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High Expression of Nicotinamide Adenine Dinucleotide Phosphate Oxidase 4 Correlates with High Grade of Clear Cell Renal Cell Carcinoma Rezeki, Dewi Sri; Laksmi, Lidya Imelda; Mariedina, Causa Trisna; Alferraly, T. Ibnu; Lukito, Joko S.; Betty, Betty
Majalah Patologi Indonesia Vol. 33 No. 2 (2024): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i2.581

Background Clear cell renal cell carcinoma (ccRCC) is the most common histological subtype in renal cell tumors (RCT). This is a very aggressive cancer, often diagnosed at advanced stage leading to increase morbidity and mortality rates. Nicotinamide adenine dinucleotide phosphate (NADPH) oxidase 4 (NOX-4) expression plays role in the regulation of several cancer types. The expression of NOX-4 is associated with a poorer degree of differentiation and a shorter survival in RCT. Therefore, NOX-4 expression is predictor of prognosis and potential therapeutic target. Research on the correlation of NOX-4 expression in RCTs is still very limited, while Correlation of NOX-4 expression in ccRCC does not exist yet. Objective To assess the relationship between NOX-4 expression and ISUP grading in ccRCC. Method In this study, 30 slide samples and ccRCC paraffin blocks were diagnosed histopathologically at Department of Anatomic Pathology of H. Adam Malik General Hospital from January 2012 to April 2022. All clinicopathological data were taken from medical records/pathology archives. The expression of NOX-4 immunohistochemical was assessed in nucleus and cytoplasm of tumor cells. The assessment was carried out semiquantitatively based on intensity and percentage of expressed tumor cells. The relationship between NOX-4 expression and ISUP grading was assessed using Fisher's exact test. Results Of the 30 ccRCC samples, high grade ccRCC was found in 21 cases (70%) and strong expression of NOX-4 in cytoplasm and nucleus in 20 cases (66.7%). Strong expression of NOX-4 in high grade ccRCC was found in 17 cases (81.0%). A significant relationship was observed between NOX-4 expression and ISUP grading on ccRCC with a p-value of 0.030 (p<0.05) using Fisher's exact test. Conclusion There is a significant relationship between NOX-4 expression and ISUP grading in ccRCC. Therefore, NOX-4 expression can be used for the prognosis of ccRCC and therapy development.

Relationship of Stromal Tumor Infiltrating Lymphocytes (STILs) with Grading Histopathology in Penis Squamous Cell Carcinoma Sihotang, Marisi Cintya Debby; Intan, T. Kemala; Alferraly, T. Ibnu; Betty, Betty; Soekimin, Soekimin; Delyuzar, Delyuzar
Majalah Patologi Indonesia Vol. 33 No. 2 (2024): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i2.580

ABSTRACT Background:Penile squamous cell carcinoma is the most common penile malignance found in the world. Assessment of stromal tumor infiltrating lymphocytes (STILs) associated with grading against penile squamous cell carcinoma can provide a potential prognostic picture and help determine the action. Method:Cross-sectional analytical study with 32 samples of histopathological preparations diagnosed as penile squamous cell carcinoma at H. Adam Malik Hospital Medan. The assessment of stromal TILs was carried out by assessing the number of lymphocyte inflammatory cells in the peritumoral stroma and then determined the assessment score, zero score no lymphocytes (minimum), score one found 0-10% lymphocytes (moderately), score two found 20-40% lymphocytes (massive) , score three found 50-90% lymphocytes. Grading assessments are categorized into grade I (well differentiated), grade II (moderately differentiated), and grade III (poorly differentiated). Result:The most grading found was grade II (43.8%) and the most STILs found were score three (50.0%). There is a significant relationship between grading and STILs in penile squamous cell carcinoma (p value=0.0001) i.e. the higher the STILs score , the lower the tumor grade. Conclusion:There is a relationship between STILs and histopathological grading in Penile Squamous Cell Carcinoma so that it can be used as an indikasi prognosis in patients with penile squamous cell carcinoma.

Correlation Ki67 Expression With peritumoral budding Tumor Index In the Case of Squamous Cell Carcinoma Cervix NOS And Adenocarcinoma Cervix NOS Wardini, Indah Astri; Alferraly, T. Ibnu; Chrestela, Jessy; Betty, Betty; Intan, T. Kemala; Lubis, H. M. Nadjib Dahlan
Majalah Patologi Indonesia Vol. 33 No. 3 (2024): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i3.611

Background Cervical cancer is a neoplasm in the cervix due to abnormal cells that damage the surrounding tissue. Cervical cancer from squamous cells is called squamous cell carcinoma cervix NOS and that from glands is called adenocarcinoma cervix NOS. The prognostic of both can be assessed by tumor budding and Ki67 immunohistochemistry, tumor budding is a tumor bud which is ≤ 5 cells in a cluster that grows in front of the parent tumor and immunohistochemistry Ki67 is a labile nonhistone nuclear protein which is expressed in the G1, S, G2 and M phases of the cycle cell. Method This research is an analytical type of research that aims to find out the relationship between Ki67 expression and the peritumoral budding tumor index compared to cases of squamous cell carcinoma cervix NOS and adenocarcinoma cervix NOS with 36 paraffin block samples diagnosed with squamous cell carcinoma NOS and adenocarcinoma NOS at HAM Hospital. Medan. Assessment method of Ki67 expression where low expression (<20%) and high expression (≥20%). Assessment of peritumoral budding tumors in both cases was said to be low buds if < 5 buds and high buds if ≥ 5 buds. Results This study provides a significant appearance (p-value 0.0001) which means that peritumoral budding tumors with HE staining can be accepted as a measuring tool for assessing cervical cancer in addition to assessment using immunohistochemistry Ki67 which is generally used in the prognostic assessment of cervical cancer. Conclusion Assessment in this case can consider peritumoral budding tumor assessment to determine prognostic in cases of squamous cell carcinoma NOS and cervical adenocarcinoma NOS, if Ki67 immunohistochemistry is not available.

Correlation between Matrix Metalloproteinase-9 Matrix Expression and Clinicopathology in Colorectal Adenocarcinoma Not Otherwise Specified Sembiring, Rica Friska; Intan, T. Kemala; Alferraly, T. Ibnu
Majalah Patologi Indonesia Vol. 33 No. 3 (2024): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i3.629

Background Matrix metalloproteinase-9 (MMP-9) is a member of the metalloproteinase enzyme that is often found in colorectal adenocarcinoma. MMP-9 is able to destroy basement membrane proteins and extracellular matrix which play a role in tumor cell invasion. Method Cross-sectional analytic study with 30 paraffin block samples diagnosed as colorectal adenocarcinoma NOS at H. Adam Malik General Hospital Medan. MMP-9 expression was assessed using immunohistochemical staining in the cytoplasm of tumor cells and cells in the stroma. Expression was assessed using the Quick Score method and was declared weak if the total value was 0-5 and strong if the total value was ≥6. Statistical analysis between MMP-9 expression and depth of invasion was carried out using Fisher's Exact and Mann-Whitney U tests. Results MMP-9 expression was significantly related to stage (p=0.01), depth of invasion (p=0.03), and stromal Tils (p=0.03) and not significantly related to gender (p=0.28) , age (p=0.82), tumor location (p=0.69), grading (p=0.26), lymph node involvement (p=0.53), metastasis (p=0.53), perineural invasion (p=0.25), lymphatic invasion (p=1.00), IMVI (p=0.531.00), EMVI (p=1.00), tumor budding (0.25). Conclusion MMP-9 expression can be used as an indication of prognosis and also helps clinicians, especially in the management of patients with colorectal adenocarcinoma NOS.

The Correlation between Matrix Metalloproteinase-9 (MMP-9) Immunohistochemical Expression and Histopathological Subtypes of Basal Cell Carcinoma: A Correlation between Matrix Metalloproteinase-9 (MMP-9) Immunohistochemical Expression and Histopathological Subtypes of Basal Cell Carcinoma Aisyah, Siti; Intan, T. Kemala; Alferraly, T. Ibnu; Betty, Betty; Soekimin, Soekimin; Laksmi, Lidya Imelda
Majalah Patologi Indonesia Vol. 33 No. 2 (2024): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i2.644

ABSTRACT Background Basal cell carcinoma (BCC) is a non-melanocytic skin cancer originating basal layer of the epidermis and/or hair follicles that shows an increasing global incidence. Disease growth is slow, rarely metastasizes but has the ability to invade and destroy deeper surrounding tissues. Low mortality, but high morbidity. Matrix metalloproteinases are enzymes that can degrade various extracellular matrix components. In skin, MMP-9 expression may be increased by prolonged ultraviolet exposure. UV radiation is one of the causes of BCC. Method Analytic study with a cross sectional approach on 40 surgical samples diagnosed as BCC and then performed with MMP-9 immunohistochemical staining. The data obtained were processed with statistical software and the relationship between the immunohistochemical expression of MMP-9 with histopathological subtypes of basal cell carcinoma was used the Somers'd statistical test. Results The expression of MMP-9 in the lower risk BCC group with the weakest expression was 37.5%, the most common nodular BCC subtype was 27.5%. The higher risk BCC group with the strongest expression was 20.0%, the most common infiltrating BCC was 17.5%. There was a significant relationship between the immunohistochemical expression of MMP-9 with histopathological subtypes of basal cell carcinoma, p value <0.0001 (p<0.05). Conclusion This study proves that there is a significant relationship between the expression of MMP-9 with histopathological subtypes of basal cell carcinoma, so it can be considered as an additional marker to predict the recurrence.

The Correlation of Clinicopathological Characteristics in Clear Cell Renal Cell Carcinoma (ccRCC) with Immunohistochemical Expression of Light Chain 3 B (LC3-B) Rezeki, Dewi Sri; Alferraly, T. Ibnu; Chrestella, Jessy; l, Lidya Imelda; Lukito, Joko S.
Majalah Patologi Indonesia Vol. 34 No. 2 (2025): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v34i2.680

Background: Clear cell renal cell carcinoma (ccRCC) is the most common histological subtype in RCTs. This tumor is very aggressive and is often diagnosed at an advanced stage. LC3-B is a specific autophagy marker that plays a role in ccRCC. Research regarding the relationship between clinicopathological characteristics of ccRCC and LC3-B expression is still very limited and controversial. Objective: To assess the relationship between clinicopathological characteristics of ccRCC and LC3-B immunohistochemical expression. Materials and methods: This study used 22 slide samples/paraffin blocks of ccRCC cases that had been diagnosed histopathologically at the Anatomic Pathology Unit of H. Adam Malik General Hospital, Medan from January 2017 to April 2023. All clinicopathological data was taken from medical records/pathology archives. LC3-B expression was assessed in the cytoplasm of tumor cells with assessment semiquantitatively based on the multiplication of intensity and percentage of expressed tumor cells. Statistical analysis was carried out using Fischer's Exact and Kruskal Wallis tests. Results: Among the 22 ccRCC samples, weak expression of LC3-B was found in the age group ≤60 years, male gender, tumor size >10 cm, positive LVI, negative PNI, grade IV, severe stromal TILs, mild intratumoral TILs and low budding in intratumoral budding tumors. Fischer's Exact and Kruskal Wallis statistical tests showed that there was no significant relationship between gender, tumor size, LVI, PNI, ISUP grading, TILs and peritumoral tumor budding with LC3-B expression. Conclusion: There was no significant relationship between clinicopathological characteristics of ccRCC with LC3-B expression (The Null Hypothesis is accepted (H0 ρ=0)). Key words: clinicopathology, ccRCC, LC3-B

Hubungan Ekspresi CD117 dan Epidermal Growth Factor Receptor (EGFR) terhadap Grading Histopatologi Adenoid Cystic Carcinoma pada Kelenjar Liur Siregar, Ren Astrid Allail; Alferraly, T. Ibnu; Delyuzar
Majalah Patologi Indonesia Vol. 29 No. 1 (2020): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v29i1.402

BackgroundTend to have adenoid cystic carcinoma (AdCC) is one of malignant epithelial tumor of the salivary gland poor prognosis, localrecurrence and metastases. Histopathological grading system according Weert, et al. observed from presence or absence solidcomponent of AdCC. CD117 is a transmembrane tyrosine kinase receptor usually strong expression in AdCC. EGFR belongs to theErbB family of receptor tyrosine kinases associated with cell proliferation, angiogenesis and metastases. Patients with advanceddisease may benefit from targeted therapy besides conventional management. Expression of CD117 and EGFR may give proposaltherapy through difference histology pattern of AdCC based on histopathological grading.MethodsThis is an analytical descriptive study with cross sectional approach. Formalin-fixed paraffin-embedded sections from 35 adenoidcystic carcinomas were obtained for histopathological grading and for immunostained of CD117 and EGFR using monoclonalantibodies. The staining intensity and percentage of cells with membranous and cytoplasmic of CD117 and EGFR expression werescored and then grouped according to the parameters of the Allred scoring system.ResultsChi-square test between CD117, EGFR expression and histopathological grading of AdCC showed no sigficant differences.Besides, McNemar test between CD117 and EGFR expression and histopathological grading AdCC showed significant differences,p-value=0.03 (p<0.05).ConclusionsCD117 and EGFR could be used to detected salivary gland AdCC

Hubungan Ekspresi Sex Determining Region Y Box 2 (SOX2) dengan Grading Histopatologi, Invasi Vaskular Intramural dan Ekstramural pada Adenokarsinoma Kolorektal Rizki, Diana; Delyuzar, Delyuzar; Alferraly, T. Ibnu; Betty, Betty; Soekimin, Soekimin; S. Lukito, Joko
Majalah Patologi Indonesia Vol. 32 No. 2 (2023): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v32i2.617

Background Incidence and mortality of colorectal carcinoma (CRC) worldwide varies widely (10 times). Ninety percent colorectal malignancies are adenocarcinomas. Expression SOX2 is associated with high tumor grade, invasion, metastasis as well as a prognostic predictor of colorectal adenocarcinoma. Objective: Analyze the association of SOX2 immunohistochemistry expression with histopathological grading, intramural and extramural vascular invasion in colorectal adenocarcinoma. Methods Analytical study using a cross-sectional approach on 35 samples from the Anatomic Pathology Unit, H. Adam Malik Hospital, Medan. Immunohistochemical staining of SOX2 mouse monoclonal antibody (Bioassay Technology Laboratory) was performed and expression assessed as low (0-3) and high (4-6). Differences in expression were analyzed by Chi-square and Mann-Whitney correlation tests. Results The most patients with colorectal adenocarcinoma were at age of 51-60 years (34.3%), male sex was more common (60%), the most tumor location was in the rectum (40%), the most depth of invasion was T3 (74.3%) , low grade was more common (60%), more intramural vascular invasion was found (40%), and the highest expression of SOX2 was found to high expression which mostly in the nucleus and cytoplasm (84.6%) There was no significant association between SOX2 expression and histopathological grading (p= 0.884) and there was no significant association between SOX2 expression and vascular invasion, both intramural and extramural (p= 0.390). Conclusion There was no significant association between SOX2 expression and histopathological grading and vascular invasion, both intramural and extramural.

Correlation between Microvessel Density Based on CD31 Immunohistochemical Expression and Clinicopathology of Invasive Breast Carcinoma Bitaria Febrawati, Eka; Alferraly, T. Ibnu; Betty, Betty
Majalah Patologi Indonesia Vol. 32 No. 2 (2023): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v32i2.619

Background Breast carcinoma is the most common malignancy in women worldwide. Tumor size, metastases, lymph node involvement (KGB), stage and histopathological grade are significant prognostic factors in invasive breast carcinoma. Microvessel density (MVD) assessment is used to measure angiogenesis which helps predict tumor behavior and the effect of antiangiogenic therapy. MVD is a quantitative calculation of intratumoral capillary blood vessels which reflects the results of the process of angiogenesis. The aim of this study was to analyze the relationship between MVD based on CD31 immunohistochemical expression and the clinicopathology of invasive breast carcinoma. Method Cross sectional analytic study with 42 samples diagnosed with invasive breast carcinoma at H. Adam Malik General Hospital Medan. MVD is the number of small blood vessels in terms of size and diameter (arterioles and venules) with a round lumen that is positively stained with CD31 at 10 large visual fields, categorized as low if <45 blood vessels/10 LPB and high if ≥45 blood vessels/10 LPB. The relationship between MVD and several clinicopathological parameters was analyzed using the Chi-Square, Fisher's Exact and Mann-Whitney tests. Results There was a significant relationship between tumor size (p=0.029), metastasis (p=0.014), stage (p=0.002), histopathological grade (p=0.0043), LVI (p=0.002), TILs (p=0.007). Large tumor size, metastases, high histopathological stage and grade, positive LVI and high TILs were significantly associated with MVD. However, there was no significant relationship between KGB involvement (p=0.570) and MVD. Conclusion MVD is significantly related to tumor size, metastases, stage, histopathological grade, LVI and TILs, and not significantly related to lymph node involvement. MVD plays a role in the angiogenesis of invasive breast carcinoma clinicopathology.

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