Agus Rizal AH. Hamid
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Perbedaan Ekspresi Chromogranin A pada Adenokarsinoma Prostat Berdiferensiasi Baik, Sedang dan Buruk Gandi Haryono; Budiana Tanurahardja,; Agus Rizal AH. Hamid
Majalah Patologi Indonesia Vol 28 No 2 (2019): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (641.689 KB)

Abstract

Latar belakang Kanker prostat merupakan tumor ganas terbanyak ketiga pria di dunia. Penyebabnya dipengaruhi faktor usia, genetik, ras, hormonal, diet dan lingkungan. Kanker prostat dapat mengalami neuroendocrine differentiation (NED), meningkat pada kanker prostat berdiferensiasi buruk terutama yang tidak merespon baik terhadap terapi hormonal. NED akan menentukan prognosis dan pemilihan alternatif terapi. Tujuan penelitian ini untuk mengetahui perbedaan ekspresi chromogranin A (CgA) pada adenokarsinoma prostat berdiferensiasi baik, sedang dan buruk serta kaitannya dengan derajat keganasan berdasarkan grading tumor yang diharapkan dapat menentukan prognosis dan pemilihan alternatif terapi. Metode Studi potong lintang terhadap jaringan biopsi yang difiksasi formalin, diletakkan dalam parafin dari pasien dengan adenokarsinoma prostat berdiferensiasi baik, sedang dan buruk. Sampel penelitian dipulas dengan pewarnaan imunohistokimia CgA, diidentifikasi dan dianalisa hubungan ekspresi CgA berdasarkan usia, diagnosis histopatologik, grade groups, skor Gleason dan kadar PSA. Hasil Ekspresi CgA positif dengan median 40 (0,4-100) banyak terjadi pada kelompok usia <70 tahun. Ekspresi CgA positif dengan median 56,2 (0,4-100) banyak terjadi pada kasus adenokarsinoma prostat berdiferensiasi buruk, grade tinggi dan skor Gleason >7. Ekspresi CgA positif dengan median 35,4 (0,4-88,6) banyak terjadi dengan kadar PSA >52,4 μg/ml. Didapatkan hubungan bermakna antara ekspresi CgA dengan diagnosis histopatologik, grade groups dan skor Gleason (p=0,006; p=0,021; p=0,006). Tidak didapatkan hubungan bermakna antara ekspresi CgA dengan usia dan kadar PSA (p=0,412; p=0,969). Kesimpulan Terdapat kecenderungan positivitas ekspresi CgA lebih banyak terjadi pada kasus adenokarsinoma prostat berdiferensiasi buruk dengan grade tinggi, yang dapat mempengaruhi prognosis dan pemilihan alternatif terapi
Profil Klinikopatologik Kasus Adenokarsinoma Prostat di RSCM Tahun 2010-2019 dengan Tinjauan Khusus Biopsi Robotik Gusti Rizky Prasetya; Meilania Saraswati; Agus Rizal AH. Hamid; Sahat BRE. Matondang
Majalah Patologi Indonesia Vol. 31 No. 3 (2022): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v31i3.512

Abstract

BackgroundProstate adenocarcinoma is second most common malignancy in men and fourth leading death cause from malignancy worldwide. Prostate biopsy is the gold standard for diagnosing this disease. However, the difficulty of sampling is a weakness in this procedure. In Cipto Mangunkusumo hospital, biopsy technology is now available with robotic techniques for biopsy sampling, which is expected to increase prostate biopsy accuracy. This study was to determine prostate adenocarcinoma case profile in the Department of Pathology Anatomic Cipto Mangunkusumo Hospital for 10 years and to examine differences in sampling of biopsy preparations with robotic and non-robotic techniques. MethodsThis study was an exploratory descriptive study with cross-sectional design to determine prostate adenocarcinoma case profile in the Department of Anatomic Pathology FKUI-RSCM for 10 years. The data obtained between the Gleason score of prostate biopsy preparations and surgery. Robotic prostate biopsy results were compared with prostate imaging reporting and data system (PIRADS) score. ResultsThe mean age of the patients was 67 years old and several patients were aged <50 years old. Many poor differentiation cases were found. It appears that there is a relationship between WHO/ISUP degree and perineural invasion. In 14 patients who underwent histopathological examination more than once, it was found that 9 patients had the same WHO/ISUP degree and 5 patients had a changed WHO/ISUP degree. There are several discrepancies in PIRADS score and histopathological findings from 21 robotic preparations examined. ConclusionThe mean age of patients fit to theory of generalized prostate adenocarcinoma. Many cases of poor differentiation were found, possibly related to RSCM as a national referral center. The repeated sample examination results are similar to the results of other studies. Robotic method biopsy gives the sense of more comprehensive sampling in comparison to non-robotic method.