Hasil Pencarian  ::  Simpan CSV :: Kembali

Hasil Pencarian

Ditemukan 9 dokumen yang sesuai dengan query
cover
Shintia Christina
Penilaian respon terapi neoadjuvan pada kanker payudara lanjut lokal dengan sistem Miller-Payne dan penanda apoptosis TUNEL = Pathological response assessment of neoadjuvant chemotherapy in locally advanced breast cancer with MP system and TUNEL
"[ABSTRAK
Latar belakang : Kanker payudara lanjut lokal (KPLL) adalah kanker payudara stadium III.Modalitas terapi KPLL adalah pembedahan, kemoterapi, radioterapi, hormonal terapi dan terapi target. Respon kemoterapi neoadjuvan terdiri dari respon klinis dan respon patologi. Penilaian respon kemoterapi neoadjuvan penting untuk memprediksi angka ketahanan hidup dan dapat menjadi pedoman kemoterapi selanjutnya. Penilaian respon patologi selama ini bersifat kuantitatif dan sering tidak selaras dengan respon klinis. Perubahan jumlah selularitas dapat terlihat, tetapi kualitas sel tumor tersebut tidak dapat diketahui dengan pulasan Haematoxylin-eosin (HE) pada fase awal fragmentasi DNA, sehingga penilaian respon patologi perlu dilakukan secara kuantitatif dan kualitatif yaitu menilai selularitas sel tumor dan persentase apoptosis.
Bahan dan cara : Dilakukan penelitian retrospektif analitik secara potong lintang pada kanker payudara lanjut lokal tahun 2010-2014 di Departemen Patologi Anatomi FKUI/RSCM dan divisi bedah onkologi RSCM. Sampel biopsi dan reseksi dibandingkan untuk mengevaluasi penurunan selularitas, kemudian diklasifikasikan ke derajat Miller- Payne (MP). Sampel reseksi dipulas dengan TUNEL dan dihitung persentase apoptosis. Penurunan selularitas antara biopsi dan mastektomi dengan TUNEL merupakan Modifikasi MP. Hasil : Perubahan respon patologi dengan Modifikasi MP menimbulkan peningkatan derajat pada 24 kasus. Tidak terdapat hubungan antara respon klinis dengan persentase apoptotis (p=0,108), respon klinis dengan MP (p=1,000) dan Modifikasi MP (p=0,655). Tidak didapatkan hubungan dan adanya korelasi yang lemah antara penyusutan massa tumor secara klinis dengan jumlah sel tumor yang mati dengan MP (p=0,177; r =0,212) dan Modifikasi MP (p=0,609; r = 0,081). Terdapat perbedaan signifikan antara jumlah sel mati yang dinilai dengan MP dan Modifikasi MP (p =0,000).
Kesimpulan : Persentase apoptosis tidak berhubungan dengan respon klinis. Modifikasi MP meningkatkan nilai derajat respon patologik, tetapi penilaian Modifikasi MP tetap tidak menunjukkan korelasi dengan respon klinik.ABSTRACT Background: Locally advanced breast cancer (LABC) is a stage III breast cancer. The management of LABC includes surgery, chemotherapy, radiotherapy, hormonal and targeted therapy. Responses to neoadjuvant (before surgery) chemotherapy consist of clinical and pathological responses. Evaluating chemotherapy response is essential to predict survival rate and it may become guidelines for the next chemotherapy in the future. Until now, the evaluation of pathological response only involves quantitative assessment and the clinical responses are often inconsistent with the pathological responses. Morphological changes of apoptotic cells can still be seen. However, the quality of the tumor cells is vague when the cells are stained with Hematoxylin-eosin (HE) during the first stage of DNA fragmentation. The evaluation of pathological responses; therefore, need to be performed by quantitative and qualitative methods, i.e. by evaluating the cellularity of tumor cells and the percentage of apoptosis.
Materials and method: A cross-sectional analytical retrospective study was conducted on the issue of locally advanced breast cancer between 2010 and 2014 at the Department of Anatomical Pathology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital and Division of Surgical Oncology, Cipto Mangunkusumo Hospital. Specimens of biopsy and resection were compared to evaluate reduction in cellularity, which were subsequently categorized into stages of Miller-Payne (MP) classification. The specimens of resection were stained with TUNEL and the percentage of apoptosis was calculated. Reduction in cellularity between biopsy and mastectomy specimens with TUNEL staining is a modified MP methods.
Results: The evaluation of pathological responses using the modified MP method has increased the value of MP grading in 24 cases. We found no association between clinical responses with percentage of apoptosis (p=0,108), MP pathological responses (p=1,000) and modified MP (p=0,655). There is no association and weak correlation between decreasing tumor mass with MP (p=0,177; r=0,212) and modified MP (p=0,609; r=0,081). There was a correlation between the dead cell evaluated by MP and by modified MP. (p=0.000)
Conclusion: Apoptosis percentage does not correlate with clinical responses. Modified MP increases the degree or grading of pathological responses, but it does not improve the correlation with clinical responses., Background: Locally advanced breast cancer (LABC) is a stage III breast cancer. The management of LABC includes surgery, chemotherapy, radiotherapy, hormonal and targeted therapy. Responses to neoadjuvant (before surgery) chemotherapy consist of clinical and pathological responses. Evaluating chemotherapy response is essential to predict survival rate and it may become guidelines for the next chemotherapy in the future. Until now, the evaluation of pathological response only involves quantitative assessment and the clinical responses are often inconsistent with the pathological responses. Morphological changes of apoptotic cells can still be seen. However, the quality of the tumor cells is vague when the cells are stained with Hematoxylin-eosin (HE) during the first stage of DNA fragmentation. The evaluation of pathological responses; therefore, need to be performed by quantitative and qualitative methods, i.e. by evaluating the cellularity of tumor cells and the percentage of apoptosis.
Materials and method: A cross-sectional analytical retrospective study was conducted on the issue of locally advanced breast cancer between 2010 and 2014 at the Department of Anatomical Pathology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital and Division of Surgical Oncology, Cipto Mangunkusumo Hospital. Specimens of biopsy and resection were compared to evaluate reduction in cellularity, which were subsequently categorized into stages of Miller-Payne (MP) classification. The specimens of resection were stained with TUNEL and the percentage of apoptosis was calculated. Reduction in cellularity between biopsy and mastectomy specimens with TUNEL staining is a modified MP methods.
Results: The evaluation of pathological responses using the modified MP method has increased the value of MP grading in 24 cases. We found no association between clinical responses with percentage of apoptosis (p=0,108), MP pathological responses (p=1,000) and modified MP (p=0,655). There is no association and weak correlation between decreasing tumor mass with MP (p=0,177; r=0,212) and modified MP (p=0,609; r=0,081). There was a correlation between the dead cell evaluated by MP and by modified MP. (p=0.000)
Conclusion: Apoptosis percentage does not correlate with clinical responses. Modified MP increases the degree or grading of pathological responses, but it does not improve the correlation with clinical responses.]"
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
Weny Yusnita
Peningkatan akurasi diagnosis fibroadenoma dan tumor filodes jinak payudara pada sediaan core biopsy dengan menggunakan skoring gambaran histopatologik = Increasing diagnostic accuracy of fibroadenoma and benign phyllodes breast tumor in core biopsy using histopathologic scoring system
"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."
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
Harahap, Agnes Stephanie
Reseptor estrogen B sebagai penanda potensi ganas pada atypical ductal hyperplasia payudara = Estrogen receptor B as a potential predictive marker of malignancy in atypical ductal hyperplasia of the breast
"Latar belakang. Reseptor estrogen β (RE β) dapat berperan dalam progresi kanker payudara sesuai teori karsinogenesis multistep. Reseptor estrogen β berperan sebagai supresor tumor dan ekspresinya menurun seiring progresifitas tumor. Atypical ductal hyperplasia (ADH) adalah lesi proliferatif intraduktal payudara yang memiliki risiko 4-5 kali menjadi karsinoma payudara. Diperlukan penanda prediktif ADH yang dapat menjadi karsinoma atau tidak. Tujuan penelitian ini adalah untuk mengetahui penanda potensi ganas pada lesi ADH melalui ekspresi RE β.
Bahan dan cara. Penelitian menggunakan metode potong lintang, analitik dan deskriptif. Sampel terdiri atas 24 kasus ADH tanpa karsinoma dan 24 kasus ADH yang disertai karsinoma. Dilakukan pulasan RE β dan penilaian dilakukan menggunakan H score.
Hasil. H score RE β pada ADH yang disertai karsinoma lebih rendah secara bermakna dibandingkan ADH tanpa karsinoma (p 0,006). RE β dinyatakan tinggi bila H score ≥ 229,2.
Kesimpulan. REβ potensial dijadikan penanda prediktif ADH yang akan menjadi karsinoma.
Background. Estrogen receptor β (ER β) have a role in breast cancer progression through multistep carcinogenesis. ER β is a tumor supressor and its expression decreases during the tumor progression. Atypical ductal hyperplasia (ADH) is an intraductal proliferative lesion of the breast and has 4-5 times of a risk in becoming a carcinoma. The aim of this study is to obtain a marker that can predict malignant potential in ADH through expression of ER β.
Patients and methods. This is a descriptive-analytic cross-sectional study using 24 cases of ADH without carcinoma and 24 cases of ADH with carcinoma. Estrogen receptor β status were assessed by immunohistochemistry and the H score was calculated.
Results. Estrogen receptor β H score in ADH with carcinoma is significantly lower than ADH without carcinoma (p 0,006). ER β is catagorized as high if the H score ≥ 229,2.
Conclusion. ER β can potentialy be used as a malignant predictive marker in ADH."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2012
T33083
UI - Tesis Membership  Universitas Indonesia Library
cover
Indri Windarti
Hubungan ekspresi Topoisomerase IIa pada Diffuse Large B Cell Lymphoma dengan respon terapi = The relation between Topoisomerase IIa expression in Diffuse Large B Cell Lymphoma with treatment response / Indri Windarti
"ABSTRAK
Latar belakang: Kemoterapi pilihan untuk Diffuse Large B Cell Lymphoma (DLBCL) adalah regimen yang mengandung doksorubisin. Doksorubisin merupakan obat kemoterapi golongan antrasiklin yang bekerja sebagai anti Topoisomerase II (Top2). Penelitian sebelumnya terhadap galur sel tumor menunjukkan bahwa ekspresi Topoisomerase IIα (Top2A) yang tinggi berhubungan dengan sensitifitas terhadap antrasiklin yang tinggi pula. Tujuan penelitian ini adalah untuk mengetahui ekspresi protein Top2A pada DLBCL dan hubungannya dengan respon terapi.
Bahan dan cara kerja: Dilakukan studi analitik potong lintang terhadap 38 kasus DLBCL dengan pulasan CD20 positif dan telah mendapatkan kemoterapi minimal 4 siklus. Dilakukan pulasan imunohistokimia terhadap protein Top2A dan dinilai menggunakan H-score.
Hasil: Secara keseluruhan ekspresi Top2A ditemukan pada 37 dari 38 kasus (97,4%) dengan nilai H-score sangat bervariasi yaitu antara 101,5 sampai dengan 215,0 dan median 124,1. H-score Top2A digolongkan tinggi jika H-score lebih dari 124,1. Analisis statistik menunjukkan bahwa ekspresi Top2A pada DLBCL tidak berhubungan bermakna dengan respon terapi (p=0,670).
Kesimpulan: Tidak ditemukan hubungan bermakna antara ekspresi Top2A dengan respon terapi. Ekspresi Top2A tidak dapat dijadikan faktor prediktor respon terapi pada DLBCL.
ABSTRACT
Background: Standard of chemotherapy for Diffuse Large B Cell Lymphoma (DLBCL) is a regimen containing doxorubicin. Doxorubicin is a component of anthracycline based chemotherapy that work as anti Topoisomerase II (Top2). Previous study on tumor cell lines showed that high expression of Topoisomerase IIα (Top2A) was related to higher sensitivity to anthracycline. The aim of this study is to know the expression of Top2A and its relation to treatment response.
Material and methods: This is an analytic cross-sectional study on 38 CD20 positive DLBCL cases that have been treated with at least 4 cycles of chemotherapy. The immunohistochemical staining for Top2A protein was performed assesed using H-score.
Result: Expression of Top2A protein were found in 37 of 38 (97,4%) cases (H-score range: 101.5-215.0 and median 124.1). Top2A was defined as high if H-score was higher than 124.1. Statistical analysis showed that Top2A expression in DLBCL was not significantly related to treatment response (p=0.670).
Conclusion : There was no significant relation between Top2A expression to treatment response. Top2A expression in DLBCL cannot be used as a predictor of treatment response."
2012
T32509
UI - Tesis Membership  Universitas Indonesia Library
cover
Erwina Muhadi
Penilaian indeks apoptosis untuk mempertajam diagnosis karsinoma medular payudara pada sediaan eksisi/mastektomi dan simulasi core biopsy = Apoptotic index to improve diagnostic accuracy in medullary breast carcinoma in excision mastectomy and core biopsy simulation
"ABSTRAK
Latar belakang. Karsinoma medular sulit dibedakan secara histopatologik dan imunohistokimia dengan karsinoma invasif NST dengan gambaran medular derajat 3, karena beberapa gambaran yang tumpang tindih. Pembedaannya sangat penting terkait perbedaan tatalaksana dan prognosis. Karsinoma invasif NST dengan gambaran medular derajat 3 dianggap varian dari karsinoma invasif NST derajat 3, sehingga dapat mewakilinya. Karsinoma medular menunjukkan indeks apoptosis yang lebih tinggi dibandingkan karsinoma invasif NST derajat 3. Tujuan penelitian ini adalah mengetahui apakah indeks apoptosis dapat digunakan untuk mempertajam diagnosis karsinoma payudara medular secara obyektif menggunakan indeks apoptosis. Bahan dan Cara. Dilakukan penelitian retrospektif observasional analitik secara potong lintang terhadap 20 kasus karsinoma medular dan 20 kasus karsinoma invasif NST derajat 3. Dilakukan penilaian indeks apoptosis dengan metode TUNEL (terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate in situ nick endlabeling); selanjutnya membandingkan nilai keduanya dan menghitung titik potongnya. Dari titik potong yang didapat, selanjutnya dibandingkan indeks apoptosisnya pada sediaan simulasi core biopsy dan sediaan mastektomi/eksisinya pada kedua kasus. Hasil. Indeks apoptosis (IA) pada karsinoma medular lebih tinggi secara bermakna dibandingkan karsinoma invasif NST derajat 3 ( p 0,001). Berdasarkan kurva ROC, kami mendapatkan titik potong yang optimal pada IA 1.25. Uji kappa terhadap keselarasan sediaan core biopsy dan eksisi/mastektomi mendapatkan hasil 0,3. Kesimpulan. IA dapat digunakan untuk mempertajam diagnosis karsinoma meduler payudara pada sediaan eksisi/mastektomi. Didapatkan titik potong IA: dinyatakan ´medular´ apabila lebih besar/ sama dengan 1,25. IA potensial dapat membantu pada sediaan core biopsy jika >1.25 pada gambaran histopatologik yang memenuhi sebagian kriteria karsinoma medular.
ABSTRACT
Background. Difficulties are often faced to differentiate between medullary breast carcinoma and invasive carcinoma of no special type with medullary features grade 3, due to morphology and immunohistochemistry overlapping features. It is important to differentiate between them due to differences in the treatment and prognosis . Invasive carcinoma NST with medullary features grade 3 is considered a variant of invasive carcinoma NST grade 3 so it can represent it. Some study showed that apoptotic index in medullary breast carcinoma is higher than invasive carcinoma of no special type grade 3. The aim of this study is to investigate whether apoptotic index can be more definitive in diagnosing medullary breast carcinoma. Patients and methods. This is a retrospective-analytic cross-sectional study using 20 cases of medullary breast carcinoma and 20 cases of invasive carcinoma of no special type grade 3. Apoptotic cell were assessed by TUNEL and the apoptotic index (AI) was calculated. Results. AI in medullary breast carcinoma is significantly higher than invasive carcinoma of no special type grade 3 (p 0,001). The cut off point of AI between medullary carcinoma and invasive carcinoma NST grade 3 is 1.25. Kappa test was done to determine the concordance between core biopsy simulation AI with the related excision/mastectomy and the result is 0,3. Conclusion. The AI can be used to improve diagnostic accuracy of medullary breast carcinoma in excision/mastectomy. The cut off point of the apoptotic index between medullary carcinoma and invasive carcinoma NST grade 3 is 1.25. Only if AI >1.25 can potentially be used to support the diagnosis of medullary carcinoma in core biopsy in case showing some of the medullary carcinoma morphologic criteria."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013
T58559
UI - Tesis Membership  Universitas Indonesia Library
cover
Erna Kristiani
Imunoekspresi braf V600E pada karsinoma papiler tiroid dan hubungannya dengan faktor-faktor prognostik serta varian histopatologik = Braf V600E immunoexpression in thyroid papillary carcinoma and its association with prognostic factors and histopathologic variants / Erna Kristiani
"[ABSTRAK
Latar Belakang: Karsinoma papiler tiroid (KPT) merupakan keganasan tersering
organ endokrin dengan prognosis yang sangat baik, namun pada beberapa kasus
dapat terjadi rekurensi dan mortalitas. Beberapa faktor prognostik dan mutasi Btype
rapidly accelerated fibrosarcoma V600E (BRAF V600E) dikatakan
berhubungan dengan prognosis yang lebih buruk. Pemeriksaan imunohistokimia
protein BRAF V600E dipercaya dapat mendeteksi adanya mutasi dengan
spesifisitas 100% dan sensitivitas 89%. Tujuan penelitian ini untuk mengetahui
imunoekspresi BRAF V600E dan hubungannya dengan faktor-faktor prognostik.
Bahan dan Cara: Penelitian dilakukan secara retrospektif, desain deskriptif
analitik studi potong lintang. Sampel penelitian berasal dari RSCM berjumlah 50
kasus KPT yang dinilai ulang untuk menentukan faktor-faktor prognostik secara
mikroskopik. Pemeriksaaan mutasi BRAF V600E menggunakan tehnik
imunohistokimia dan penilaian menggunakan H score.
Hasil: Nilai H score ³ 326,5 ditentukan sebagai mutasi BRAF V600E positif dan
< 326,5 sebagai mutasi BRAF V600E negatif. Terdapat 17 (34%) kasus positif
mengalami mutasi BRAF V600E. Rerata usia pada kasus dengan mutasi BRAF V600E
positif adalah 44,71 tahun. Ukuran tumor pada kasus dengan mutasi BRAF V600E positif
berkisar antara 0,1-4cm. Tujuh belas kasus yang mengalami mutasi, 6 dlaki-laki dan 11
perempuan. Tujuh kasus dengan perluasan keluar tiroid, 11 kasus dengan metastasis
kelenjar getah bening (KGB), dan 8 kasus dengan varian histopatologik tall cell.
Kesimpulan: Terdapat hubungan bermakna antara mutasi BRAF V600E dengan
perluasan keluar tiroid, metastasis kelenjar getah bening (KGB), dan varian
histopatologik tall cell. Tidak terdapat hubungan bermakna antara mutasi BRAF
V600E dengan usia, jenis kelamin, dan ukuran tumor.
ABSTRACT
Backgroud: Papillary Thyroid Carcinoma (PTC) is the most common malignant
neoplasm of the endocrine organ with an excellent prognosis, but in some cases
present with recurrency and mortality. There are prognostic factors and BRAF
V600E mutation that related to worse prognosis. Immunohistochemical
investigetion of BRAF V600E protein believe can detect mutation wth 100%
specificity and 89% sensitivity. Recent study suggest PTC with BRAF V600E
mutation do thyroidectomy with prophylactic lymph node dissection. BRAF
V600E specific inhibitor effective to the patient with advance stadium, patient
with metastases, and resistant to iodium radioactive. Aim of this study is to obtain
BRAF V600E and the relation with prognostic factors.
Material and Methods: This is a retrospective descriptive-analytic crosssectional
study. Fifty patient with PTC comes from Ciptomangunkusumo Hospital
and reviewed to determine prognostic factors microscopicaly. BRAF V600E
mutation detected by immunohistochemical staining and assesed with H score.
Result: H score ³ 326,5 determined as positive BRAF V600E mutation and <
326,5 as negative BRAF V600E mutation. BRAF V600E mutation was detected
in 17 (34%) cases by immunohistochemistry. The mean age of the cases with
positive BRAF V600E mutation was 44.71 years, while the negative 41.58. The
size of the tumor in cases with BRAF V600E mutation positive range between
0,1-4cm, while negative 0,1-9cm. Seventeen cases have mutations, 6 of them sex
male and 11 female. Seven cases with extrathyroidal extension (ETE), 11 cases
with lymph node metastasis (KGB), and 8 cases with tall cell variant.
Conclusion: There are significant correlation between BRAF V600E mutation
with extrathyroidal extension, lymph node metastases, and tall cell variant. There
are no significant correlation between BRAF V600E mutation with age, gender,
and size of the tumor, Backgroud: Papillary Thyroid Carcinoma (PTC) is the most common malignant
neoplasm of the endocrine organ with an excellent prognosis, but in some cases
present with recurrency and mortality. There are prognostic factors and BRAF
V600E mutation that related to worse prognosis. Immunohistochemical
investigetion of BRAF V600E protein believe can detect mutation wth 100%
specificity and 89% sensitivity. Recent study suggest PTC with BRAF V600E
mutation do thyroidectomy with prophylactic lymph node dissection. BRAF
V600E specific inhibitor effective to the patient with advance stadium, patient
with metastases, and resistant to iodium radioactive. Aim of this study is to obtain
BRAF V600E and the relation with prognostic factors.
Material and Methods: This is a retrospective descriptive-analytic crosssectional
study. Fifty patient with PTC comes from Ciptomangunkusumo Hospital
and reviewed to determine prognostic factors microscopicaly. BRAF V600E
mutation detected by immunohistochemical staining and assesed with H score.
Result: H score ³ 326,5 determined as positive BRAF V600E mutation and <
326,5 as negative BRAF V600E mutation. BRAF V600E mutation was detected
in 17 (34%) cases by immunohistochemistry. The mean age of the cases with
positive BRAF V600E mutation was 44.71 years, while the negative 41.58. The
size of the tumor in cases with BRAF V600E mutation positive range between
0,1-4cm, while negative 0,1-9cm. Seventeen cases have mutations, 6 of them sex
male and 11 female. Seven cases with extrathyroidal extension (ETE), 11 cases
with lymph node metastasis (KGB), and 8 cases with tall cell variant.
Conclusion: There are significant correlation between BRAF V600E mutation
with extrathyroidal extension, lymph node metastases, and tall cell variant. There
are no significant correlation between BRAF V600E mutation with age, gender,
and size of the tumor]"
2015
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Indah Widya Lestari
Ekspresi Ezh2 secara imunohistokimia sebagai penanda potensi ganas pada columnar cell lesion payudara = Ezh2 imunohistochemistry expression as a marker of malignant potential in breast columnar cell lesion
"ABSTRAK
Latar belakang: Enhancer of Zeste homolog 2 (EZH2) merupakan kelompok protein grup polycomb yang berperan penting dalam regulasi epigenetik dan berkaitan erat dengan tumorigenesis. EZH2 ekspresinya meningkat pada kanker payudara. Peningkatan ekspresi EZH2 dapat memprediksi peningkatan risiko keganasan. Columnar cell lesion (CCL) merupakan lesi proliferatif, sering ditemukan seiring dengan meningkatnya deteksi dini kanker payudara dengan mammografi. Lesi ini terbagi atas columnar cell change (CCC), columnar cell hyperplasia (CCH), flat epithelial atypia (FEA). CCL menjadi penting setelah dikaitkan dengan risiko menjadi karsinoma payudara, serta hubungannya dengan lesi jinak dan lesi ganas payudara lainnya. Penanda prediktif CCL dibutuhkan untuk memilah CCL yang berpotensi menjadi ganas, sehingga dapat digunakan untuk deteksi dini kanker payudara kelak. Bahan dan cara: Penelitian ini menggunakan metode potong lintang, deskriptif dan analitik. Sampel terdiri atas masing-masing 25 kasus CCL tanpa karsinoma dan CCL dengan karsinoma. Dilakukan pulasan EZH2 secara imunohistokimia dan penilaian dilakukan menggunakan H score dengan modifikasi oleh dua pengamat secara independen. Hasil: Hasil penilaian dua pengamat menyimpulkan nilai tidak ada perbedaan bermakna antar pengamat (p 0,655). Median H score EZH2 pada CCL tanpa karsinoma lebih tinggi secara bermakna (p 0,002) dibandingkan EZH2 dengan karsinoma, dinyatakan tinggi bila H score ≥ 100,16 (dengan sensitivitas 40,00). Kecenderungan sebaran median H score EZH2 didapatkan lebih tinggi pada FEA dengan nilai H score 119,03, diikuti CCH sebesar 103,63 dan CCC sebesar 100,07. Median H score EZH2 pada FEA tanpa karsinoma lebih tinggi (218,26) daripada CCL dengan karsinoma (101,53). Kesimpulan: Ekspresi EZH2 pada CCL tanpa karsinoma lebih tinggi dibandingkan CCL dengan karsinoma, terdapat kecenderungan ekspresi EZH2 yang lebih tinggi pada FEA dibandingkan CCH dan CCC pada semua kasus dan masing-masing kedua kelompok. Ekspresi EZH2 pada FEA tanpa karsinoma lebih tinggi dibandingkan FEA dengan karsinoma. EZH2 diduga berperan dalam karsinogenesis CCL yaitu terutama pada tahap transformasi.
ABSTRACT
Background: Enhancer of Zeste homolog 2 (EZH2) is a group of polycomb which has an important role in epigenetic regulation and is related to tumorigenesis. The expression of EZH2 is increasing in breast cancer. Overexpression of EZH2 can predict the risk of malignant. Columnar cell lesion (CCL) is a proliferatif lesion, and it is increasingly found with the increasing breast screening by mammography. This lesion divided consisted of columnar cell change (CCC), columnar cell hyperplasia (CCH), flat epithelial atypia (FEA). CCL become important related to the risk for carcinoma, and the relation with others benign lesion and maligna lesion. The predictive sign of CCL needed to assess CCL transformation become malignancy. Methods: This was cross sectional study. The sampling consisted of 25 CCL cases without carcinoma and 25 CCL cases with carcinoma. EZH2 immunostainning was assesed using H score by two independent observers. Result: The H score between two observers showed high concordance (p 0,655). Median EZH2 H score in CCL without carcinoma is significantly higher (p 0,002) than CCL with carcinoma, is high if H score ≥ 100,16 (with sensitivity 40,00). Inclination distribution of median H score EZH2 resulted higher in FEA with H score 119,03, followed by CCH 103,63 and CCC 100,07. Median EZH2 H score in FEA without carcinoma (218,26) higher than CCL with carcinoma (101,53). Conclusion: The expression of EZH2 in CCL without carcinoma is higher than CCL with carcinoma, and it shows higher tendency of EZH2 expression in FEA compared by CCH and CCC in all cases and in each group. The expression of EZH2 in FEA without carcinoma is higher than FEA with carcinoma. Hence EZH2 is predicted has a role in malignant transformation and the carcinogenesis of CCL."
2016
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Indira Kalyana Makes
Dampak pembaharuan nilai cut-off pada klasifikasi molekuler kanker payudara: pengalaman RSCM dari kasus-kasus 2014 = The impact of new cut off values in breast cancer molecular classification RSCM experience from 2014 cases
" ABSTRAK
Latar Belakang: Kanker payudara invasif adalah tipe penyakit kanker yang paling sering ditemui pada wanita, dan juga penyebab kematian yang cukup tinggi. Adanya perubahan dalam nilai ambang positiftas reseptor hormone dan HER2 pada kanker payudara invasif akan mendatangkan perubahan dalam profil molekuler, yang mungkin mempunyai makna klinis. Tujuan: Penelitian ini dilakukan untuk melihat perubahan dalam profil molekuler berdasarkan perubahan dalam nilai ambang untuk Estrogen Receptor ER , Progesterone Receptor PR , dan Human Epidermal Growth Factor 2 HER2 , pada kasus kanker payudara invasif di RSCM pada tahun 2014, dan juga untuk mengevaluasi perubahan dalam fitur klinikopatologis. Metode: Penelitian ini dilakukan menggunakan 94 sampel, diambil dengan metode systematic random sampling dari semua kasus kanker payudara invasif di RSCM pada tahun 2014. Sampel mencakup rekam medis serta spesimen biopsi, yang digunakan untuk mengklasifikasi kasus-kasus secara molekuler.Hasil: Kedua klasifikasi baru dan lama menghasilkan pola yang mirip, yaitu subtipe Luminal A yang paling banyak ditemukan, sementara subtipe HER2 yang paling sedikit ditemukan. Reklasifikasi juga menghasilkan penurunan jumlah kasus tripel negatif, namun tidak mengubah profil klinikopatologis semua subtipe molekuler. Kata kunci: kanker payudara, klasifikasi molekuler, ER, PR, HER2.
ABSTRACT
Background Invasive breast carcinoma is the most common type cancer found in women, and is also the leading cause of death in women. Recent changes in cut off values of invasive breast carcinoma molecular classification will result in changes in the molecular profile, which may have clinically significant.Aim This study was conducted to observe the changes in the molecular profile based on the changes in cut off values of Estrogen Receptor ER , Progesterone Receptor PR and Human Epidermal Growth Factor 2 HER2 , among invasive breast carcinoma cases in RSCM in the year 2014, as well as to evaluate the changes in the corresponding clinicopathologic features. Method This study uses 94 samples, which is obtained through consecutive random sampling from all of the invasive breast carcinoma cases in RSCM in 2014. The samples consist of medical record and specimen biopsy, in which old and new classifications are made based on the corresponding cut off values.Results Both old and new classification yielded a very similar trend of number of cases, in which Luminal A makes up the most of the cases and HER2 cases makes up the least number of cases. The reclassification, however, causes a decrease in the number of triple negative cases, although the clinicopathologic profile of all molecular subtypes did not have any significant changes. Keywords breast cancer, molecular classification, ER, PR, HER2 "
2015
S-Pdf
UI - Skripsi Membership  Universitas Indonesia Library
cover
Sitti Fatimah Hanum
Perbedaan ekspresi c-myc dan epstein-barr virus ebv antara diffuse large b-cell lymphoma subtipe germinal center b-cell like dan non-germinal center b-cell like. = The Difference of c myc and epstein barr virus ebv between expression germinal centerb-cell lymphoma subtipe germinal center b-cell like and non-germinal center b-cell like
"ABSTRAK
Latar belakang: Diffuse large B-cell lymphoma DLBCL merupakan suatu entitas yang heterogen baik secara klinik maupun morfologik. Berdasarkan kriteria Hans melalui pemeriksaan imunohistokimia IHK CD10, Bcl-6 dan MUM1, DLBCL dikelompokkan menjadi 2 subtipe yaitu germinal center B-cell like GCB dan non-germinal center B-cell like non-GCB . Kesintasan subtipe GCB umumnya lebih baik daripada non-GCB, namun sebagian dapat berespon buruk. Penanda prognosis buruk c-Myc lebih sering ditemukan pada subtipe GCB, sedangkan infeksi EBV melalui NF-kB lebih sering ditemukan pada subtipe non-GCB. Penelitian ini bertujuan untuk mengetahui perbedaan ekspresi c-Myc dan EBV pada kedua subtipe DLBCL yang dapat berpengaruh pada kesintasan.Bahan dan cara: Penelitian ini menggunakan metode potong lintang, deskriptif analitik. Sampel terdiri atas 20 kasus untuk masing-masing subtipe. Dilakukan penilaian ulang diagnosis imunohistopatologik dari sediaan H E dan IHK sesuai kriteria Hans. Penilaian pulasan dilakukan oleh kedua pengamat dengan program ImageJ pada c-Myc dengan cut off ge; 60,4 dan EBV melalui EBER-ISH dengan nilai positivitas ge; 20 .Hasil: Hasil penilaian antar kedua pengamat menyimpulkan tidak ada perbedaan bermakna dengan p = 0,952. Ekspresi c-Myc tinggi secara bermakna lebih sering ditemukan pada subtipe GCB dibandingkan subtipe non-GCB p < 0,05 . Disisi lain EBV positif hanya ditemukan 4 kasus 10 dan cenderung lebih banyak pada subtipe non-GCB.Kesimpulan: DLBCL subtipe GCB lebih sering ditemukan ekspresi c-Myc tinggi, sedangkan infeksi EBV melalui NF-kB cenderung terdapat pada subtipe non-GCB. Positivitas c-Myc dan EBV ini diduga berkaitan dalam perbedaan kesintasan pada masing-masing subtipe DLBCL.
ABSTRACT
"Background Diffuse large B cell lymphoma DLBCL is clinically and morphologically heterogeneous groups of lymphoma. Based on Han 39 s immunohistochemistry IHC features consists of CD10, Bcl 6 and MUM1, DLBCL are grouped into 2 subtypes the germinal center B cell like GCB and non germinal center B cell like non GCB . GCB subtype generally has been shown to have better survival than non GCB, while some may respond poorly. c Myc is a worse prognosis marker more commonly found among GCB subtype, meanwhile the EBV infection through NF kB pathway that mostly found among non GCB subtype. The study aims was analyzed the difference of c Myc and EBV expression in both subtypes which could predict survival.Methods This research used cross sectional method. The samples were consist of 20 cases for each DLBCL subtype. The slides were rediagnosed based on immunohistopathologic diagnosis from H E and IHC slides based on Han rsquo s criteria. c Myc immunostaining cut off ge 60,4 and EBV with Eptein Barr early RNA in situ hibridization cut off 20 which are assesed using ImageJ programe by two independent observers. Result The results between two observers showed no significant difference with p 0,952. Expression of high c Myc is found to be significantly higher in GCB subtype p 0,05 . Whereas EBV positive were only found in 4 cases 10 , mostly in non GCB subtype. Conclusion The expression c Myc is higher in GCB than non GCB subtype. While the EBV infection found among non GCB subtype. Positivity of c Myc and EBV is believed to affect differences in survival for each subtype DLBCL."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2016
T58857
UI - Tesis Membership  Universitas Indonesia Library