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All Journal E-Jurnal Medika Udayana Indonesian Journal of Cancer Jurnal Ilmiah Kedokteran Wijaya Kusuma ISM (Intisari Sains Medis) : Jurnal Kedokteran Majalah Patologi Indonesia Neurologico Spinale Medico Chirurgico IJCNP (INDONESIAN JOURNAL OF CLINICAL NUTRITION PHYSICIAN) Indonesian Journal of Cancer
Luh Putu Iin Indrayani Maker
Departemen Patologi Anatomi, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Perbedaan ekspresi Vascular Endothelial Growth Factor (VEGF) pada meningioma risiko rendah dan risiko tinggi di RSUP Sanglah, Bali, Indonesia Ivana Juliarty Sitanggang; Ni Putu Sriwidyani; I Wayan Juli Sumadi; I Gusti Ayu Sri Mahendra Dewi; Luh Putu Iin Indrayani Maker; I Made Muliarta
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (507.348 KB) | DOI: 10.15562/ism.v12i2.1027

Abstract

Background: Vascular Endothelial Growth Factor (VEGF) is an angiogenic factor that plays an important role in tumor angiogenesis. VEGF in meningioma is up-regulated and indicates its role as a proangiogenic factor. It has an association with tumor recurrence and progression. This study aims to determine the differences in VEGF expression in low-risk and high-risk meningiomas at Sanglah General Hospital, Bali, Indonesia.Methods: This study was a cross-sectional analytical study with a sample size of 52, which came from meningioma patients examined histopathologically at the Anatomical Pathology Laboratory of Sanglah General Hospital from January to December 2019. The VEGF immunohistochemical staining was performed and interpreted using Histo score (H-score). VEGF expression was categorized into high and low expression, with the cut-off value determined based on the median value. Data were analyzed using SPSS version 20 for Windows.Methods: The results showed that out of 52 meningioma samples, 37 (71.1%) cases of low-risk meningiomas with low VEGF expression, 6 cases (11.5%) of low-risk meningiomas with high VEGF expression, and 9 cases (17.3%) of high-risk meningiomas with high VEGF expression. There was no high-risk meningioma with low VEGF expression. There was a significant difference in VEGF expression between the low-risk and high-risk meningioma groups (p = 0.00), and high VEGF expression had a prevalence risk for the incidence of high-risk meningioma by 2.5 times (95% CI=1.3-4.6).Conclusion: Based on the results of this study, it was concluded that there was a VEGF expression difference between low-risk and high-risk meningiomas in Sanglah General Hospital Denpasar and high VEGF had a prevalence risk for the occurrence of high-risk meningiomas by 2.5 times. Latar Belakang: Vascular Endothelial Growth Factor (VEGF) merupakan faktor angiogenik yang berperan penting dalam angiogenesis tumor. VEGF pada meningioma mengalami up-regulation yang menunjukkan perannya sebagai faktor proangiogenik yang berkaitan dengan rekurensi dan perkembangan tumor. Penelitian ini bertujuan untuk menentukan perbedaan ekspresi VEGF pada meningioma risiko rendah dan risiko tinggi di RSUP Sanglah, Bali, Indonesia.Metode: Penelitian ini merupakan studi analitik potong lintang dengan besar sampel adalah 52, yang berasal dari blok parafin penderita meningioma yang diperiksa histopatologi di Laboratorium Patologi Anatomi RSUP Sanglah Denpasar dari Januari - Desember 2019. Dilakukan pulasan imunohistokimia VEGF dan penilaiannya menggunakan Histo score (H-score). Ekspresi VEGF dikategorikan menjadi tinggi dan rendah dengan nilai cut-off yang ditentukan berdasarkan nilai median. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Hasil penelitian ini menunjukkan bahwa dari 52 sampel meningioma, terdapat 37 kasus (71,1%) meningioma risiko rendah dengan ekspresi VEGF rendah, 6 kasus (11,5%) meningioma risiko rendah dengan ekspresi VEGF yang tinggi, dan 9 kasus (17,3%) meningioma risiko tinggi dengan ekspresi VEGF tinggi. Tidak didapatkan meningioma risiko rendah dengan ekspresi VEGF rendah. Didapatkan perbedaan ekspresi VEGF yang bermakna antara kelompok meningioma risiko rendah dan risiko tinggi (p=0,00) dan ekspresi VEGF tinggi mempunyai risiko prevalensi untuk terjadinya meningioma risiko tinggi sebesar 2,5 kali (95% IK=1,3-4,6).Kesimpulan: Berdasarkan hasil penelitian ini didapatkan perbedaan ekspresi VEGF antara meningioma risiko rendah dan risiko tinggi di RSUP Sanglah Denpasar dan pada VEGF tinggi mempunyai risiko prevalensi untuk terjadinya meningioma risiko tinggi sebesar 2,5 kali.
Hubungan Lymph Vessel Density (LVD) dengan invasi limfatik dan metastasis kelenjar getah bening regional pada karsinoma payudara invasif tipe tidak spesifik di RSUP Sanglah, Bali, Indonesia Katrin Rotua Simbolon; I Gusti Ayu Sri Mahendra Dewi; Ni Putu Sriwidyani; Luh Putu Iin Indrayani Maker; Herman Saputra; I Made Muliarta
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (724.217 KB) | DOI: 10.15562/ism.v12i2.1037

Abstract

Background: Lymph Node Metastasis (LNM) is considered the most important prognostic factor in breast cancer. The progress of lymphatic metastasis is thought to involve the proliferation of lymphatic vessels (lymphangiogenesis), Lymph Vessel Invasion (LVI), and lymph node metastasis step by step. This study aims to evaluate the association between LVD with LVI and regional LNM in invasive breast carcinoma of no special type.Methods: This study used a cross-sectional analytical study, using a sample of 38 paraffin-embedded tissue from the patient with invasive breast carcinoma of no special type in Sanglah General Hospital, Bali, Indonesia, in 2018. The sample will be used to assess LVD and LVI by D2-40 immunohistochemistry. Expression of D2-40 with vigorous-intensity was evaluated on the membrane and cytoplasm of lymphatic endothelial cells to determine the definition of lymphatic vessels. Lymph vessel density was determined by counting the number of lumens of peritumoral lymphatic vessels in five fields of view with the densest lymphatic vessel lumen using a Leica microscope (DM750, 400x, area 0.225mm2). Data were analyzed using SPSS version 24 for Windows.Results: The LVD cut-off value is 16.5 lymphatic vessel lumens/0.225 mm2 (65.4% for sensitivity and area Under the Curve (AUC)=70.2%). Then cases were classified into the category of high LVD (?16,5 lymphatic vessel lumen/0,225 mm2) and low LVD (<16.5 lymphatic vessels lumen/0,225 mm2). The study found a statistically significant association between LVD and lymph vessel invasion (PR=3.6; p=0.043; 95%CI=0.88-14.78) and regional lymph node metastases (PR =1.7; p=0.02; 95%CI=1.03-2.79).Conclusion: This study proved an association between LVD with lymph vessel invasion and regional lymph node metastases.  Latar Belakang: Metastasis Kelenjar Getah Bening (KGB) dianggap sebagai faktor prognostik yang paling penting pada kanker payudara. Perkembangan metastasis limfatik diduga melibatkan proliferasi pembuluh limfatik (limfangiogenesis), Lymph Vessel Invasion (LVI) atau invasi limfatik, dan metastasis kelenjar getah bening secara bertahap. Penelitian ini bertujuan untuk mengevaluasi hubungan antara Lymph Vessel Density (LVD) dengan invasi limfatik dan metastasis kelenjar getah bening regional pada karsinoma payudara invasif tipe tidak spesifik.Metode: Penelitian ini menggunakan metode analitik potong lintang dengan sampel 38 blok parafin dari pasien karsinoma payudara invasif tipe tidak spesifik di RSUP Sanglah, Bali, Indonesia tahun 2018. Penilaian LVD dan LVI dengan pulasan imunohistokimia D2-40. Ekspresi D2-40 dengan intensitas yang kuat dievaluasi pada membran dan sitoplasma sel endotel limfatik untuk menetapkan definisi pembuluh limfatik. Lymph vessel density ditentukan dengan menghitung jumlah lumen pembuluh limfatik peritumoral pada lima lapangan pandang yang memiliki lumen pembuluh limfatik terpadat, menggunakan mikroskop Leica (DM750, 400x, luas area 0,225mm2). Data dianalisis dengan SPSS versi 24 untuk Windows.Hasil: Nilai cut-off LVD adalah 16,5 lumen pembuluh limfatik/0,225 mm2 (sensitivitas 65,4% dan Area Under the Curve (AUC)=70,2%). Kemudian kasus dikategorikan menjadi LVD tinggi (?16,5 lumen pembuluh limfatik / 0,225 mm2) dan LVD rendah (<16,5 lumen pembuluh limfatik / 0,225 mm2). Hasil analisis statistik menunjukkan bahwa terdapat hubungan antara LVD dengan invasi limfatik (PR=3,6; p=0,043; IK 95%=0,88-14,78) dan metastasis KGB regional (PR=1,7; p=0,02; IK 95%=1,03-2,79).Kesimpulan: Penelitian ini membuktikan bahwa terdapat hubungan antara LVD dengan invasi limfatik dan metastasis KGB regional. 
Hubungan antara ekspresi BRAF V600E dengan metastasis dan derajat diferensiasi pada adenokarsinoma kolorektal Ni Kadek Ayu Maya Damayanti; Ni Wayan Winarti; Ni Putu Sriwidyani; Luh Putu Iin Indrayani Maker; Herman Saputra; I Made Muliarta
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (607.077 KB) | DOI: 10.15562/ism.v12i2.1045

Abstract

Background: Colorectal carcinoma is a malignant epithelial tumor of the large bowel that occurs due to extrinsic and intrinsic factors. BRAF V600E gene mutation was found in about 10-15% of colorectal carcinoma. This mutation was associated with aggressive biologic behaviors, metastasis and lesser responsiveness to EGFR inhibitors therapy. This study aims to determine the association between BRAF V600E expression with metastasis and the degree of differentiation of colorectal adenocarcinoma.Methods: This cross sectional study involved 43 samples of adenocarcinoma colorectal patients who had histopathological examinations in the period 2018-2019. Immunohistochemical were performed to assess the expression of BRAF V600E. This expression was concluded positively if 75% or more tumor cells showed intense cytoplasmic staining. Data were analyzed using SPSS version 20 for Windows.Results: Within 43 colorectal adenocarcinoma cases, it was found 7 cases (16.3%) had a positive expression of BRAF V600E. This expression was found in metastasis cases (7/25), not found in cases without metastasis (0/18). There was an association between BRAF V600E expression and metastasis (p=0.014). The positive expressions of BRAF V600E were only found in low-grade differentiation (7/35 cases), were not found in high-grade differentiation (0/8 cases), and no association between BRAF V600E mutation and the degree of differentiation (p=0.167).Conclusion: There was an association between BRAF V600E expression and metastasis of colorectal adenocarcinoma. There was no significant association between BRAF V600E expression and the degree of differentiation of colorectal adenocarcinoma. Latar Belakang: Karsinoma kolorektal merupakan suatu tumor ganas epitelial usus besar yang terjadi akibat pengaruh dari faktor ekstrinsik dan intrinsik. Mutasi gen BRAF V600E ditemukan pada sekitar 10-15% kasus karsinoma kolorektal. Mutasi ini berkaitan dengan perilaku biologik agresif, metastasis, serta kurangnya respon terhadap terapi dengan inhibitor EGFR. Penelitian ini bertujuan untuk mengetahui adanya hubungan antara ekspresi BRAF V600E dengan metastasis dan derajat diferensiasi adenokarsinoma kolorektal.Metode: Penelitian menggunakan rancangan analitik potong lintang dengan 43 sampel penderita adenokarsinoma kolorektal yang telah dilakukan pemeriksaan histopatologi pada periode tahun 2018-2019. Pulasan imunohistokimia dikerjakan untuk menilai ekspresi BRAF V600E. Ekspresi BRAF V600E dinyatakan positif jika 75% atau lebih sel tumor mununjukkan pulasan sitoplasma dengan intensitas kuat. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Dari 43 kasus, ditemukan 7 kasus (16,3%) dengan ekspresi BRAF V600E positif. Ekspresi ini hanya dijumpai pada kasus dengan metastasis (7 dari 25 kasus), tidak dijumpai pada kasus tanpa metastasis (0 dari 18 kasus). Didapatkan hubungan bermakna antara ekspresi BRAF V600E dengan metastasis (p=0,014). Ekspresi BRAF V600E positif hanya ditemukan pada kasus derajat diferensiasi rendah (7 dari 35 kasus), tidak ditemukan pada derajat tinggi (0 dari 8 kasus), dan hubungan tersebut tidak bermakna secara statistik (p=0,167).Kesimpulan: Terdapat hubungan antara ekspresi BRAF V600E dengan metastasis pada adenokarsinoma kolorektal. Tidak terdapat hubungan antara ekspresi BRAF V600E dengan derajat diferensiasi pada adenokarsinoma kolorektal.
Hubungan antara status tumor budding dengan berbagai parameter klinikopatologi pada adenokarsinoma kolorektal di RSUP Sanglah, Bali, Indonesia Luh Putu Iin Indrayani Maker; Ni Putu Sriwidyani
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (503.532 KB) | DOI: 10.15562/ism.v12i3.1123

Abstract

Background: Colorectal malignancies are common, with adenocarcinoma as the most prevalent type. Recently, studies of specific morphology like tumor budding have already started and related with tumor’s aggressivity as well as several parameters. This study aims to evaluate the association between tumor budding grade with patient age, sex, tumor location, histological grade, depth of invasion, and nodal status in colorectal adenocarcinoma at Sanglah General Hospital.Methods: This cross-sectional descriptive study used samples of intestinal resection specimens accompanied by Regional Lymph Node (RLN) removal of colorectal adenocarcinoma patients at Sanglah Hospital in 2018-2020. The sampling technique was carried out consecutively, which met the inclusion and exclusion criteria. Data on age, sex, tumor location, histologic grade, depth of invasion, and nodal status were obtained from the archives of examination results. At the same time, tumor budding data were obtained from observations of histopathological preparations with Hematoxylin-Eosin (H&E) staining. The results of the observations were tested statistically and presented descriptively. Data were analyzed with Chi-Square using SPSS version 22 for Windows.Results: Most of the study samples were 50 years old (84.0%), followed by male gender (62.0%), tumor location in the left colon (67.0%), low-grade (90.0%), T3-T4 invasion depth (77.0%), negative nodal status (60.0%), and high-tumor budding grade (51.0%). The Chi-Square test showed a significant relationship between the depth of invasion (p=0.001) and nodal status (p=0.009) variables on tumor budding grade.Conclusion: There were significant correlations between tumor budding grade and depth on invasion and nodal status. Latar Belakang: Kanker kolorektal merupakan keganasan yang sering ditemukan dengan adenokarsinoma merupakan tipe histopatologi terbanyak. Dewasa ini telah mulai diteliti morfologi spesifik yaitu tumor budding yang dikaitkan dengan agresivitas tumor maupun parameter lainnya. Penelitian ini bertujuan untuk mengetahui hubungan antara tumor budding grade dengan umur pasien, jenis kelamin, lokasi tumor, grade histopatologi, kedalaman invasi, dan status nodal pada adenokarsinoma kolorektal di RSUP Sanglah Denpasar.Metode: Penelitian deskriptif potong lintang ini menggunakan sampel spesimen reseksi usus disertai pengangkatan Kelenjar Getah Bening (KGB) regional pasien adenokarsinoma kolorektal di RSUP Sanglah tahun 2018-2020. Teknik pengambilan sampel dilakukan secara konsekutif, yang memenuhi kriteria inklusi dan eksklusi. Data umur, jenis kelamin, lokasi tumor, grade histopatologi, kedalaman invasi dan status nodal diperoleh dari arsip hasil pemeriksaan. Sedangkan data tumor budding diperoleh dari pengamatan sediaan histopatologi pewarnaan Hematoksilin-Eosin (H&E). Hasil pengamatan diuji secara statistik dan ditampilkan secara deskriptif. Data dianalisis dengan Chi-Square menggunakan SPSS versi 22 untuk Windows.Hasil: Sebagian besar sampel penelitian berusia ? 50 tahun (84,0%), diikuti dengan jenis kelamin laki-laki (62,0%), lokasi tumor pada kolon kiri (67,0%), low-grade (90,0%), kedalaman invasi T3-T4 (77,0%), status nodal negatif (60,0%), dan high-tumor budding grade (51,0%). Uji Chi-Square menunjukkan bahwa terdapat hubungan yang bermakna antara variabel kedalaman invasi (p=0,001) dan status nodal (p=0,009) terhadap tumor budding grade.Kesimpulan: Terdapat hubungan yang bermakna antara tumor budding grade dengan kedalaman invasi dan status nodal adenokarsinoma kolorektal.
Hubungan antara ekspresi Epidermal Growth Factor Receptor (EGFR) dengan berbagai parameter klinik dan patologis Triple Negative Breast Cancer (TNBC) di RSUP Sanglah, Bali, Indonesia Volman Tampubolon; Ni Putu Sriwidyani; Luh Putu Iin Indrayani Maker; I Gusti Ayu Sri Mahendra Dewi; Ni Made Mahastuti; I Made Muliarta
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (543.529 KB) | DOI: 10.15562/ism.v12i3.1189

Abstract

Background: Triple Negative Breast Cancer (TNBC) is a heterogeneous group of breast cancer. Some cases show a good outcome; others show higher recurrence and metastasis. There are several molecular subtypes of TNBC. Basal-like 2 (BL-2) subtype involves Epidermal Growth Factor (EGF) signaling pathway, enriched with many growth factor receptors such as EGFR. This study aims to determine the association between EGFR expression and various clinicopathological parameters in TNBC patients in Sanglah Hospital Denpasar.Methods: This study was an analytical cross-sectional study involving 35 patients TNBC who were examined histopathologically at the Anatomical Pathology Laboratory in Sanglah Hospital Denpasar from January 1st 2016 to December 31st 2020. Re-evaluation of the specimen was conducted to assess histopathological diagnosis, grade, tumor size (T), Lymphovascular Invasion (LVI) and nodal status (N). EGFR expression was evaluated by immunohistochemistry staining and then interpreted based on the intensity and continuity of the stained cell membrane. The association between EGFR expression and clinicopathological parameters was analyzed with a Chi-Square test with a 0.05 significance level.Result: The result of this study showed the age range of TNBC patients was 29-70 years with mean age was 49.7±11.4 years. There were significant association between EGFR expression with T (p=0.008; PR = 2.7; 95%CI 1.4-5.1), LVI (p=0.018; PR = 3.0; CI95% 1.300-7.137) and N (p=0.033; PR=2.7; CI95% 1.121-6.543). There were no significant association between EGFR expression with age (p=1.000), grade (p=0.689) and Ki67 index (0.689).Conclusion: It can be concluded that there are associations between EGFR expression with T, LVI and N. There was no association between EGFR expression with age, grade and Ki67 index.  Latar Belakang: Triple negative breast cancer (TNBC) merupakan kelompok kanker payudara yang heterogen. Sebagian kasus menunjukkan survival yang baik, namun sebagian lainnya dengan rekurensi dan metastasis yang lebih tinggi. Terdapat beberapa subtipe molekuler dari TNBC, salah satunya subtipe Basal-like 2 (BL2) yang melibatkan jalur pensignalan Epidermal Growth Factor (EGF), melalui berbagai reseptor factor pertumbuhan, salah satunya EGFR. Penelitian ini bertujuan untuk mengetahui hubungan antara ekspresi EGFR dengan berbagai parameter klinikopatologi pada kasus TNBC di RSUP Sanglah Denpasar.Metode: Penelitian ini merupakan studi analitik potong lintang dengan besar sampel 35 kasus TNBC yang diperiksa histopatologi di Laboratorium Patologi Anatomi RSUP Sanglah Denpasar dari 1 Januari 2016 hingga 31 Desember 2020. Evaluasi ulang preparat dilakukan untuk menilai diagnosis histopatologi, grade, ukuran tumor (T), Lymphvascular Invasion (LVI) dan status nodal (N). Ekspresi EGFR dinilai dengan pewarnaan imunohistokimia selanjutnya di interpretasi berdasarkan intensitas dan kuntinuitas membran  sel yang terpulas. Hubungan antara ekspresi EGFR dengan parameter klinikopatologi dianalisis dengan uji Chi-Square dengan nilai kemaknaan p<0,05.Hasil: Hasil penelitian ini menunjukkan rentang usia pasien TNBC 29-70 tahun dan rerata 49,7±11,4 tahun. Terdapat hubungan bermakna antara ekspresi EGFR dengan T (p=0,008; RP=2,7; IK95% 1,4-5,1), LVI (p=0,018; RP = 3,0; IK 95% 1,300-7,137), dan N (p=0,033; RP=2,7; IK95% 1,121-6,543). Tidak terdapat hubungan bermakna antara umur (p=1,000), grade (p=0,689) dan indeks Ki67 (p=0,689).Simpulan: Hasil dari penelitian ini adalah terdapat hubungan antara ekspresi EGFR dengan ukuran tumor, LVI dan status nodal (N). Tidak terdapat hubungan antara ekspresi EGFR dengan umur, grade dan indeks Ki67.          
Case Report: Gastric Wall Thickening: Radiological Diagnostic Challenges in Gastric Malignancy Putu Ayu Winda Wirastuti Giri; Nyoman Srie Laksminingsih; Firman Parulian Sitanggang; I Gusti Ayu Sri Mahendra Dewi; I Wayan Juli Sumadi; Luh Putu Iin Indrayani Maker
Jurnal Ilmiah Kedokteran Wijaya Kusuma Vol 10, No 1 (2021): MARET 2021
Publisher : Universitas Wijaya Kusuma Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (470.819 KB) | DOI: 10.30742/jikw.v10i1.983

Abstract

Gastric abnormalities show nonspecific gastrointestinal symptoms and similarly radiological findings. Intra and extra luminal gastric wall thickening are the most common finding in benign and malignant pathologic process. This aim of this case report was to describe several characteristics such as the location and size of the lesion, involvement of the gastric wall and surrounding structures, calcifications, and contrast enhancement pattern which can assist in radiological diagnosis. Several cases at our institution have similar gastrointestinal complaints, however, there were different lesions characteristic found in contrast enhanced abdominal CT scan. The first case 72-years-old man experienced hematemesis with radiologic finding diffuse gastric mucosal thickening as well as homogenous contrast enhancement but without calcification.  The second case 37-years-old man complaint dizziness and melena with radiologic finding large tumor more than 10 cm in size, amorph calcification and heterogenous contrast enhancement. The last 60-years-old man case experienced melena and hematemesis, from abdominal CT scan showed irregular gastric mucosal thickening with heterogenous contrast enhancement and fat stranding around the lesion, without calcification. Methods used in these cases were contrast-enhanced abdominal CT scan, esophagogastroduodenoscopy (EGD), and biopsy in order to determine the diagnosis. Contrast-enhanced abdominal CT scan plays a vital role in describing the lesion characteristics which affects the determination of treatment options and future prognosis.
Prevalensi Infeksi Human Papilloma Virus Tipe 16 dan 18 serta Lesi Prakanker dari Pemeriksaan Pap smear Berbasis Cairan pada Pasien dengan Infeksi Human Immunodeficiency Virus Iin Indrayani Maker Luh Putu; Moestikaningsih .; Ketut Suwiyoga; Mona Mariana
Majalah Patologi Indonesia Vol. 23 No. 2, Mei 2014
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

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Abstract

Background Bali province is the sixth highest Human Immunodeficiency Virus (HIV) prevalence in September 2012, which was 5871 cases, among them were 1227 women. HIV infected women with latent Human Papilloma Virus (HPV) in cervical uterine will have 10-20 times risk to develop cervical precancerous and cancer. The high risk group of HPV including HPV type 16 and 18. The aim of this study is to get the epidemiologic data of HPV type 16 and 18 prevalency and precancerous cervical lesion prevalency from liquid based pap smear of HIV infected women. Methods This was a descriptive prospective cross sectional study. Fifty samples were collected by concecutive sampling from liquid based pap smear of HIV infected women. Two smears were made from each sample, stain with Papanicolaou, then examination of HPV (especially type 16 and 18) was conducted by Polymerase Chain Reaction (PCR) from the remaining sample of each patient. The results of pap smear and PCR examination were grouped into whether there is positive or negative of HPV infection, type of HPV, positive or negative precancerous lesion and age groups. Results From 50 samples, 60% were HPV positive (13.3% type 16, 10% type 18, and 6.7% type 16 and 18). From 30 HPV positive samples, there were 11 (11.3%) precancerous lesions, and from 20 HPV negative samples, there were 1 (5.0%) precancerous lesions. The youngest HPV infected women with precancerous lesion was 19 years old. Conclusion Prevalency of HPV was found in more than half HIV infected samples, which type 16 was found higher than type 18. Precancerous lesions were higher in HIV with HPV infected women. Key words : Cervical precancerous lesion, Human immunodeficiency virus, human papilloma virus, liquid based pap smear, PCR, type 16 and 18
Laporan Kasus: Melanoma Maligna pada Gingiva Regio Mandi-bulla Luh Putu Iin Indrayani Maker; Moestikaningsih .
Majalah Patologi Indonesia Vol. 23 No. 3, September 2014
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

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Abstract

Primary oral malignant melanoma is a very rare case (0.2-8%), and because of it’s hidden location and asymptomatic, it was often found at a late stage. This kind of case was never been reported in the past 10 years in Denpasar. Malignant melanoma, especially the pigmented variant, was easily diagnosed from histopathology specimen. But many variations occurred, and could be mistaken with nevus (nevoid melanoma) or mesenchymal spindle cell tumour, so immunohistochemistry examination is needed to confirmed it. In certain cases, cell block from FNAB aspirate material could help the patient to spent a lower cost to get a diagnostic material, considering the possibility of using immunohistochemistry procedure from cell block material. The case that we reported here was clinically, Radiologic, FNAB, histopathologically and immunohistochemistry for HMB45 and S100 from cell block was confirmed the primary malignant melanoma of right gingival mandible with a late stage. Key words : cell block, FNAB, histopathology, immunohistochemistry, malignant melanoma
Hubungan Ekspresi CXC Reseptor 4 dan Vascular Endothelial Growth Factor A dengan Invasi Pembuluh Darah dan Metastasis pada Karsinoma Payudara Analysa -; Luh Putu Iin Indrayani Maker
Majalah Patologi Indonesia Vol. 22 No. 1, Januari 2013
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

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Abstract

ABSTRAK Latar belakang Penelusuran 10 tahun pemeriksan HE pada penderita karsinoma payudara dengan T1N0M0 ditemukan angka rekurensi 33%, karena adanya metastasis yang tidak terdeteksi. Karena itu dipandang perlu dilakukan pemeriksaan dini yang dapat memprediksi potensi metastasis tumor dengan mengunakan faktor prediktif biologik seperti CXCR4 dan VEGF A yang belum dilakukan. Penelitian ini bertujuan untuk mengetahui hubungan antara CXCR4 dan VEGF A pada karsinoma payudara dengan invasi pembuluh darah dan metastasis jauh secara klinis. Metode Penelitian potong lintang dilaksanakan di Bagian/SMF Patologi Anatomik Fakultas Kedokteran Universitas Udayana/RSUP Sanglah Denpasar mulai 20 September 2011 sampai 30 Januari 2012. Karsinoma payudara sebanyak 75 sediaan yang memenuhi kriteria inklusi dan eksklusi dipulas dengan pewarnaan imunohistokimia VEGF A dan CXCR4 lalu dikorelasikan dengan invasi ke pembuluh darah dan metastasis jauh. Penilaian ekspresi CXCR4 dan VEGF A dibuat berdasarkan analisis persentase sel tumor yang positif dan intensitas pewarnaan (Imuno score). Hasil Berdasarkan analisis dengan analisis statistik non parametrik Spearman’s rho dengan SPSS 19.0 for window terlihat hubungan yang bermakna dari beberapa variabel yang dikorelasikan. Penelitian ini menunjukkan ada hubungan yang bermakna antara tingkat ekspresi CXCR4 dengan VEGF A (r=0,572; p=0,000). Ditemukan pula adanya hubungan yang bermakna antara CXCR4 dengan invasi ke pembuluh darah (r=0,538; p=0,000) dan CXCR4 dengan metastasis jauh (r=0,526; p=0,000) serta antara VEGF A dengan invasi ke pembuluh darah (r=0,568; p=0,000) dan VEGF A dengan metastasis jauh berdasarkan klinis (r=0,518; p=0,000). Kesimpulan CXCR4 dan VEGF A dapat dipertimbangkan sebagai petanda biologi untuk memprediksi metastasis pada karsinoma payudara. Kata kunci : karsinoma payudara, CXCR4, VEGF A, Invasi pembuluh darah, metastasis jauh. ABSTRACT Background Ten years follow up of T1N0M0 breast carcinoma patiens with H.E staining discovered 33% recurency rate consed by undetectable metastasis before. To be able to predict the metastatic potensiality the biologic predictive factors such as CXCR4 and VEGF A could be performed. The purpose of this study is to investigate the relationship between CXCR4 and VEGV A expression with vascular invasion and distant metastasize. Methods This study is a cross sectional study, conducted in Anatomical Pathology Department, Faculty of Medicine, University of Udayana, Sanglah general hospital since September 20th 2011 until January 30th 2012. 75 breast carcinoma speciment was steined by CXCR4 and VEGF A and correlated with evidance of vascular invasion and distant metastasis. The expression of CXCR4 and VEGF was scoring using immuno score system (analysis of percentage of positive stained tumor cells and intensity of the staining). Results Statistical analysis was done using non parametric Spearman’s rho with SPSS 19.0 for windows program, found correlation between degree of CXCR4 and VEGF A expression (r=0.572; p=0.000). There was also correlation between degree of CXCR4 expression with vascular invasion (r=0.538; p=0.000) and with distant metastasis (r=0.526; p=0.000). There was correlation between VEGF A expression with vascular invasion (r=0.568; p=0.000) and VEGF A with distant metastasis (r=0.518; p=0.000). Conclusion CXCR4 and VEGF A could be considerated as a predictive factor for metastasis in breast carcinoma. Key words : breast carcinoma, CXCR4, VEGF A, vascular invasion, distant metastasis.
Ekspresi Galectin-3 pada Karsinoma Papiler, Hiperplasia Nodular dan Adenoma Folikular Organ Tiroid Di Bali Ni Ketut Ari Widhiasih; Herman Saputra; Luh Putu Iin Indrayani Maker
Majalah Patologi Indonesia Vol. 25 No. 2, Mei 2016
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

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Abstract

Latar belakang Karsinoma tiroid merupakan keganasan organ endokrin tersering. Lebih dari 85% kasus merupakan karsinoma papiler, yang tidak jarang menimbulkan kesulitan diagnosis, dan dapat dikelirukan dengan hiperplasia nodular dan adenoma folikular. Galectin-3 merupakan salah satu petanda yang terlibat pada mekanisme adesi sel. Protein ini mempunyai struktur pentamer unik yang berfungsi meregulasi berbagai mekanisme, antara lain kelangsungan hidup, proliferasi, transformasi, serta migrasi sel. Tujuan penelitian ini adalah untuk melihat apakah ekspresi galectin-3 pada karsinoma papiler lebih tinggi dibandingkan dengan hiperplasia nodular dan adenoma folikular tiroid, dan untuk melihat apakah ekspresi galectin-2 dapat digunakan sebagai petanda diagnostik. Metode Penelitian ini menggunakan metode analitik potong lintang. Sampel penelitian diambil dari sediaan blok parafin dari bahan operasi tiroidektomi penderita yang telah diperiksa secara histopatologik di Bagian/SMF Patologi Anatomik Fakultas Kedokteran Universitas Udayana/RSUP Sanglah Denpasar, sejak Januari 2013 sampai Agustus 2014. Jumlah sampel adalah 42, terdiri atas 14 kasus hiperplasia nodular, 14 kasus adenoma folikular, dan 14 kasus karsinoma papiler tiroid. Selanjutnya dilakukan pulasan imunohistokimia dengan antibodi primer anti galectin-3 pada seluruh sampel. Hasil penelitian dianalisis dengan uji chi-square, dengan tingkat kemaknaan (α) pada p
Co-Authors Anak Agung Ayu Ngurah Susraini Anak Agung Gde Putra Wiraguna Analysa - Andrew Lie annie minerva datui Astrid Amanda Pangalela Ayunda Tamara Barito Saritani Firman Parulian Sitanggang Herman Saputra Herman Saputra Herman Saputra Herman Saputra I Gede Indradika Pratama Putra I Gusti Ayu Sri Mahendra Dewi I Ketut Mulyadi I Ketut Suwiyoga I Made Gotra I Made Muliarta I MADE MULIARTA . I Made Wirya Sastra I Nyoman Sasputra I Wayan Juli Sumadi I Wayan Juli Sumadi I Wayan Weta Ivana Juliarty Sitanggang JOHANA SENSY LENI MANNA KADE YUDI SASPRIYANA Katrin Rotua Simbolon Ketut Mulyadi M. Arif Perdana Ariyansyah MANNA, JOHANA SENSY LENI Michelle Anne Anthonysamy Moestikaningsih . Mona Mariana Monika Nur Indah Pawana Ni Kadek Ayu Maya Damayanti Ni Ketut Ari Widhiasih Ni Made Mahastuti Ni Putu Ekawati Ni Putu Sriwidyani Ni Wayan Armerinayanti Ni Wayan Winarti Novitasari Novitasari Nyoman Bayu Mahendra Nyoman Srie Laksminingsih Popi Imelda Margareth Sitompul Putu Ayu Winda Wirastuti Giri Tjandra Kristiana Volman Tampubolon Wimpie I Pangkahila