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Studi Nilai AgNOR dan MIB-1 pada Kanker Payudara yang Ditangani dengan Operasi Kurnia, Iin; Soetrisno, Esti; Yulian, Erwin D.; Ramli, Irwan; Alatas, Zubaidah
Indonesian Journal of Clinical Pharmacy Vol 1, No 3 (2012)
Publisher : Indonesian Journal of Clinical Pharmacy

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AgNOR dan MIB-1 adalah marker proliferasi sel kanker payudara yang berguna sebagai dasar pemberian radioterapi setelah operasi. Penetapan nilai AgNOR dan indeks MIB-1 dilakukan dengan teknik pewarnaan dan teknik pewarnaan imunohistokimia MIB-1 terhadap 25 sediaan mikroskopik jaringan kanker payudara dari penderita hasil operasi, dan dikelompokkan berdasarkan derajat diferensiasinya menjadi 3 kelompok sediaan berderajat diferensiasi baik (G1), 16 sediaan berderajat diferensiasi menengah (G2), dan 6 sediaan berderajat diferensiasi buruk (antara G2 dan G3). Hasil penelitian menunjukkan nilai AgNOR dan indeks MIB-1 cenderung meningkat seiring dengan meningkatnya derajat diferensiasi. Terdapat pula kecendrungan korelasi positif antara nilai AgNOR dan indeks MIB-1 (r =0,21) pada seluruh derajat diferensiasi, terdapat korelasi negatif antara AgNOR dan MIB-1 pada G1 (r=-0,97), korelasi positif pada G2 (r=0,36) serta korelasi positif antara G2 dan G3 (r=0,33). Korelasi positif antara AgNOR dan MIB-1 terkait dengan peningkatan fase G1, S dan G2 pada sel yang berproliferasi dan peningkatan jumlah sel yang mengalami mitosis. Korelasi negatif disebabkan oleh perbedaan proporsi antara sel yang berada pada fase G1, S dan G2 dengan yang sedang bermitosisKata kunci: Kanker payudara, AgNOR, MIB-1, operasiÂ Study of AgNOR Value and MIB-1 in Breast CancerTreated With Surgery AbstractAgNOR and MIB-1 are marker for breast cancer cell proliferation and can be use as based for radiotherapytreatment after surgery. Value of AgNOR and MIB-1 index were determined using staining and immunohistochemistry staining method respectively from 25 of microscopic slides of breast cancer tissue patients with surgery, and grouped based on degree of differentiation, 3 slides were good degree (G1), 16 slides were medium degree (G2) and 6 slides were poor degree (between G2 and G3). The result shown that the value of AgNOR and MIB-1 index were tended to increase with the increased differentiation degree. There was a positive correlation between the value of AgNOR and index of MIB-1 in all group of differentiation degree (r = 0.21), there is a negative correlation between AgNOR and MIB-1 on G1 (r =-0,97), positive correlation in G2 (r = 0.36) as well as positive correlation between G2 and G3 (r = 0.33). The positive correlation between AgNOR and MIB-1 were associated to the increased of G1, S and G2 phase in the proliferation cell and an increase of cells undergoing mitosis. The negative correlation were caused by the different cell proportion in G1, S and G2 phase, and undergoing mitotis.Key words: Breast cancer, AgNOR, MIB-1, surgery

Evaluation of Local Advanced Breast Cancer Following Mastectomy: Recurrence and Influencing Clinicohistopathology Factors Yulian, Erwin D.; Yang, Andrew J.
The New Ropanasuri Journal of Surgery Vol. 1, No. 1
Publisher : UI Scholars Hub

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Introduction. Locally advanced breast cancer is a quite common clinical scenario in the developing countries where the recurrence remains a problem. Mastectomy is one of the primary treatment. Age, clinical stage, lymph nodes involvement, histopathlogy, tumorgrading and itssubtypes are thought as clinic histopathologic factors influencing the recurrence. We run a study aimed to find out role of these factors on the recurrence after mastectomy. Method. The study designed as an analytical cross–sectional one. A complete data of all patients treated in dr. Cipto Mangunkusumo General Hospital with locally advanced breast cancer underwentmastectomy withappropriate definitive treatmenttothe stage, and had disease free interval, and could be followed for at least 24 months during period of January 2011 to December 2012 is recorded. Results. There were 39 subjects enrolled. Among these subjects, the recurrence was 7.6%. Through bivariate analysis we found a significant correlation between the histopathology type (p = 0.008), lymph nodes involvement (p = 0.026) with the recurrence. In multivariate analysis we found that the most influential factor to reccurrence was lymph node involvement (p = 0.002). Conclusion. In this study the most influential factor on the recurrence in locally advanced breast cancer following mastectomy is positive lymph nodes more than three nodes.

Clinicopathological Predictors of Central Compartment Lymph Node Metastases in cN0 Papillary Thyroid Carcinoma Purnomo, Henricus SW.; Yulian, Erwin D.; Makes, Benyamin; Wangge, Grace
The New Ropanasuri Journal of Surgery Vol. 2, No. 1
Publisher : UI Scholars Hub

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Introduction. Prevalence of the lymph node metastases of central neck compartment in papillary thyroid carcinoma (PTC) and its correlation with regional metastatic remains high. There are pros and cons on central neck dissection which is thought to solve the problem. Selection of appropriate patient to undergo central neck dissection is then essential. Thus, predictive factors were very useful in such selection, and we run a study aimed to find out the clinicopathological predictive factors for metastases of central compartment in subjects treated in Cipto Mangunkusumo General Hospital. Method. Data of 62 cN0 papillary thyroid carcinoma (PTC) subjects who underwent central neck dissection were collected consecutively and retrospectively studied. The correlations between clinicopathological factors such as age. Gender, tumor size, extra thyroid extension. Distant metastasis, completeness of resection, histopathology variant, lymphovascular invasion and central compartment metastases were the variables analyzed. Chi square. Fischer exact and stratification test were used. Significance found if p value of <0.05 with 95% confidence interval. Results. In this study, the prevalencein our hospital is 20.9%. The clinicopathological factors that statistically showed significance were the positive lymphovascular invasion (OR=14.40; p<0.05), tall cell variant (OR= 14.00; p <0.05), positive extra thyroid extension (OR=10.44; p<0.05) and age ≥45 years (OR= 9.47; p <0.05). Lymphovascular invasion showed a higher OR (OR=14.40). Conclusion. The lymphovascular invasion, tall cell variant, extra thyroidal extension and age might be the predictors for central compartment lymph node metastases in cN0 PTC patients. However, lymphovascular invasion has the highest risk factor for central neck compartment metastases.

Survival Analysis in Young–Age Breast Cancer and Related Clinicopathologic Factors at dr. Cipto Mangunkusumo General Hospital 2008–2015 Yulian, Erwin D.; Salim, Adrian
The New Ropanasuri Journal of Surgery Vol. 3, No. 2
Publisher : UI Scholars Hub

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Introduction. Various cancer registrations and reports had confirmed the higher proportion of young women with breast cancer in Asian countries. This mandates special attention for clinician since this group of patients need different management approach, especially regarding the more aggressive biological behavior, worse prognosis and the escalating psychosocial burden that young women endure. We conducted a study to describe the clinicopathological characteristics of young–aged breast cancer in Indonesia and its relationship with overall survival. Method. This study is a survival analysis using samples all young–aged women with histologically–proven cancer diagnosis that underwent treatment (surgery and/or chemotherapy and/or irradiation and/or hormonal therapy) since January 2008 to August 2015. Data were collected from both medical records and interview. Data were analyzed using SPSS Results. Young–age women comprise 35% of total breast cancer patients, with most cases were in the locally advanced stage, histologic type NST, grade 2, no lymphovascular invasion, positive hormone receptors, negative HER2 status, high Ki–67 and Luminal B subtype. The 5–year overall survival rates were 64%; variables that showed statistically significant correlation was tumor size, nodal status, metastasis status and clinical stage. Histologic type NST, grade 2, positive lymphovascular invasion, high Ki–67 and positive HER2 were related to survival, but this correlation was not statistically significant. Conclusion. Overall 5–year survival rates of young–aged breast cancer at dr.Cipto Mangunkusumo General Hospital was 64%, much lower that reported figures from literatures and other countries’ reports. Clinical stage was the only variable with statistically significant correlation. Luminal B subtype was observed the most, but the worst survival was found in the HER2 subtype group.

A Solitary Bone Plasmacytoma In the Mandible: A Case Report Yulian, Erwin D; Suryadi, Andre S
The New Ropanasuri Journal of Surgery Vol. 5, No. 1
Publisher : UI Scholars Hub

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Abstract Introduction: Solitary bone plasmacytoma (SBP) is a localized neoplasms in the bone consisting of abnormal plasma cells. We herein report an unusual case of SBP that presents in mandible bone. Case Illustration: A 57-year-old woman, with chief complaint for the lump at right jaw, which gradually increasing in size since 13 years ago. Diagnosis was based on clinical, radiological, and histopathological findings. The patient was referred for radiotherapy before surgery using 50 Gy dose of radiation for 25 times with the result of partial response, followed by hemimandibulectomy and reconstruction with free fibular flap. Complete resection in a form of hemimandibulectomy can eliminate monoclonal proteins in serum, and can reduce the progression of the disease into multiple myeloma. Patient was still in regular visits to oncology surgery clinic in RSCM, with no reccurence of disease after six months of postoperative.

Risks and Benefits of Central Neck Dissection (CND) in Differentiated Thyroid Carcinoma (DTC) Purnomo, H.S. Wahyu; Yulian, Erwin D; Wangge, Grace
Jurnal llmu Bedah Indonesia Vol 46 No 1 (2018): Artikel Penelitian
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v46i1.34

Introduction: The role of central neck dissection (CND) remains controversial in differentiated thyroid cancer (DTC). Risk and benefit of CND is necessary to be identified for judging whether CND will be performed or not. Methods: A literature search was performed in MEDLINE (pubmed) using main keywords such as differentiated thyroid carcinoma (DTC), central neck dissection (CND), total thyroidectomy. The literature had inclusion criteria english language literature with risk and benefit of CND. We used qualitative approach to summary descriptive papers result. Results: Sixteen trials were analyzed. There was no increased risk of recurrent laryngeal nerve (RLN) injury (temporary or permanent), permanent hypocalcemia, or locoregional recurrence when CND was performed in addition to TT. Postoperative temporary hypocalcemia was more common after TT with CND than after TT alone. Conclusion: TT alone results in less surgical morbidity in the immediate postoperative period and an identical locoregional recurrence rate compared with TT plus CND.

RARE CASE OF LEPTOMENINGEAL METASTASES FROM POORLY DIFFERENTIATED PAROTID CARCINOMA : RARE CASE OF LEPTOMENINGEAL METASTASES Tiara Aninditha; Dyah Ayu Puspita Anggarsari; Radius Kusuma; Eka Susanto; Erwin Danil Yulian; Irma Savitri; Henry Riyanto Sofyan
Acta Neurologica Indonesia Vol. 3 No. 01 (2025): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v3i01.43

exceedingly rare and challenging to diagnose, requiring confirmation via imaging and cerebrospinal fluid (CSF) cytology. Clinical signs like secondary headache often signal critical intracranial involvement. Case Report: A 27-year-old woman presented with severe headache, dizziness, and vomiting. She had a history of poorly differentiated parotid carcinoma with liver metastases and prior chemotherapy (CAF: cisplatin, doxorubicin, and fluorouracil). Physical exam revealed mild peripheral facial nerve palsy, ataxic gait, and tremor. High-dose dexamethasone and acetaminophen provided headache relief. CT brain imaging showed vasogenic edema with leptomeningeal enhancement in the right cerebellum and a 46% reduction in the parotid lesion. MRI of the nasopharynx identified leptomeningeal enhancement, notably in the right cerebellum, suggesting metastasis, along with fourth ventricle narrowing and ventricular dilation. CSF cytology revealed poorly differentiated malignant cells with pleomorphic nuclei. Craniospinal irradiation was planned. Discussion: Leptomeningeal metastasis is an uncommon parotid carcinoma complication. Secondary headache, diffuse and bilateral, typically affects the C2-C3 dermatome and is accompanied by dizziness. Symptom relief with high-dose dexamethasone was observed. Definitive LM diagnosis combines CSF cytology and MRI leptomeningeal enhancement. As chemotherapy options for LM from parotid carcinoma are limited, craniospinal irradiation is the preferred treatment. Conclusion: Leptomeningeal metastasis from poorly differentiated parotid carcinoma is extremely rare, confirmed by clinical signs, imaging, and CSF analysis. Severe secondary headache is a key indicator, and delayed diagnosis could prove fatal.

Relationship Between C-Reactive Protein-Albumin Ratio and Metastasis in Breast Cancer Hazmi, Mohammad Zul; Panigoro, Sonar Soni; Yulian, Erwin Danil; Nugroho, Nyityasmono Tri; Agustina, Amilya
Indonesian Journal of Cancer Vol 19, No 1 (2025): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i1.1224

Background: Breast cancer is a type of malignancy with the highest number of cases in the world and Indonesia. The C-reactive protein-albumin ratio (RCA) is a simple, feasible, and objective breast cancer serum marker representing inflammatory and nutritional status. There are not many studies regarding the relationship between RCA and breast cancer metastasis, especially in the advanced-stage case population in Indonesia.Method: Study with a cross-sectional design in 180 breast cancer patients stage III and IV at Cipto Mangunkusumo Hospital, who were diagnosed in 2018 until 2023. Comparative analysis of the RCA values between the groups with and without metastasis was carried out using the Chisquare test. All statistical test results are considered significant if the p-value is 0.05.Results: A receiver-operating characteristic curve (ROC) is a graphical analytical technique used to assess the effectiveness of a binary diagnostic classification method. The ROC area under the curve (AUC) value was 0.713 (IC 95%; 0.638–0.789) and significance 0.001, with the RCA cut-off value was 0.515 with sensitivity 74.4% and specificity 67.8%. The high RCA proportion was 53.3%. There is a significant relationship (p-value 0,001) between RCA level and the risk of metastasis in breast cancer patients. Liver and lung metastases of breast cancer are the most frequent locations. Conclusion: The CRP-albumin ratio has a significant relationship with the incidence of metastasis in breast cancer

Studi Nilai AgNOR dan MIB-1 pada Kanker Payudara yang Ditangani dengan Operasi Kurnia, Iin; Soetrisno, Esti; Yulian, Erwin D.; Ramli, Irwan; Alatas, Zubaidah
Indonesian Journal of Clinical Pharmacy Vol 1, No 3 (2012)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1011.587 KB)

AgNOR dan MIB-1 adalah marker proliferasi sel kanker payudara yang berguna sebagai dasar pemberian radioterapi setelah operasi. Penetapan nilai AgNOR dan indeks MIB-1 dilakukan dengan teknik pewarnaan dan teknik pewarnaan imunohistokimia MIB-1 terhadap 25 sediaan mikroskopik jaringan kanker payudara dari penderita hasil operasi, dan dikelompokkan berdasarkan derajat diferensiasinya menjadi 3 kelompok sediaan berderajat diferensiasi baik (G1), 16 sediaan berderajat diferensiasi menengah (G2), dan 6 sediaan berderajat diferensiasi buruk (antara G2 dan G3). Hasil penelitian menunjukkan nilai AgNOR dan indeks MIB-1 cenderung meningkat seiring dengan meningkatnya derajat diferensiasi. Terdapat pula kecendrungan korelasi positif antara nilai AgNOR dan indeks MIB-1 (r =0,21) pada seluruh derajat diferensiasi, terdapat korelasi negatif antara AgNOR dan MIB-1 pada G1 (r=-0,97), korelasi positif pada G2 (r=0,36) serta korelasi positif antara G2 dan G3 (r=0,33). Korelasi positif antara AgNOR dan MIB-1 terkait dengan peningkatan fase G1, S dan G2 pada sel yang berproliferasi dan peningkatan jumlah sel yang mengalami mitosis. Korelasi negatif disebabkan oleh perbedaan proporsi antara sel yang berada pada fase G1, S dan G2 dengan yang sedang bermitosisKata kunci: Kanker payudara, AgNOR, MIB-1, operasi Study of AgNOR Value and MIB-1 in Breast CancerTreated With Surgery AbstractAgNOR and MIB-1 are marker for breast cancer cell proliferation and can be use as based for radiotherapytreatment after surgery. Value of AgNOR and MIB-1 index were determined using staining and immunohistochemistry staining method respectively from 25 of microscopic slides of breast cancer tissue patients with surgery, and grouped based on degree of differentiation, 3 slides were good degree (G1), 16 slides were medium degree (G2) and 6 slides were poor degree (between G2 and G3). The result shown that the value of AgNOR and MIB-1 index were tended to increase with the increased differentiation degree. There was a positive correlation between the value of AgNOR and index of MIB-1 in all group of differentiation degree (r = 0.21), there is a negative correlation between AgNOR and MIB-1 on G1 (r =-0,97), positive correlation in G2 (r = 0.36) as well as positive correlation between G2 and G3 (r = 0.33). The positive correlation between AgNOR and MIB-1 were associated to the increased of G1, S and G2 phase in the proliferation cell and an increase of cells undergoing mitosis. The negative correlation were caused by the different cell proportion in G1, S and G2 phase, and undergoing mitotis.Key words: Breast cancer, AgNOR, MIB-1, surgery

Five-year survival of triple-negative breast cancer and the associated clinicopathological factors: a study in an Indonesian tertiary hospital Yulian, Erwin Danil; Fachriza, Ihza
Medical Journal of Indonesia Vol. 32 No. 4 (2023): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247161

BACKGROUND Triple-negative breast cancer (TNBC) has a worse rate of recurrence, survival, and overall survival. This study aimed to find the survival of TNBC and its clinicopathological factors at Cipto Mangunkusumo Hospital. METHODS This study used survival analysis based on clinicopathology in 112 TNBC cases at Cipto Mangunkusumo Hospital, Jakarta, Indonesia, diagnosed from 2009 to 2019. Kaplan–Meier and log-rank tests were used for the analysis. Bivariate and multivariate analyses using Cox regression were performed to obtain the hazard ratios (HRs). RESULTS Most patients were diagnosed at the locally advanced stage (40.2%) compared to the early (33.0%) and metastatic stages (17.9%). The 5-year survival of TNBC was 81.2% with an HR value of 1.372 (p = 0.239) compared to luminal A. Bivariate analyses showed that the older age group with an HR of 6.845 (p = 0.013; CI 1.500–31.243), larger tumor size and extension (T) with an HR of 11.826 (p = 0.001; CI 2.707–51.653), broader regional lymph node involvement (N) with an HR of 8.929 (p = 0.019; CI 1.434–55.587), farther distant metastases (M) with an HR of 3.016 (p = 0.015; CI 1.242–7.322), more lymphovascular invasion with HR of 3.006 (p = 0.018; CI 1.209–7.477), and not operated-on cases with an HR of 9.165 (p<0.001; CI 3.303–25.434) significantly shortened the survival of TNBC. Multivariate analysis found that the only factor worsening the survival was not having surgery, with an HR of 6.175 (p<0.001; CI 1.518–34.288). CONCLUSIONS The 5-year survival rate of TNBC patients was 81.2%. Not having surgery was a clinicopathological factor that worsened survival outcomes in TNBC.

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