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"[ABSTRAKLatar belakang: Interpretasi cairan peritoneum yang tepat secara sitopatologi sangatmempengaruhi tatalaksana dan prognosis pasien, padahal pemeriksaan sitopatologi cairanperitoneum masih memiliki nilai negatif palsu dan positif palsu yang cukup tinggi, danhingga saat ini penelitian tentang arsitektur sitopatologi maupun penanda sitomorfologi yangmengarahkan pada adanya sel neoplasma di cairan peritoneum masih menunjukkan hasilyang beragam.Bahan dan cara kerja: Penelitian potong lintang dengan data sekunder berupa slaiddan formulir sediaan sitopatologi cairan peritoneum yang memiliki data berpasangan dengandiagnosis histopatologi. Diagnosis klinis berupa neoplasma epitelial ovarium. Slaid danformulir diambil dari arsip Departemen Patologi Anatomik FKUI/RSCM tahun 2011 ? 2012,dilakukan pembacaan ulang semua slaid sitopatologi dengan diagnosis akhir dikategorikansebagai positif atau negatif, peneliti membaca pula sediaan histopatologi untuk mengetahuimorfologi sel pada lesi, kemudiaan dilakukan penilaian terhadap arsitektur sitopatologiberupa: selularitas, sel berkelompok, struktur papiler, intercelular windows, group contours,jisim psamoma, dan penanda sitomorfologi berupa: atipia inti, inti bertumpuk, anak inti,rasio inti:sitoplasma, ukuran inti, dan ukuran sel.Hasil penelitian: Sampel penelitian sejumlah 47 sediaan sitopatologi dengandiagnosis sitopatologi akhir 34 kasus (72.3%) negatif, 13 kasus (27.7%) positif. Terdapatperbedaan bermakna arsitektur sitopatologi berupa: selularitas (p = 0.017), sel berkelompok(p = 0.001), intercellular windows (p = 0.00), group contours (p = 0.00), dan gambaransitomorfologi berupa: atipia inti (p = 0.00), inti bertumpuk (p = 0.001), anak inti (p = 0.001),rasio inti:sitoplasma (p = 0.00), ukuran inti (p = 0.00), ukuran sel (p = 0.00) antara cairanperitoneum positif dan negatif. Melalui uji multivariat didapatkan penanda yang palingberpengaruh terhadap diagnosis sitopatologi positif atau negatif yaitu: intercellular windows,atipia inti, dan selularitas.Kesimpulan: Terdapat tiga penanda yang paling berpengaruh terhadap diagnosispositif ditemukannya sel neoplasma ganas dalam cairan peritoneum pada kasus dengan lesiovarium, secara berturut - turut yaitu: tidak ditemukannya intercellular windows padakelompokan sel, sel memiliki atipia inti sedang hingga berat, dan selularitas lebih dari 20kelompok dari keseluruhan sediaan apus.

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ABSTRACTBackground : Peritoneal fluid cytopathology interpretation profoundly influences patientsmanagement and prognosis, however this practice still has high false positive and falsenegative value, and until now research concerning the architectural and cytomorphologyfeatures for detecting malignant cells in peritoneal fluid still has various result.Materials and Methods : Cross sectional study using secondary data of peritoneal fluidcytopathology and histopathology slides and form, from patients with clinical diagnosis ofovarian epithelial neoplasm. The data was taken from the archive of Anatomical PathologyDepartment Cipto Mangunkusumo Hospital 2011 ? 2012. The researchers examined thecytopathology slides and also examined the histopatology slide for morphology comparison,and then make a final cytopathological diagnosis of positive peritoneal fluid containingneoplastic cells or negative. Architectural features including: cellularity, cells grouping,papillary structure, intercellular windows, group contours, psamoma bodies, andcytomorphology features including: nuclear atypia, overlapping nuclei, nucleoli, nuclei :cytoplasm ratio, the dimension of the nuclei and cells were also examined.Result : There were 47 samples with final cytopathology diagnosis: 34 cases (72.3%)negative for neoplastic cells in the peritoneal fluid and 13 cases (27.7%) positive. There weresignificant differences in cytopathology architectural including cellularity (p = 0.017), cellsgrouping (p = 0.001), intercellular windows (p = 0.00), group contours (p = 0.00) andcytomorphology features including nuclear atypia (p = 0.00), overlapping nuclei (p = 0.001),nucleoli (p =0.001), nuclei : cytoplasm ratio (p = 0.00), the dimension of nuclei (p = 0.00),the dimension of cell (p = 0.00) between the positive and negative peritoneal fluidcytopathology. Using multivariate analysis there were 3 cytological features that have thestrongest association with positive or negative peritoneal cytopathology diagnosis, they were:intercellular windows, nuclear atypia, and cellularity.Conclusion: In peritoneal fluid cytopathology for examining ovarian lesion there were 3cytological features that have the strongest association with finding neoplastic cells inperitoneal fluid, they were: the absent of intercellular windows, moderate to severecytological atypia, and cellularity more than 20 groups in all smear preparation, Background : Peritoneal fluid cytopathology interpretation profoundly influences patientsmanagement and prognosis, however this practice still has high false positive and falsenegative value, and until now research concerning the architectural and cytomorphologyfeatures for detecting malignant cells in peritoneal fluid still has various result.Materials and Methods : Cross sectional study using secondary data of peritoneal fluidcytopathology and histopathology slides and form, from patients with clinical diagnosis ofovarian epithelial neoplasm. The data was taken from the archive of Anatomical PathologyDepartment Cipto Mangunkusumo Hospital 2011 – 2012. The researchers examined thecytopathology slides and also examined the histopatology slide for morphology comparison,and then make a final cytopathological diagnosis of positive peritoneal fluid containingneoplastic cells or negative. Architectural features including: cellularity, cells grouping,papillary structure, intercellular windows, group contours, psamoma bodies, andcytomorphology features including: nuclear atypia, overlapping nuclei, nucleoli, nuclei :cytoplasm ratio, the dimension of the nuclei and cells were also examined.Result : There were 47 samples with final cytopathology diagnosis: 34 cases (72.3%)negative for neoplastic cells in the peritoneal fluid and 13 cases (27.7%) positive. There weresignificant differences in cytopathology architectural including cellularity (p = 0.017), cellsgrouping (p = 0.001), intercellular windows (p = 0.00), group contours (p = 0.00) andcytomorphology features including nuclear atypia (p = 0.00), overlapping nuclei (p = 0.001),nucleoli (p =0.001), nuclei : cytoplasm ratio (p = 0.00), the dimension of nuclei (p = 0.00),the dimension of cell (p = 0.00) between the positive and negative peritoneal fluidcytopathology. Using multivariate analysis there were 3 cytological features that have thestrongest association with positive or negative peritoneal cytopathology diagnosis, they were:intercellular windows, nuclear atypia, and cellularity.Conclusion: In peritoneal fluid cytopathology for examining ovarian lesion there were 3cytological features that have the strongest association with finding neoplastic cells inperitoneal fluid, they were: the absent of intercellular windows, moderate to severecytological atypia, and cellularity more than 20 groups in all smear preparation]"

"[ABSTRAKLatar belakang: Malignant peripheral nerve sheath tumor (MPNST) adalah sarkoma jaringan lunak yang sulit dibedakan dengan beberapa sarkoma sel spindel karena morfologinya yang serupa. MPNST bersifat agresif dengan angka rekurensi yang tinggi dan cenderung bermetastasis terutama ke paru. Salah satu tahap metastasis adalah invasi dengan cara mendegradasi matriks ekstraseluler dimana Matrix Metalloproteinase (MMP) memainkan peranan penting dalam proses ini. MMP tipe gelatinase yaitu MMP-2 dan MMP-9 memiliki kemampuan dalam mendegradasi membran basal dan kolagen fibrilar sehingga dapat membuka jalur invasi bagi sel tumor. MMP-2 mampu mendegradasi lebih banyak tipe kolagen dan MES non kolagen dibandingkan MMP-9. Penelitian ini bertujuan untuk menilai hubungan antara peningkatan ekspresi MMP-2 dengan derajat keganasan histologik dan variabel prognostik klinis lainnya.Bahan dan cara: Dilakukan pulasan imunohistokimia MMP-2 pada 39 kasus yang terdiri atas 19 MPNST derajat rendah dan 20 MPNST derajat tinggi. Selanjutnya dilakukan analisis hubungan antara peningkatan ekspresi MMP-2 dengan derajat keganasan dan variabel klinis seperti usia, jenis kelamin, ukuran dan lokasi tumor.Hasil: Peningkatan ekspresi MMP-2 ditemukan pada 19 (95%) kasus MPNST derajat tinggi dan 3 kasus (15,8%) kasus MPNST derajat rendah (p=0.000). Terdapat hubungan yang kuat antara peningkatan ekspresi MMP-2 dengan derajat keganasan MPNST. Tidak ditemukan hubungan antara ekspresi MMP-2 dengan jeni usia, jenis kelamin, ukuran dan lokasi tumor.Kesimpulan: Peningkatan ekspresi MMP-2 sejalan dengan peningkatan derajat histologik, sehingga dapat digunakan untuk membantu menentukan progresifitas MPNST.

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ABSTRACTBackground: Malignant peripheral nerve sheath tumor (MPNST) is a sarcoma that is difficult to differentiate with other spindle cell sarcomas, because of their similar morphology. The behavior of MPNST is aggressive, with a high recurrence and tend to metastases hematogenous, especially to lung. Important step of metastases is invasion by degradating extracellular matrix, in which Matrix Metalloproteinase (MMP) play important role in this process. Gelatinase type of MMP, MMP-2 and MMP-9 have ability to degrade basal membrane and fibriler collagen, in order to open the way of invasion. MMP-2 can degrade type collagen and non collagen extracellular matrix than MMP-9. The aim of this study is to see the correlation between expression of MMP-2 and histopathology grading and other prognostic clinical variables.Methods: This study enrolled 39 cases of consisted of 19 low grade MPNST and 20 high grade MPNST. The case were stained for MMP-2 imunnohistochemistry and the expression of MMP-2 were scored. Analysis the correlation between over expression of MMP-2 and histopathology grading and other clinical variables , such as age, sex, size and location of the tumor.Results: Overexpression of MMP-2 was observed in 19 (95%) cases of high grade MPNST and 3 (15,8%) cases of low grade MPNST (p=0.000). There is a significant correlation between MMP-2 over expression and histopathology grade. There is no correlation between MMP-2 expression and age, sex, siize and location of tumor.Conclusion: High expression of MMP-2 is in parallel with high histologic grade, therefore it may be of additional use as prognostic factor., ackground: Malignant peripheral nerve sheath tumor (MPNST) is a sarcoma that is difficult to differentiate with other spindle cell sarcomas, because of their similar morphology. The behavior of MPNST is aggressive, with a high recurrence and tend to metastases hematogenous, especially to lung. Important step of metastases is invasion by degradating extracellular matrix, in which Matrix Metalloproteinase (MMP) play important role in this process. Gelatinase type of MMP, MMP-2 and MMP-9 have ability to degrade basal membrane and fibriler collagen, in order to open the way of invasion. MMP-2 can degrade type collagen and non collagen extracellular matrix than MMP-9. The aim of this study is to see the correlation between expression of MMP-2 and histopathology grading and other prognostic clinical variablesMethods: This study enrolled 39 cases of consisted of 19 low grade MPNST and 20 high grade MPNST. The case were stained for MMP-2 imunnohistochemistry and the expression of MMP-2 were scored. Analysis the correlation between over expression of MMP-2 and histopathology grading and other clinical variables , such as age, sex, size and location of the tumor.Results:. Overexpression of MMP-2 was observed in 19 (95%) cases of high grade MPNST and 3 (15,8%) cases of low grade MPNST (p=0.000). There is a significant correlation between MMP-2 over expression and histopathology grade. There is no correlation between MMP-2 expression and age, sex, siize and location of tumor.Conclusion: High expression of MMP-2 is in parallel with high histologic grade, therefore it may be of additional use as prognostic factor.]"

"ABSTRAKLatar Belakang:Pada KKR, miofibroblas merupakan komponen sel utama dalam stroma desmoplastik yang memiliki peran penting dalam proses metastasis. Persentase antara karsinoma dengan stroma desmoplastik dikenal sebagai Carcinoma Percentage CP berperan sebagai independent predictor metastasis. D2-40/ Podoplanin PDPN dikenal sebagai marker spesifikLymphatic Endothelial Cell LEC , digunakan untuk menilai Lymphatic Microvessel Density LMVD danLymphatic Vessel Invasion LVI . Tujuan penelitian untuk mengetahui korelasi dan hubungan CP, LMVD dan LVI dengan metastasis sel tumor ke kelenjar getah bening KGB .Bahan dan Metode:Dilakukan penilaian CP terhadap 44 sampel adenokarsinoma Not Otherwise Specified NOS kolorektal dan pulasan D2-40/Podoplanin untuk menilai LMVD dan LVI. Uji statistik dilakukan untuk mencari korelasi antara CP dan LMVD, serta hubungan antara CP, LVI serta metastasis KGB.Hasil:Terdapat korelasi kuat antara CP dan LMVD area intratumoral dan peritumoral dengan arah korelasi negatif. Terdapat hubungan bermakna p=0,00 antara LMVD area intratumoral dan area peritumoral dengan adanya LVI. Terdapat hubungan bermakna antara LVI dengan kejadian metastasis KGB p=0,03 . Area intratumoral menunjukkan hubungan bermakna dengan kejadian metastasis KGB nilai p=0,04 , sedangkan area peritumoral tidak menunjukkan hubungan bermakna nilai p=0,17 .Kesimpulan:Pemeriksaan CP pada sediaan histopatologi dapat digunakan untuk memprediksi tinggi/rendahnya kejadian metastasis sel tumor ke KGB, didasarkan adanya korelasi kuat antara CP dan LMVD. Kata kunci:Carcinoma Percentage, Lymphatic Microvessel Density, Lymphatic Vessel Invasion, Lymphatic Endothelial Cell

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ABSTRACTBackground In CRC, myofibroblast are the main component cells in tumour stroma which have an important role in the metastases process. The precentage between carcinoma and desmoplastic stroma known as Carcinoma Percentage CP , can be used as an independent predictor metastases. D2 40 Podoplanin PDPN known as a spesific marker forLymphatic Endothelial Cell LEC , which used to assess Lymphatic Microvessel Density LMVD and Lymphatic Vessel Invasion LVI . This study aims to determine correlation and association between CP, LMVD and LVI with the metastases process to lymph node LN .Materials and Methods CP assessment conducted on 44 samples of adenocarcinoma Not Otherwise Specified NOS colorectal and examination D2 40 Podoplanin to assess LMVD and LVI. The statistical test is performed to find the correlation between CP and LMVD, as well as the relationship between CP, LVI and metastasis KGB.Result There were a strong correlation between CP and LMVD intratumoral and peritumoral area with the negative correlation. There were a significant association p 0,00 between LMVD intratumoral and peritumoral area with the LVI. There was a significant association between LVI and lymph node metastases p 0,03 . Intratumoral area showed significant association with lymph node metastases nilai p 0,04 , whereas peritumoral area showed no significant association nilai p 0,17 .Conclusion CP examination in histopathology specimen can be used to predict high low rate of tumour cells metastases to the lymph node, based on a strong correlation between CP and LMVD. "

"ABSTRAKLatar belakang:Karsinoma sebasea palpebra merupakan karsinoma adneksa mata terbanyak dan memiliki prognosis buruk. Penyebaran pagetoid pada karsinoma sebasea palpebra merupakan faktor yang mempengaruhi prognosis buruk. Hasil retrospektif karsinoma sebasea palpebra di Departemen Patologi Anatomik FKUI/RSCM Jakarta tahun 2010 sampai 2015 didapatkan 89 kasus memiliki prognosis buruk. Pemeriksaan imunohistokimia IHK Ki67 merupakan salah satu marker yang digunakan utuk menentukan prognosis. Pada penelitian ini akan diteliti hubungan ekspresi Ki67 pada karsinoma sebasea palpebra dengan penyebaran pagetoid dan tanpa penyebaran pagetoid.Bahan dan cara: Penelitian ini menggunakan desain potong lintang. Sampel terdiri atas 40 kasus karsinoma sebasea palpebra di Departemen Patologi Anatomik FKUI/RSCM periode Januari 2009 sampai September 2016.Sampel dibagi menjadi dua kelompok yaitu kelompok dengan penyebaran pagetoid dan tanpa penyebaran pagetoid.Dilakukan pulasan imunohistokimia Ki67, kemudian dihitung persentase positivitasnya.Hasil: Ekspresi Ki67 pada semua kasus mempunyai rentang antara 2,8 sampai 88 , ekspresi Ki67 tinggi sebanyak 30 kasus 75 . Tidak terdapat perbedaan bermakna ekspresi Ki67antara karsinoma sebasea palpebra dengan penyebaran pagetoid dan tanpa penyebaran pagetoid p=0,136 . Ekspresi Ki67 pada kelompok penyebaran pagetoid cenderung lebih tinggi mean 43,83 dibandingkan tanpa penyebaran pagetoid mean 34,10 . Tidak terdapat perbedaan bermakna ekspresi Ki67 antara karsinoma sebasea palpebra berdiferensiasi baik, sedang dan buruk p=0,396 .Kesimpulan: Ditemukan ekspresi tinggi Ki67 pada karsinoma sebasea palpebra.Tidak terdapat perbedaan ekspresi Ki67 pada karsinoma sebasea palpebra dengan penyebaran pagetoid dan tanpa penyebaran pagetoid.Ekspresi Ki67 cenderung lebih tinggi pada penyebaran pagetoid dari pada tanpa penyebaran pagetoid.

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ABSTRACTBackground Eyelid sebaceous carcinoma is the most common adnexal carcinoma of the eye and has a poor prognosis. Pagetoid spread is a factor of poor prognosis in eyelid sebaceous carcinoma. The retrospective study of eyelid sebaceous carcinoma in Anatomical Pathology Department Cipto Mangunkusumo Hospital Faculty of Medicine Universitas Indonesia between 2010 and 2015 found 89 cases with poor prognosis. Ki67 is a marker of immunohistochemical which is used to determinate the prognosis. This present study was designed to investigate the Ki67 expression in eyelid sebaceous carcinoma with and without pagetoid spread.Materials and methods This study used a cross sectional design. The sample was consist of 40 cases of eyelid sebaceous carcinoma in Anatomical Pathology Department Cipto Mangunkusumo Hospital Faculty of Medicine Universitas Indonesia between January 2009 and September 2016 period. The samples were divided into two groups with and without pagetoid spread. All cases stained by Ki67 immunohistochemistry and evaluated by the percentages of positivityResults Ki67 expression in all cases have a range between 2.8 to 88 , high Ki67 expression was found in 30 cases 75 . There were no significant differences of Ki67 expression between eyelid sebaceous carcinoma with and without pagetoid spread p 0.136 . Ki67 expression was higher in pagetoid spread mean 43.83 than without pagetoid spread mean 34.10 . There was no significant difference of Ki67 expression in eyelid sebaceous carcinoma between well differentiated, moderately differentiated and poorly differentiated p 0.396 .Conclusion Ki67 expression was high in eyelid sebaceous carcinoma. Ki67 expression was no different in eyelid sebaceous carcinoma with and without pagetoid spread. Eyelid sebaceous carcinoma with pagetoid spread tend to be higher Ki67 expression than without pagetoid spread."

"ABSTRAKLatar belakang: Karsinoma sebasea palpebra merupakan karsinoma adneksa mata terbanyak dan memiliki prognosis buruk. Penyebaran pagetoid pada karsinoma sebasea palpebra merupakan faktor yang mempengaruhi prognosis buruk. Hasil retrospektif karsinoma sebasea palpebra di Departemen Patologi Anatomik FKUI/RSCM Jakarta tahun 2010 sampai 2015 didapatkan 89 kasus memiliki prognosis buruk. Pemeriksaan imunohistokimia IHK Ki67 merupakan salah satu marker yang digunakan utuk menentukan prognosis. Pada penelitian ini akan diteliti hubungan ekspresi Ki67 pada karsinoma sebasea palpebra dengan penyebaran pagetoid dan tanpa penyebaran pagetoid.Bahan dan cara: Penelitian ini menggunakan desain potong lintang. Sampel terdiri atas 40 kasus karsinoma sebasea palpebra di Departemen Patologi Anatomik FKUI/RSCM periode Januari 2009 sampai September 2016. Sampel dibagi menjadi dua kelompok yaitu kelompok dengan penyebaran pagetoid dan tanpa penyebaran pagetoid. Dilakukan pulasan imunohistokimia Ki67, kemudian dihitung persentase positivitasnya.Hasil: Ekspresi Ki67 pada semua kasus mempunyai rentang antara 2,8 sampai 88 , ekspresi Ki67 tinggi sebanyak 30 kasus 75 . Tidak terdapat perbedaan bermakna ekspresi Ki67antara karsinoma sebasea palpebra dengan penyebaran pagetoid dan tanpa penyebaran pagetoid p=0,136 . Ekspresi Ki67 pada kelompok penyebaran pagetoid cenderung lebih tinggi mean 43,83 dibandingkan tanpa penyebaran pagetoid mean 34,10 . Tidak terdapat perbedaan bermakna ekspresi Ki67 antara karsinoma sebasea palpebra berdiferensiasi baik, sedang dan buruk p=0,396 .Kesimpulan: Ditemukan ekspresi tinggi Ki67 pada karsinoma sebasea palpebra. Tidak terdapat perbedaan ekspresi Ki67 pada karsinoma sebasea palpebra dengan penyebaran pagetoid dan tanpa penyebaran pagetoid. Ekspresi Ki67 cenderung lebih tinggi pada penyebaran pagetoid dari pada tanpa penyebaran pagetoid.

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ABSTRACTThis study aimed to determine whetherBackground Eyelid sebaceous carcinoma is the most common adnexal carcinoma of the eye and has a poor prognosis. Pagetoid spread is a factor of poor prognosis in eyelid sebaceous carcinoma. The retrospective study of eyelid sebaceous carcinoma in Anatomical Pathology Department Cipto Mangunkusumo Hospital Faculty of Medicine Universitas Indonesia between 2010 and 2015 found 89 cases with poor prognosis. Ki67 is a marker of immunohistochemical which is used to determinate the prognosis. This present study was designed to investigate the Ki67 expression in eyelid sebaceous carcinoma with and without pagetoid spread.Materials and methods This study used a cross sectional design. The sample was consist of 40 cases of eyelid sebaceous carcinoma in Anatomical Pathology Department Cipto Mangunkusumo Hospital Faculty of Medicine Universitas Indonesia between January 2009 and September 2016 period. The samples were divided into two groups with and without pagetoid spread. All cases stained by Ki67 immunohistochemistry and evaluated by the percentages of positivityResults Ki67 expression in all cases have a range between 2.8 to 88 , high Ki67 expression was found in 30 cases 75 . There were no significant differences of Ki67 expression between eyelid sebaceous carcinoma with and without pagetoid spread p 0.136 . Ki67 expression was higher in pagetoid spread mean 43.83 than without pagetoid spread mean 34.10 . There was no significant difference of Ki67 expression in eyelid sebaceous carcinoma between well differentiated, moderately differentiated and poorly differentiated p 0.396 .Conclusion Ki67 expression was high in eyelid sebaceous carcinoma. Ki67 expression was no different in eyelid sebaceous carcinoma with and without pagetoid spread. Eyelid sebaceous carcinoma with pagetoid spread tend to be higher Ki67 expression than without pagetoid spread."

"ABSTRAKLatar Belakang:Adenokarsinoma musinosum mempunyai prognosis lebih buruk dari pada adenokarsinoma Not Otherwise Specified NOS kolorektal. Ekspresi podoplanin pada Cancer associated fibroblasts CAF dan nilai Lymphatic Microvessel Density LMVD yang tinggi merupakan petanda prognosis yang buruk. Pada penelitian ini dilakukan analisis terhadap CAF, LMVD dan metastasis kelenjar getah bening KGB pada adenokarsinoma musinosum dan adenokarsinoma NOS. CAF merupakan komponen utama pada stroma desmoplastik yang memiliki peran penting dalam proses metastasis. LMVD merupakan penilaian densitas pembuluh limfatik pada massa tumor primer.Bahan dan Metode:Penelitian dilakukan terhadap 44 kasus yang terdiri atas 22 kasus adenokarsinoma musinosum dan 22 kasus adenokarsinoma NOS kolorektal. Pulasan podoplanin digunakan untuk melihat ekspresinya pada CAF dan nilai LMVD.Hasil:CAF yang terekspresi podoplanin pada adenokarsinoma NOS lebih tinggi daripada adenokarsinoma musinosum kolorektal p=0,000 . Tidak terdapat perbedaan bermakna nilai LMVD antara adenokarsinoma NOS dengan adenokarsinoma musinosum kolorektal p=0,381 . Tidak terdapat korelasi antara CAF yang terekspresi podoplanin dengan nilai LMVD pada adenokarsinoma musinosum p=0,248 dan adenokarsinoma NOS p=0,448 . Tidak terdapat korelasi antara CAF yang terekspresi podoplanin dengan metastasis KGB pada adenokarsinoma musinosum p=0,240 dan adenokarsinoma NOS p=0,791 .Kesimpulan:Ekspresi podoplanin pada CAF pada adenokarsinoma NOS lebih tinggi daripada adenokarsinoma musinosum. Tidak terdapat korelasi antara CAF yang terekspresi podoplanin dengan LMVD dan metastasis KGB pada adenokarsinoma musinosum dan adenokarsinoma NOS. Ekspresi podoplanin pada CAF tidak dapat digunakan untuk menentukan prognosis metastasis KGB pada adenokarsinoma musinosum. Terdapat kecenderungan nilai LMVD pada adenokarsinoma musinosum sedikit lebih tinggi daripada adenokarsinoma NOS kolorektal.

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ABSTRACTBackground Mucinous adenocarcinoma has worse prognosis than the Not Otherwise Specified NOS colorectal adenocarcinoma. High expression of podoplanin in Cancer Associated Fibroblasts CAF and high lymphatic Microvessel Density LMVD values is a marker of poor prognosis. This study analyzed CAF, LMVD and lymph node metastasis in mucinous adenocarcinoma and NOS adenocarcinoma.CAF are the main component of desmoplastic stroma which have an important role in the metastatic processes. LMVD is an assessment of the density of the lymphatic vessels in the primary tumor.Materials and methods The study consists of 44 cases including 22 cases of mucinous adenocarcinoma and 22 cases of NOS adenocarcinoma colorectal. Podoplanin is used to see its expression CAF and LMVD values. Results CAF expressed podoplanin at NOS adenocarcinoma is higher than mucinous adenocarcinoma p 0.000 . There was no significant difference in LMVD values between NOS adenocarcinoma and mucinous adenocarcinoma p 0.381 . There was no correlation between CAF expressed podoplanin with LMVD values in mucinous adenocarcinoma p 0.248 and NOS adenocarcinoma p 0.448 . There was no significant correlation between CAF expressed podoplanin with KGB metastasis in adenocarcinoma musinosum p 0,240 and NOS adenocarcinoma p 0.791 . Conclusion CAF expressed podoplanin at NOS adenocarcinoma is higher than that of the mucinous adenocarcinoma. There is no correlation between CAF expressed podoplanin with LMVD and KGB metastasis in NOS mucinous adenocarcinoma and NOS adenocarcinoma. Podoplanin expression in CAF can not be used to determine the prognosis of KGB metastasis in mucinous adenocarcinoma. There is a tendency for LMVD values in mucinus adenocarcinoma to be slightly higher than NOS adenocarcinoma."

"Latar belakang: Keganasan pankreas merupakan salah satu penyebab morbiditas dan mortalitas signifikan di dunia dengan 90% kasus adalah adenokarsinoma yang umumnya terdiagnosis stadium lanjut karena tidak memiliki gejala klinis spesifik dan keterbatasan dalam menegakkan diagnosis. Adenokarsinoma pankreas disebabkan oleh perubahan histologik dari neoplasma intraepitelial pankreas (PanIN) dan mutasi genetik antara lain aktivasi onkogen KRAS serta inaktivasi gen supresor tumor seperti CDKN2A/p16, p53, BRCA2 dan Small Mothers Against Decapentaplegic 4 (SMAD4) atau disebut juga Deleted in Pancreatic Cancer, locus 4 (DPC4). Mutasi DPC4 ditemukan pada 55% kasus dan relatif spesifik pada adenokarsinoma pankreas. Penelitian ini dilakukan untuk menilai ekspresi DPC4 pada adenokarsinoma pankreas dengan sampel fine-needle aspiration biopsy (FNAB) dengan tujuan meningkatkan akurasi diagnosis.Bahan dan cara: Penelitian ini menggunakan desain potong lintang. Sampel diambil dari data arsip Departemen Patologi Anatomik FKUI/RSCM terdiri atas kelompok data berpasangan dengan 9 kasus adenokarsinoma dan 5 kasus nonadenokarsinoma dari Januari 2012-Agustus 2018 serta kelompok data tidak berpasangan dengan 10 kasus adenokarsinoma dari Januari 2017-Agustus 2018. Dilakukan pulasan DPC4 pada sampel sitologi dan histopatologik. Penilaian mengunakan persentase cut off positif >50% sel tumor.Hasil: Ekspresi DPC4 negatif didapatkan pada 5 kasus adenokarsinoma dan 0 kasus nonadenokarsinoma data berpasangan, serta 5 kasus adenokarsinoma data tidak berpasangan. Uji Fisher s exact yang dilakukan mendapatkan hasil ekspresi DPC4 pada adenokarsinoma dan nonadenokarsinoma data berpasangan tidak berbeda bermakna dengan nilai p>0.05.Kesimpulan: Tidak didapatkan perbedaan yang bermakna antara ekspresi DPC4 pada adenokarsinoma dan nonadenokarsinoma.

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Background: Pancreatic malignancy is one of the causes of significant morbidity and mortality in the world with 90% of cases were adenocarcinomas which are generally diagnosed in advanced stages because there is no specific clinical symptom and limitation in making a diagnosis. Pancreatic adenocarcinoma is caused by histological changes of intraepithelial pancreatic neoplasms (PanIN) and genetic mutations including activation of KRAS oncogenes and inactivation of tumor suppressor genes such as CDKN2A/p16, p53, BRCA2 and Small Mothers Against Decapentaplegic 4 (SMAD4) or also called Deleted in Pancreatic Cancer, locus 4 (DPC4). DPC4 mutations is found in 55% of cases and relatively specific in pancreatic adenocarcinoma. This study was conducted to assess the expression of DPC4 in pancreatic adenocarcinoma using a fine-needle aspiration biopsy (FNAB) sample to increase diagnosis accuracy.

Materials and methods: This was a cross-sectional study. Samples were taken from archival data of the Anatomical Pathology Department of FKUI/RSCM consisting of paired data group with 9 cases of adenocarcinoma and 5 cases of nonadenocarcinoma from January 2012 to August 2018 and unpaired data group with 10 cases of adenocarcinoma from January 2017 to August 2018. All cytology and histopathologic samples were stained with DPC4 antibody and evaluated using a positive cut-off> 50% of tumor cells.

Results: Negative DPC4 expression was found in 5 cases of adenocarcinoma and 0 cases of nonadenocarcinoma in paired data group, and 5 cases of unpaired data group adenocarcinoma. The Fisher s exact showed no significant difference of DPC4 expression between adenocarcinoma and nonadenocarcinoma paired data group with p value> 0.05.

Conclusion: There was no significant difference in the expression of DPC4 between adenocarcinoma and nonadenocarcinoma."

"Latar Belakang: Karsinoma sel skuamosa rongga mulut (KSSRM) menempati urutan keenam dari keganasan yang paling sering terjadi di Asia. Kebanyakan pasien datang berobat dalam kondisi stadium lanjut sehingga KSSRM memiliki mortalitas yang tinggi. Angka kesintasan KSSRM satu tahun dan dua tahun di RSCM adalah 58,6% dan 43,1%; angka kesintasan spesifik penyakit adalah 66,9%. Studi ini bertujuan untuk mencari faktor-faktor yang memengaruhi kesintasan KSSRM.Metode: Studi ini merupakan kohort retrospektif berdasarkan data rekam medis pasien. Variabel yang diteliti adalah usia, jenis kelamin, lokasi tumor, stadium klinis, derajat diferensiasi sel tumor, derajat invasi tumor, dan batas sayatan. Analisis kesintasan menggunakan Kaplan-Meier dan uji log-rank. Analisis bivariat dan multivariat menggunakan regresi Cox untuk mendapatkan hazard ratio (HR).Hasil: Ada 169 subjek yang menderita KSSRM dan diterapi di RSCM tahun 2014 – 2018. Mayoritas pasien merupakan laki-laki (51,5%) dengan usia di atas 50 tahun (55,6%). Lokasi tumor paling banyak dijumpai di lidah (72,8%) diikuti mukosa bukal (13%). 82,2% pasien datang pada stadium IV, 60,4% memiliki diferensiasi baik, dan 53,8% memiliki grade rendah. Berdasarkan analisis bivariat, didapatkan bahwa ukuran dan ekstensi tumor (T), keterlibatan kelenjar getah bening regional (N), stadium klinis, dan batas sayatan memengaruhi kesintasan KSSRM (p <0,05). Keterlibatan KGB (HR: 1,212; 95% CI: 0,997-1,474; p <0,05) dan stadium klinis (HR: 1,749; 95% CI: 1,261-2,425; p <0,05) memengaruhi mortalitas secara signifikan.Kesimpulan: Faktor-faktor yang memengaruhi kesintasan KSSRM adalah stadium klinis dan keterlibatan kelenjar getah bening regional (N).

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Background: Oral squamous cell carcinoma (OSCC) is the sixth most common malignancy in Asia. Most patients were diagnosed in advanced stage; thus, the mortality rate is high. The one-year and two-year overall survival rate in Cipto Mangunkusumo Hospital are 58.6% and 43.1%, the disease-specific survival rate is 66.9%. This study is aimed to investigate the prognostic factors correlated with OSCC.

Methods: A retrospective cohort study was done on OSCC patients diagnosed and treated in Cipto Mangunkusumo Hospital from 2014 to 2018. Data regarding age, gender, site of the primary lesion, clinical stage of the disease, tumor differentiation, invasion, and surgical margins were collected. Prognostic variables were identified with bivariate analysis using Kaplan-Meier curves and log-rank testing for comparison.

Results: One hundred and sixty nine patients were included. Majority of patients were male (51.5%), age above 50 years old (55.6%). The most prevalent tumor site was the tongue (72.8%) followed by buccal mucosa (13%). 82.2% of patients had advanced (clinical stage IV) disease at diagnosis. Majority of patients had well-differentiated tumor (60.4%) and low-grade tumor (53.8%). Bivariate analysis showed that tumor size (T), nodal status (N), clinical stage, and marginal status significantly affected the overall survival (p <0.05). Nodal status (HR: 1.212; 95% CI: 0.997-1.474; p <0.05) and clinical stage (HR: 1.749; 95% CI: 1.261-2.425; p < 0.05) were independently associated with the risk of death.

Conclusion: Clinical stage and lymph node involvement are the most significant prognostic factors of OSCC."

"ABSTRAK Latar belakang: Tumor sel germinal ovarium maligna (TSGOM) yang gagal sembuh dengan penatalaksanaan konvensional memiliki prognosis buruk. Beberapa kejadian rekuren setelah kemoterapi juga ditemukan. Programmed Death Ligand-1 (PD-L1) terekspresi pada berbagai keganasan dan tumor infiltrating lymphocytes (TILs) serta telah diketahui perannya sebagai faktor prognostik. Penelitian ini dilakukan untuk mengetahui peran ekspresi PD-L1 pada TSGOM dalam menentukan overall survival (OS) dan progression free survival (PFS).Bahan dan cara: Penelitian ini merupakan penelitian kohort retrospektif dengan desain analisis kesintasan. Data klinis diambil dari rekam medis RSUPN Cipto Mangunkusumo sejak Januari 2010-Desember 2016 yang diobservasi selama 2 tahun. Data histopatologik diambil dari Departemen Patologi Anatomi RSUPN Cipto Mangunkusumo yang kemudian dilakukan pulasan imunohistokimia PD-L1.Hasil: Tidak terdapat hubungan yang bermakna antara ekspresi PD-L1 pada sel tumor dan TILs dengan 2-year OS (p=0,275) dan PFS (p=0,421) pada TSGOM. Terdapat hubungan yang bermakna antara jenis histopatologik dengan 2-year OS (p=0,002) serta stadium pada 2-year OS (p=0,028) dan PFS (p=0,014).Kesimpulan: OS dan PFS tidak berhubungan dengan ekspresi PD-L1 pada sel tumor dan TILs pada TSGOM.

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ABSTRACT

Background: The prognosis of malignant ovarian germ cell tumors (MOGCT) patients who failed to be cured with conventional therapy is poor. Several recurrent events after chemotherapy were also found. PD-L1 is expressed in various types of malignancy and tumor infiltrating lymphocytes (TILs) and its role is known as a prognostic factor. This study was conducted to determine the role of PD-L1 expression in MOGCT in determining overall survival (OS) and progression free survival (PFS).

Materials and Methods: This is a retrospective cohort study with survival analysis. Clinical data were obtained from medical record in RSUPN Cipto Mangunkusumo since January 2010-December 2016 and observed for 2 years. Histopathological data were obtained from Anatomical Pathology Department and PD-L1 immunohistochemistry staining were performed.

Results: No significant correlation between PD-L1 expression in tumor cells and TILs with 2-year OS (p=0,275) and PFS (p=0,421) in MOGCT. A significant correlation between histopathologic type and 2-year OS (p=0,002) was found. We also found significant correlations between stage and survival outcomes 2-year OS (p=0,028) and PFS (p=0,014).

Conclusion: OS and PFS were not significantly correlated with PD-L1 expression in tumor cells and TILs in MOGCT."

"ABSTRAK Karsinoma ovarium adalah salah satu keganasan paling mematikan di bidang ginekologik. Penyebab keganasan belum diketahui pasti dan umumnya tidak memiliki gejala klinik yang jelas. Karsinoma ovarium tipe I khususnya karsinoma endometrioid dan karsinoma sel jernih diketahui dapat berasal dari endometriosis. Karsinoma yang berasal dari endometriosis dikenal sebagai endometriosis-associated ovarian carcinoma (EAOC). Pengembangan model hewan coba karsinoma ovarium yang berhubungan dengan endometriosis diperlukan untuk penelitian dasar dan uji klinik menggantikan jaringan manusia. Pada penelitian ini dikembangkan model hewan coba karsinoma ovarium dengan teknik autoimplantasi dan induksi DMBA. Penelitian ini mengunakan blok parafin dari tikus yang sebelumnya telah mendapatkan operasi plasebo (SHAM), autoimplantasi endometrium, kombinasi autoimplantasi endometrium dan induksi DMBA yang dikorbankan pada minggu ke-5,10, dan 20. Dilakukan penilaian histopatologik dan pulasan imunohistokimia ARID1A dengan penilaian persentase positivitas pada 200 sel. Penelitian ini menghasilkan lesi endometriosis atipik sebanyak 1 (20%) dan karsinoma sel jernih sebanyak 1 (20%) pada implantasi dan induksi DMBA 10 minggu dan karsinoma endometrioid sebanyak 100% pada kelompok induksi DMBA. Pulasan ARID1A tidak menunjukkan perbedaan bermakna (p=0,313) pada seluruh kelompok perlakuan.

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ABSTRACT Ovarian carcinoma is one of the most deadly malignancies in the gynecologic field. The cause of malignancy is not known for sure and generally do not have clear clinical symptoms. Type I ovarian carcinoma especially endometrioid carcinoma and clear cell carcinoma is known to originate from endometriosis. Carcinoma originating from endometriosis is known as endometriosis-associated ovarian carcinoma (EAOC). The development of experimental animal models of ovarian carcinoma associated with endometriosis is needed for basic research and clinical trials replace human tissue. In this study an experimental model of ovarian carcinoma was developed with autoimplantation and DMBA induction techniques.This study used paraffin blocks from mice that had previously received placebo surgery (SHAM), endometrial autoimplantation, combination of endometrial autoimplantation and DMBA induction and were sacrificed at 5,10 and 20 weeks. Assessment of ARID1A expression by assessing the percentage of positivity in 200 cells.This study resulted in 1 (20%) atypical endometriosis lesions and 1 (20%) clear cell carcinoma in 10 weeks DMBA implantation and 100% endometrioid carcinoma in the DMBA induction group. ARID1A ekspression did not show a significant difference (p = 0.313) in all treatment groups.

 

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