n=4) had a downgrading and 47.2% (n=17) had an upgrading. Using statistical analysis we found out that low prostate specific antigen densities (PSAD) had correlation with upgrading likelihood (r 0.658, p = 0.006)Conclusion: More than half of our patient had differences between biopsy Gleason score and postoperative scores with majority showed a likelihood of upgrading rather than downgrading, PSAD was the factors that correlates with upgrading in Gleason score.]"

"Latar belakang: Adenokarsinoma prostat adalah keganasan tersering kedua yang dialami pria di Indonesia. Skor Gleason digunakan untuk mengklasifikasi tingkat diferensiasi dari tumor sedangkan menghitung kadar PSA digunakan sebagai salah satu cara untuk mendiagnosis kanker prostat.Tujuan: Riset ini bertujuan untuk mengetahui korelasi antara skor Gleason dengan kadar PSA pada pasien adenokarsinoma prostat di departemen Patologi Anatomik RSCM. Metode Penelitian: Data dikumpulkan dari 77 sampel yang didapat dari form pemeriksaan hasil diagnosis pasien adenokarsinoma prostat tahun 2011 sampai 2014 di arsip Department Patologi Anatomik RSCM. Data diolah menggunakan analisis uji korelasi Kendall Tau-b di program SPSS 20.Hasil: Sebagian besar pasien datang dengan skor Gleason yang sudah tinggi skor Gleason >7. Nilai PSA terkecil yang didapat dari arsip departemen Patologi Anatomik sebesar 2,73 ng/ml, nilai tertinggi mencapai 7100 ng/ml. Nilai rata-rata PSA meningkat dengan meningkatnya skor Gleason. Rata-rata nilai PSA dari skor Gleason 6, 7, 8, 9, dan 10 adalah 46,641 ng/ml, 63,935 ng/ml, 231,762 ng/ml, 542,146 ng/ml, and 1044,348 ng/ml p = 0,003, r = 0,254. Kesimpulan: Terdapat korelasi yang lemah antara skor Gleason dengan nilai PSA pada pasien adenokarsinoma prostat di Department Patologi Anatomik RSCM. Nilai PSA meningkat seiring meningkatnya skor Gleason.

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Background: Prostatic adenocarcinoma is the second most frequent malignancies occur in men in Indonesia. Gleason score is used to classify the grading of the tumor and PSA is used as one of diagnostic tools for prostate cancer.

Aim: To identify the correlation between Gleason score and PSA level in patients with prostate adenocarcinoma at Department of Anatomical Pathology Cipto Mangunkusumo Hospital. Method The data was obtained from 77 samples taken from request forms from patients with prostatic adenocarcinoma from 2011 to 2014 in the archive of Department of Anatomical Pathology and analyzed using Kendall Tau b rsquo s Rank Correlation in SPSS 20.

Result: Most patient came with high Gleason Score Gleason score 7 . The minimum PSA level obtained from the arcieve in Department of Anatomical Pathology is 2.73 ng ml and the highest value reached up to 7100 ng ml. The average PSA level increased with the Gleason score. Gleason score 6, 7, 8, 9, and 10 has the average PSA level of 46.641 ng ml, 63.935 ng ml, 231.762 ng ml, 542.146 ng ml, and 1044.348 ng ml respectively p 0.003, r 0.254.

Conclusion: There is statistically weak significant correlation between Gleason score and PSA level in patients with prostatic adenocarcinoma in Department of Anatomical Pathology Cipto Mangunkusumo Hospital. PSA increased as the Gleason score increase."

"Latar belakang: Kanker prostat merupakan tumor ganas terbanyak ketiga pria di dunia. Penyebabnya dipengaruhi faktor usia, genetik, ras, hormonal, diet dan lingkungan. Kanker prostat dapat mengalami Neuroendocrine Differentiation NED , meningkat pada kanker prostat berdiferensiasi buruk terutama yang tidak merespon baik terhadap terapi hormonal. NED akan menentukan prognosis dan pemilihan alternatif terapi.Tujuan: Mengetahui perbedaan ekspresi Chromogranin A CgA pada adenokarsinoma prostat berdiferensiasi baik, sedang dan buruk serta kaitannya dengan derajat keganasan berdasarkan grading tumor yang diharapkan dapat menentukan prognosis dan pemilihan alternatif terapi.Metode: Studi potong lintang terhadap jaringan biopsi yang difiksasi formalin, diletakkan dalam parafin dari pasien dengan adenokarsinoma prostat berdiferensiasi baik, sedang dan buruk. Sampel penelitian dipulas dengan pewarnaan imunohistokimia CgA, diidentifikasi dan dianalisa hubungan ekspresi CgA berdasarkan usia, diagnosis histopatologik, grade groups, skor Gleason dan kadar PSA.Hasil: Ekspresi CgA positif dengan median 40 0,4-100 banyak terjadi pada kelompok usia 7. Ekspresi CgA positif dengan median 35,4 0,4-88,6 banyak terjadi dengan kadar PSA > 52,4 ?g/ml. Didapatkan hubungan bermakna antara ekspresi CgA dengan diagnosis histopatologik, grade groups dan skor Gleason p = 0, 006;p = 0,021;p = 0,006 . Tidak didapatkan hubungan bermakna antara ekspresi CgA dengan usia dan kadar PSA p = 0,412;p = 0.969 . Kesimpulan: Terdapat kecenderungan positivitas ekspresi CgA lebih banyak terjadi pada kasus adenokarsinoma prostat berdiferensiasi buruk dengan grade tinggi, yang dapat mempengaruhi prognosis dan pemilihan alternatif terapi.Kata kunci: Ekspresi Chromogranin A, adenokarsinoma prostat, grade groups, skor Gleason.

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Background Prostate cancer is the third most common malignant tumor in men worldwide. Predisposing factors of prostate cancer are influenced by age, genetics, race, hormonal, diet and environment. Prostate cancer may undergo Neuroendocrine Differentiation NED , and it found to be increase in poorly differentiated type of prostate cancer, especially who do not respond well to hormonal therapy. NED will determine the prognosis and selection of therapeutic alternatives.Objective To determine differences in expression of Chromogranin A CgA in prostate adenocarcinoma well, moderately and poor differentiated and its relationship to the tumour grading, and its effect on determining prognosis and selecting therapeutic alternatives.Methods A cross sectional study conducted to formalin fixed paraffin embedded biopsy tissue that are taken from a patient with prostate adenocarcinoma well, moderately and poor differentiated. The sample are immunohistochemical stained with CgA, identified and analyzed. The reviewed and analized it rsquo s relationship to the parameter on age, histopathological diagnosis, grade groups, Gleason score and PSA level.Results Chromogranin A positive expression with median 40 0.4 100 was found in the age 7 of prostate adenocarcinoma. CgA positive expression with median 35.4 0.4 88, 6 was found with PSA level 52.4 g ml. There were a significant difference between CgA expression with histopathological diagnosis, grade groups and Gleason score p 0, 006 p 0.021 p 0.006 . There were no significant difference between CgA expression with age and PSA level p 0.412 p 0969 .Conclusion There is a statistically significant difference of CgA expression with histopathologycal diagnosis and grade groups of prostate adenocarcinoma that reflect a worse prognosis in CgA positive group among prostate adenocarcinoma, which will need alternative therapies beside widely used hormonal therapy.Keywords Expression Chromogranin A, prostate adenocarcinoma, grade groups, Gleason score."

"ABSTRAKLatar belakang : Insiden Adenokarsinoma di RSCM meningkat pada periode 2001-2006 dibanding periode sebelumnya 1995-2000 . Banyak penderita yang resisten terhadap pengobaan hormonal. Resistensi ini diduga akibat sel tumor mengalami transformasi Neuroendokrin. Akan dilakukan penelitian untuk melihat ekspresi Androgen Receptor AR dan Chromogranin A CgA pada adenokarsinoma prostat di RSCM tahun 2011-2015.Tujuan : Membuktikan korelasi ekspresi AR dan CgA dengan derajat keganasan.Metode : Studi potong lintang analitik terhadap 70 kasus adenokarsinoma prostat di departemen PA FKUI/RSCM tahun 2011-2015. Kasus dipulas imunohistokimia AR dan Cg A serta dilakukan interpretasi hasil. AR dinilai prosentase positivitasnya pada inti epitel dan stromal. CgA dinilai prosentase positivitasnya pada sitoplasma. Uji korelasi dilakukan untuk melihat kemaknaan dan kekuatan korelasi antar variabel terikat.Hasil : Karakteristik sampel usia 47,1 >70 tahun; diferensiasi histopatologik/skor gleason 42,9 buruk/>7, grade group 28,6 grade5 dan PSA 64,3 dalam rentang 11-100ng/ml. Ekspresi CgA berkorelasi negatif lemah dengan ekspresi AR epitel r=-0,288;p=0,016 . Ekspresi CgA tidak berkorelasi dengan ekspresi AR stromal p=0,886 . Terdapat hubungan bermakna ekspresi AR epitel dengan grade group p=0,003 . Tidak terdapat hubungan bermakna ekspresi AR epitel dengan usia, diferensiasi histopatologik/skor gleason dan PSA. Ekspresi CgA berhubungan bermakna dengan diferensiasi histopatologik/skor gleason dan grade group p=0,018;p=0,038 . Tidak terdapat hubungan bermakna ekspresi CgA dengan usia dan PSA. Ekspresi AR stromal tidak berhubungan bermakna dengan usia, diferensiasi histopatologik, grade group, skor gleason, maupun PSA.Kesimpulan : Terdapat korelasi yang lemah antara AR dan CgA sehingga pulasan AR dan CgA dapat dipakai untuk pemilihan terapi.

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ABSTRACT Background Prevalence of prostate adenocarcinoma doubled in 2001 2006 compared to 1995 2000 in RSCM. Many patients resistant to hormonal treatment. This resistance is thought to be due to tumor cells undergoing neuroendocrine transformation. Study will be conducted to analyze the expression of Androgen Receptor AR and Chromogranin A CgA in prostate adenocarcinoma at RSCM in 2011 2015. Objective To prove correlation of expression of AR and CgA with degree of malignancy. Methods A cross sectional study was carried out on 70 cases of prostate adenocarcinoma in department of Anatomic Pathology FKUI RSCM from 2011 2015. AR expressed in stromal and epithelial nuclei, CgA expressed in cytoplasm. Statistical tests used to discover significance and correlation between the dependent variables. Results Most samples are more than 70 years old 47,1 , has poor histologic gleason score 42.9 , are in clinical grade 5 28.6 , and has PSA score range between 11 100 ng ml. CgA expression negatively correlates to epithelial AR expression r 0,288 p 0.016 , while no correlation are found between CgA expression and stromal AR expression p 0.886 . There is significant difference between epithelial AR expression with grade group p 0.003 , but not with age, histopathologic differentiation Gleason score and PSA. There are significant difference between CgA expression and histopathologic differentiation grade group and Gleason score p 0.018 p 0.038 , but not with age and PSA. No significant difference observed between stromal AR expression with age, histopathologic differentiation gleason score, grade group or PSA. Conclusion There rsquo s a weak correlation between AR and CgA so that AR and CgA expression can be used for the selection of therapy. "