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All Journal Medical Journal of Indonesia Universa Medicina Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)
Andrijono Andrijono
Faculty of Medicine, University of Indonesia, Jakarta
Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Level of Retinol Deposit and Cervical Cancer Utami, Tofan W; Ibrahim, Fera; Purwoto, Gatot; Tiffani, Wely L; Aziz, Muhammad F; Andrijono, Andrijono
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 1, January 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (131.483 KB) | DOI: 10.32771/inajog.v5i1.465

Abstract

Objective: To analyze level of retinol deposit sufficiency in the natural history of cervical cancer. Methods: Serum retinol level was measured by ELISA from peripheral blood of subjects with normal cervix, cleared and persistent high risk human papilloma virus (HR-HPV) subclinical infection, and cervical cancer who fulfilled the inclusion and exclusion criteria. The study was held in Dr. Cipto Mangunkusumo and Fatmawati Hospital, Jakarta, within 2 years (August 2013- 2015). Blood was taken twice, consisting of post-8-hour fasting blood and 2 hours after 6000 IU retinyl palmitate oral administration. Results: Of 47 total samples, sufficient level of retinol deposit in normal cervix, cleared and persistent HR-HPV subclinical infection, and cervical cancer group was 85.0% (reference), 75.0% (OR 1.89), 33.3% (OR 11.33), and 75% (OR 1.89); respectively. Statistically, there was no significant difference from sufficiency level of retinol deposit between normal cervix and clearance HR-HPV subclinical infection (p=0.628), normal cervix and persistent HR-HPV subclinical infection (p=0.078), normal cervix and cervical cancer (p=0.433), cervical cancer and clearance HR-HPV subclinical infection (p=1.000), cervical cancer and persistent HR-HPV subclinical infection (p=0.430), persistent and clearance HR-HPV subclinical infection group (p=0.740). Conclusion: This study proves that normal cervix group has the highest level of retinol deposit sufficiency; however, it cannot be stated that cervical cancer group has less sufficiency level. Persistent HR-HPV subclinical infection group has the lowest level of retinol deposit (OR 11.33). There is no association between sufficient level of retinol deposit and clearance of HR-HPV. [Indones J Obstet Gynecol 2017; 5-1: 46-54] Keywords: cervical cancer, HR-HPV clearance, retinol deposit
Human Papilloma Virus L1 Gene Methylation as a Potential Biomarker for Precancerous Cervical Lesion: a Preliminary Report Mongan, Suzanna P; Andrijono, Andrijono; Tjahadi, Hartono
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 2, April 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (115.068 KB) | DOI: 10.32771/inajog.v5i2.532

Abstract

Objective: To determine whether HPV L1 gene methylation can be used in triage of precancerous cervical lesions. The main objective is to determine the genotype of HPV in cervical precancerous lesions and to determine the percentage, the sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio of DNA HPV L1 methylation in precancerous cervical lesions. Methods: A number of 57 samples of paraffin blocks (FFPE) from precancerous lesions and cervical cancer biopsies in the Department of Pathology Faculty of Medicine-Cipto Mangunkusumo General Hospital that had been re-evaluated by the pathologist, underwent extraction of HPV DNA. The genotypes of HPV DNA were examined using primers GP5 / 6 and specific HPV 16, HPV 18 and HPV 52 probes and analyzed by real time PCR. Sequencing was performed on samples with unknown HPV DNA type that were detected using the specific probes to determine the type of HPV. Bisulfite conversion procedure was then performed for the samples that met the inclusion criteria. Results: There were 30 samples (52.6%) with CIN 1, 12 samples (21.1%) CIN 2, 9 samples (15.8%) CIN 3 and 6 samples (10.5%) of cervical cancer. Most of the samples were 36-45 years (35.1%). Of the total 57 samples, 55 samples were successfully extracted and determined the DNA genotyping of HPV (96.5%). HPV 16 infections both in the form of single or multiple was found to be 76.36%. The samples were mostly dominated by co-infection of HPV16 and 18 (49.1%) followed by HPV 16 (24.6%) and HPV 18 (14.0%). Based on the sequencing results there were other types of high risk HPV infection found: HPV 33, HPV 35, HPV 58 and also undeterminate risk HPV 53 and low risk HPV 54. After several procedures of optimization for methylation examination of HPV DNA L1 there was thin band found in electrophoresis procedure in 8 of 42 samples (19%) of HPV 16 after bisulfite conversion but once it was purified there weren’t any band found so we can not proceed to the stage sequencing. Until now we are still in the stage of optimizing the methylation procedure. Conclusion: HPV 16 infection were most commonly found in the form of single or multiple. Co-infection of HPV 16 and 18 were found in the majority of the samples. There were no significant correlation between HPV type and the severity of cervical lesions. Until now, the examination of DNA methylation HPV L1 already obtained eight samples of HPV 16 with a thin band on electrophoresis but the result could not be concluded because it is still in the process of optimization. [Indones J Obstet Gynecol 2017; 5-2: 120-126] Keywords: HPV DNA genotype, L1 gene methylation, precancerous cervical lesions
Incidence of Pelvic and Paraaortic Lymph Node Metastasis in Epithelial Ovarian Cancer at a Tertiary Care Center Andrijono, Andrijono; Risfiandi, Risa
Indonesian Journal of Obstetrics and Gynecology Volume 6. No. 1. January 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (81.832 KB) | DOI: 10.32771/inajog.v6i1.760

Abstract

Objective: To investigate the incidence of pelvic and paraaorticlymph node metastasis in epithelial ovarian cancer.Methods: This was a cross-sectional study. Data were collectedfrom medical records, and from the cancer registry 1539 medicalrecords were obtained. From there, 863 patients were operatedand 676 were not, and only 401 medical records were foundcomplete, and 306 samples were excluded because they have beentreated with NAC and underwent surgery, patients who underwentsurgery but the results is not the epithelium, and patients whounderwent surgery, but the results were benign or borderline. And95 patients who underwent primary surgery and lymphadenectomyonly 55 patients have results in lymphadenectomy. This study usesa calculation of sample size with categorial descriptions, withprecision of 3% then obtained a minimum sample size of 261patients.Results: According to the characteristics of the study subjectsabove, the results were stage I, II, III respectively 60%, 10.9%, and29%. The metastasized of the lymph node paraaortic 9.1%, andpelvic/paraaortic 20% pelvic/paraaortic23.6%. Based on thedegree of differentiation the results were good differentiation30.9%, moderate differentiation 23.6%, and poor differentiation45.5%. We found that paraaortic lymph node metastasis weremost frequent at stadium III (43.8%). In relationship betweenlymph node metastasis with differentiation of epithelial ovariancancer, the most frequent epithelial ovarian cancer were one withpoor differentiation in pelvic/paraaortic lymph node with the sumof 69.2%. From analysis, there is significant difference betweenserous hystologic subtype with mucinosum subtype in pelviclymph node, significant difference between serous hystologicsubtype and clear cell in paraorta or pelvic lymph node andbetween the serous histology subtype and mucinous as well.Conclusion: Lymph node metastasis incident of ovarian epithelialcancer in paraaorta amounts 20%, pelvic 9.1% and pelvic orparaaortic 23.6%. Higher the stadium, the lymph node involvementswill be higher as well (pelvic and paraaortic). In stadium 1of mucinous subtype with well differentiation has minimal lymphnode involvement so we can be more selective in considering therisk and benefit of lymphadenectomy.[Indones J Obstet Gynecol 2018; 6-1: 60-63]Keywords: lymph node metastasis, ovarian cancer
The Proportion of Lymph Node Metastasis in Patients with Stage IIA1 and IIA2 Cervical Cancer who were Treated for Radical Hysterectomy and Pelvic Lymphadenectomy andrijono, Andrijono; Ginealdy, Wahyu
Indonesian Journal of Obstetrics and Gynecology Volume 7, No. 1 January 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (59.963 KB) | DOI: 10.32771/inajog.v7i1.872

Abstract

Objective: This study was designed to determine a difference in prognosis of stage IIA1 cervical cancer compared to stage IIA2 based on the incidence of metastasis to pelvic lymph nodes by radical hysterectomy. Methods:A cross sectional study was conducted among 108 stage II cervical cancer patient post radical hysterectomy in obstetric gynecologic department of Dr. CiptoMangunkusumo hospital since 2006-2016. Results: From 108 patients with cervical cancer stage IIA, 80 (74%) patients are stage IIA1 and the remaining the remaining 28 (26%) patients are stage IIA2. The average age of patients at stage IIA2 (47.79 years) younger than IIA1 (55.85 years) and also patient at stage IIA1 having a higher parity number which is 4 compare to stage IIA2 with the number of parity 2. The Involvement of lymph node metastasis in patients with stage IIA1 and IIA2 cervical cancer were 51 (63.75%) and 16 (57.14%) respectively. Conclusion: Metastatic factor to lymphnode in both stage have the same result. There was no difference in the proportion of lymph node metastasis occurring in both stage IIA cervical cancer stage which was corrected with radical hysterectomy and pelvic lymphadenectomy with p = 0,535. Changing staging does not seem to improve the prognosis. Keywords: cervical cancer, stage IIA, lymphnode metastatic   Tujuan:Membuktikan adanya perbedaan prognosis kanker servik stadium IIa1 dibanding stadium IIa2 berdasarkan kejadian metastasis ke kelenjar getah bening pelvik yang dilakukan histerektomi radikal. Metode: Dengan menggunakan metode potong lintang dilakukan pengambilan data  108 sampel pasien kanker serviks stadium IIA yang dilakukanpembedahanhisterektomiradikal di Departemen OnkologiGinekologi RSUP. Dr. Cipto Mangunkusumo Jakarta sejak tahun 2006 hingga tahun 2016. Hasil: Pasien kanker serviks stadium IIA1 sebanyak 80 (74%) pasien dan stadium IIA2 sebanyak 28 (26 %) pasien. Pada stadium IIA2 (47.79 tahun) didapatkan rata ratausiapasienlebihmudadibandingkan IIA1 (55.85 tahun). Pada stadium IIA1 jugadidapatkanjumlahparitas yang lebihtinggiyaitu 4 sedangkanpada stadium IIA2 denganjumlahparitas 2. Keterlibatan metastasis kelenjar getah bening pada pasien kanker serviks stadium IIA1 dan IIA2 berjumlah 51 (63.75%) dan 16 (57.14%) secara berurutan. Tidak terdapat perbedaan proporsi kejadian metastasis kelenjar getah bening pada kedua kelompok stadium kanker serviks pada stadium IIA dengan nilai p = 0,535. Kesimpulan: Faktor metastasis kelenjar getah bening pada kedua stadium memiliki hasil yang serupa.Tidak terdapat perbedaan proporsi kejadian metastasis kelenjar getah bening pada kedua kelompok stadium kanker serviks stadium IIA1 dan IIA2 yang ditatalaksna dengan histerektomi radikal dan limfadenektomi pelvis. Perubahan penetapan stadium sepertinya tidak memperbaiki prognosis. Kata kunci : Kanker serviks, stage IIA, kelenjar getah bening, faktor prognostik
Cullin 1 is not associated with late-onset preeclampsia Samara, Tjam Diana; Liem, Isabella Kurnia; Prijanti, Ani Retno; Andrijono, Andrijono
Universa Medicina Vol 38, No 1 (2019)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (653.458 KB) | DOI: 10.18051/UnivMed.2019.v38.4-9

Abstract

BackgroundLate-onset preeclampsia (PE) is preeclampsia occurring after 34 weeks of gestational age or later.  Cullin 1 (CUL1), a proangiogenic protein, is expressed in the placenta, where an imbalance between proangiogenic and antiangiogenic proteins during gestation can cause disturbance of trophoblast invasion. This defect results in vascular ischemia that may produce preeclampsia. The objective of this study was to determine the correlation between CUL1 as proangiogenic factor and late-onset preeclampsia. MethodsThis study was of analytical observational cross-sectional design and involved 44 preeclampsia patients with ³34 weeks of gestational age (late-onset PE). The CUL1 level in the subjects’ sera, taken before they gave birth, and in homogenates of their placenta, obtained per vaginam or by cesarean section, were examined by the ELISA technique.  Statistical analysis was performed with the Spearman correlation test with significant p value of <0.05.ResultsMedian maternal age was 31 years and median gestational age was 37 weeks.  Median serum CUL1 was 41.78 pg/mL and median placental homogenate CUL1 was 32.24 pg per milligram of total placental tissue protein. There was no significant correlation between serum CUL1 level and late-onset preeclampsia (r=-0.281; p=0.065). There was also no significant correlation between placental CUL1 level and late-onset preeclampsia (r=-0.166; p=0.281).ConclusionSerum CUL1 and placental CUL1 were not correlated with late-onset preeclampsia. However, this study indicated that low serum CUL1 tends to prolong gestational age in preeclampsia.
Comparison of matrix metalloproteinase-9 and E-cadherin expression in early- and late-onset preeclampsia Samara, Tjam Diana; Wibowo, Heri; Liem, Isabella Kurnia; Prijanti, Ani Retno; Andrijono, Andrijono
Universa Medicina Vol. 40 No. 3 (2021)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2021.v40.200-206

Abstract

BACKGROUNDPreeclampsia (PE) is one of the most common pregnancy complications worldwide. Turnover of villous trophoblast is affected by impaired placental perfusion in preeclampsia. Among the various factors that influence pro and antiangiogenic factors in trophoblast invasion of PE are E-cadherin and matrix metalloproteinase-9 (MMP-9). The current classification scheme differentiates PE into two variants early-onset (EO) and late-onset (LO) PE. The aim of this study was to compare MMP-9 and E-cadherin expression between early- (EO) and late-onset (LO) PE. METHODSThis study used a cross-sectional design involving 26 women with gestational age <34 weeks (EO) and 38 women with gestational age ≥34 weeks (LO) from PE patients. Placentas born to preeclamptic mothers were taken in the form of small pieces of the maternal side to measure the levels of MMP-9 and E-cadherin by the ELISA method. Statistical analysis was assessed using the Mann Whitney and independent t-test with a significant p value <0.05. RESULTSSemiquantitative proteinuria levels were significantly higher in EO-PE group compared to LO-PE group (p=0.000). Mean E-cadherin levels were significant lower in the EO-PE group (125.94 ± 54.22 pg/mg) compared to LO-PE group (157.95 ± 54.12 pg/mg) (p=0.024). However, there was no significance difference in median MMP-9 levels between EO-PE group and LO-PE group (p=0.376). CONCLUSIONThis study demonstrate that E-cadherin had lower levels in preeclampsia patients who gave birth <34 weeks. This study indicated that lower levels of e-cadherin can lead to early delivery in preeclampsia patients.
Co-Authors A. F. Tangdialla A.A. Ketut Agung Cahyawan W Abdul B. Saifuddin Achmad Noerkhaerin Putra Achmad Tjarta Ahmad Fuady Aldri Frinaldi Ani Retno Prijanti B. A. Tjokroprawiro B. Siregar Bambang Sutrisna Bram Pradipta Budiningsih Siregar Chairil Hamdani Christin Wigin, Christin Dewi Wulandari Dharmeizar Dharmeizar DJAENUDIN, A. E. Taufik FAUZIAH, I. Fera Ibrahim Ferry Armanza, Ferry Fiastuti Witjaksono Gatot Purwoto Ginealdy, Wahyu Gunawan D. Prayitno Harahap, Alida Roswita Hariyono Winarto Heru Priyanto Imam Rasjidi Isrin Ilyas J. Prihartono Junizaf Junizaf Kukung Kurnia Laila Nuranna Liem, Isabella Kurnia Luh Putu Ratna Sundari M. F. Aziz M. Hartati M. Iskandar Markus, Unedo H Markus, Unedo H Mongan, Suzanna P Mpu Kanoko Muhammad F Aziz MUHILAL, M. N. Kampono N. Supriana Nana Supriana Nur Asikin P. Hartono Pelupessy, Nugraha Utama R. Kodaria Rinaldy, Dino Risfiandi, Risa Rochani Rochani Rukmini T. Mangunkusumo S. G. Mihardja Santoso Cornain Sigit Purbadi Sri Wuryanti Susworo Susworo Tiffani, Wely L Tjahadi, Hartono Tjam Diana Samara Tofan W Utami UTAMI, T. W. W. L. Heffen Y. M. Hidayat