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Peran EGFR sebagai Prediktor Sensitivitas Radioterapi pada Adenokarsinoma Serviks Fennisia Wibisono; Sri Suryanti; Bethy S. Hernowo
Majalah Patologi Indonesia Vol 25 No 3 (2016): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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Abstract

Latar belakang Karsinoma serviks menduduki urutan pertama dari kejadian keganasan pada wanita dan merupakan masalah penting dalam onkologi ginekologi di Indonesia. Mayoritas pasien karsinoma serviks termasuk adenokarsinoma serviks datang pada stadium lanjut dan radioterapi merupakan salah satu modalitas terapinya. Keberhasilan radioterapi dinilai dari respons radioterapi yang dipengaruhi beberapa faktor prognostik, yaitu keadaan umum, stadium, histopatologi dari tumor, adanya gangguan fungsi organ, dan beberapa petanda molekular seperti epidermal growth factor receptor (EGFR). Saat ini sedang dikembangkan studi-studi mengenai EGFR berhubungan dengan sensitivitas radioterapi namun hasilnya masih kontroversi. Aktivasi sinyal EGFR dapat menginduksi terjadinya radioresistensi pada adenokarsinoma serviks. Tujuan dari studi penelitian ini adalah untuk menganalisis korelasi antara ekspresi EGFR, dan sensitivitas radioterapi adenokarsinoma serviks. Metode Penelitian ini merupakan studi retrospektif, cross sectional, dan analisis korelasional. Sampel penelitian sebanyak 32 blok parafin yang berasal dari pasien adenokarsinoma serviks yang telah mendapatkan radioterapi dan merupakan sampel yang tersimpan di Departemen Patologi Anatomik RSUP Dr. Hasan Sadikin Bandung, periode Januari 2007-Mei 2014. Pada sampel tersebut dilakukan pulasan imunohistokimia EGFR. Hasil Analisis statistik antara ekspresi EGFR dan sensitivitas radioterapi adenokarsinoma serviks menunjukkan adanya perbedaan bermakna (p=0,000). Kesimpulan Ekspresi EGFR dapat digunakan sebagai prediktor sensitivitas radioterapi karsinoma serviks. Kata kunci : adenokarsinoma serviks, EGFR, radioterapi.
Validitas Pemeriksaan Imunositokimia HMGA2 dalam Penegakan Diagnosis Nodul Jinak dan Ganas Tiroidpada Sediaan Biopsi Aspirasi Jarum Halus Yenni Wisudarma; Hasrayati Agustina; Sri Suryanti; Bethy S. Hernowo
Majalah Patologi Indonesia Vol 26 No 1 (2017): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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Abstract

Latar belakang Tindakan biopsi aspirasi jarum halus (BAJAH) merupakanpemeriksaan preoperatif baku yang sederhana dan relatif lebih murah dalam penegakan diagnosis karsinoma tiroid, tetapi diagnosis sitologi BAJAH tersebut tidak selalu mudah. Penelitian ini bertujuan untuk mengetahui validitas pemeriksaan imunositokimia HMGA2 dalam penegakan diagnosis sediaan BAJAH nodul tiroid jinak, ganas dan indeterminate. Metode Penelitian ini merupakan penelitian uji diagnostik yang dilakukan terhadap 62 kasus nodul tiroid yang terdiri dari 18 kasus karsinoma papiler,13 kasus nodul folikular jinak dan 31 kasus indeterminate (27 kasus follicular neoplasmdan 4 kasus suspicious for papillary carcinoma) yang didiagnosis tahun 2011-2014 dan telah dilakukan pemeriksaan histopatologi pasca operasi sebagai konfirmasi diagnosis. Pemeriksaan imunositokimia HMGA2 dilakukan terhadap semua kasus dengan metode cell transfer. Hasil Akurasi, sensitivitas, spesifisitas, nilai duga positif dan nilai duga negatif pemeriksaan imunositokimia HMGA2 dalam diagnosis nodul tiroid masing-masing adalah 85,5%, 79,4%, 92,8%, 93,1% dan 78,8%. Sedangkan untuk kasus indeterminate, akurasi, sensitivitas, spesifisitas, nilai duga positif dan nilai duga negatif pemeriksaan imunositokimia HMGA2 adalah 77,4%, 68,7%%, 86,7%, 84,6% dan 72,2%. Kesimpulan Pemeriksaan imunositokimia HMGA2 relatif spesifik dan sensitif dalam menegakkan diagnosis preoperatif nodul tiroid termasuk pada kasus indeterminate. Kata kunci : biopsi aspirasi jarum halus, HMGA2, indeterminate, nodultiroid.
Characteristics of Patients with Estrogen Receptor (ER)-Negative, Progesterone Receptor (PR)-Negative, and HER2-Negative Invasive Breast Cancer in Dr. Hasan Sadikin General Hospital, Bandung, Indonesia from 2010 to 2011 Nadytia Kusumadjayanti; Dharmayanti Francisca Badudu; Bethy S. Hernowo
Althea Medical Journal Vol 2, No 3 (2015)
Publisher : Faculty of Medicine Universitas Padjadjaran

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Abstract

Background: Breast cancer is the most common type of cancer that has been diagnosed among Indonesian women. One of the subtypes that frequently being studied is the triple negative breast cancer which has poorer prognosis among all subtypes. The objective of this study was to investigate the incidents and the characteristics of triple negative breast cancer patients.Methods: This study used triple negative breast cancer patients’ medical records in Dr. Hasan Sadikin General Hospital. Some characteristics were identified, such as age at presentation, menopause status, tumor size, stage at presentation, grades of tumor, pathological features, and metastatic status.  Data were taken during 2010 and 2011 and presented in table.Results: Thirty women among 252 patients were identified as having triple negative breast cancer. Based on those 30 cases, 11 patients were in the age group of 40‒55 years. Fifteen out of 30 cases were premenopausal. From 30 cases, 14 patients had tumor size bigger than 5 cm.  Sixteen cases had stage III tumor.  Most of the cases were invasive ductal carcinoma mammae as their histological features. Two cases had metastized to pleura.Conclusions: The incidence rate of triple negative breast cancer in Dr. Hasan Sadikin General Hospital is 11.9% with these common characteristics: range of age are between 40 to 45 years, have a premenopausal, had >5cm tumor , stage III tumor and has histological feature IDC, and only 2 patients were metastized to pleura. DOI: 10.15850/amj.v2n3.494
Diagnostic Value of Narrow Band Imaging in Diagnosing Nasopharyngeal Carcinoma Debbi Yuniserani; Bethy S. Hernowo; Agung Dinasti Permana
Althea Medical Journal Vol 4, No 1 (2017)
Publisher : Faculty of Medicine Universitas Padjadjaran

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Abstract

Background: Carcinoma is the most common tumor in nasopharynx. Endoscopy is used to determine the presence of lesions suspected of malignancy. Narrow Band Imaging is an endoscopic technique that uses narrow–band spectrum as a filter to determine any mucosal vascular changes in carcinoma. Narrow Band Imaging can early detect superficial mucosal lesions that are difficult to detect with conventional endoscopy, so that diagnosing is more accurate and occurrence of unnecessary biopsies can be reduced. This study aimed to determine diagnostic value of Narrow Band Imaging in diagnosing nasopharyngeal carcinoma.Methods: This diagnostic test study was conducted at Department of Otorhinolaryngology-Head and Neck Surgery Dr. Hasan Sadikin General Hospital, Bandung from September to October 2014. Twenty four patients with clinical signs and symptoms of nasopharyngeal carcinoma that fulfilled the study criteria were assigned using consecutive sampling to examine with Narrow Band Imaging and histopathology examination. The data were then analyzed with 2x2 table to determine sensitivity, specificity, positive predictive value, negative predictive value, and accuracy.Results: In this study, the results of sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in diagnosing nasopharyngeal carcinoma using Narrow Band Imaging were 93.75%, 62.5%, 83.3%, 83.3%, and 83.3%, respectively. Conclusions: Sensitivity of Narrow Band Imaging is 93.75%. [AMJ.2017;4(1):133–7] DOI: 10.15850/amj.v4n1.1034
Bcl-2 Immunoexpression as Radiotherapy Response Predictor in Undifferentiated Nasopharynx Carcinoma Beby S. Damayanti; . Afiati; Abdul H. Hassan; Bethy S. Hernowo
Journal of Medicine and Health Vol. 1 No. 1 (2015)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (403.834 KB) | DOI: 10.28932/jmh.v1i1.494

Abstract

Nasopharyngeal carcinoma (NPC) is an epithelial malignancy originating from the surface of the lateral and posterior wall of the nasopharynx. Bcl-2 is an oncoprotein that plays an important role in disrupting the process of apoptosis. Expression of Bcl-2 in biopsy samples of undifferentiated NPC also related to the nature of more aggressive tumor mass and unfavorable clinical radiotherapy response. The purpose of this study was to assess the relationship of Bcl-2 expression with radiotherapy response in undifferentiated NPC. The method of this study areusing 40 samples of paraffin blocks were diagnosed as undifferentiated NPC by histopathologic examination with H&E staining. The samples were divided into 2 groups who respond and do not respond to radiotherapy. All samples examined by Bcl-2 immunohistochemistry and the expression willanalyzed and assess therelationship to radiotherapy response. Of the 40 cases of undifferentiated NPC show imunoekspresi Bcl-2 positive in 39 cases (97.5%) and 1 case (2.5%) negative from response group. The results of statistical analysis of the Bcl-2 obtained significant results with p value <0.05 so we can conclude there is a relationship between Bcl-2 expression with radiotherapy response. Conclusion, Bcl-2 can be used as a predictor for the success of radiotherapy in undifferentiated NPC. Keywords: Bcl-2, undifferentiated NPC, radiotherapy response
Analisis Imunoekspresi Emmprin pada Karsinoma Urotelial Infiltrating dan Non Infiltrating Agus Koesmawan; Sri Suryanti; Bethy S. Hernowo
Jurnal Kedokteran Universitas Lampung Vol 1, No 3 (2017): JK UNILA
Publisher : Fakultas Kedokteran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23960/jk unila.v1i3.2187

Abstract

Karsinoma urotelial adalah keganasan yang berasal dari epitel transisional vesika urinaria. Karsinoma ini merupakan jenis keganasan vesika urinaria paling sering sekitar 90% dari seluruh tumor primer pada organ ini. Pemberian terapi yang tepat merupakan hal penting dalam  menungkatkan harapan hidup pasien. Pemilihan terapi yang optimalsangat dipengaruhi oleh gradasi histopatologi. Penentuan diagnostik dan prognostik menjadi lebih akurat jika didukung dengan melihat peranan penanda molekuler Extracelullar Matrix Metalloproteinase Inducer (EMMPRIN) dalam menentukan adanya invasi pada karsinoma urotelial. Penelitian ini merupakan penelitian studi observasional analitik dengan desain crossectional. Analisis katagorik tidak berpasangan terhadap 40 kasus karsinoma urotelial di Departemen Patologi Anatomi Fakultas Kedokteran Universitas Padjadjaran/RSUP Dr.Hasan Sadikin Bandung, yangterdiri dari 20 kasus karsinoma urotelial infiltrating dan 20 kasus karsinoma urotelial non infiltrating. Seluruh sampel yang terkumpul diperiksa imunohistokimia EMMPRIN di Laboratorium Patologi Anatomi RSHS Bandung. Penelitian ini menunjukan terdapat perbedaan distribusi proporsi skor EMMPRIN pada kelompok karsinoma infiltrating dannon infiltrating diperoleh informasi nilai P=0,000 (<0,005).Berdasarkan hasil penelitian ini didapatkan hasil kesimpulan nahwa imunoekspresi EMMPRIN pada karsinoma infiltrating lebih tinggi dibandingkan karsinoma non infiltrating yang berarti signifikan atau bermakna secara statistik.Kata kunci : EMMPRIN,Karsinoma urotelial infiltrating, karsinoma urotelial non infiltrating
Bcl-2 Immunoexpression as Radiotherapy Response Predictor in Undifferentiated Nasopharynx Carcinoma Beby S. Damayanti; . Afiati; Abdul H. Hassan; Bethy S. Hernowo
Journal of Medicine and Health Vol 1 No 1 (2015)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.28932/jmh.v1i1.494

Abstract

Nasopharyngeal carcinoma (NPC) is an epithelial malignancy originating from the surface of the lateral and posterior wall of the nasopharynx. Bcl-2 is an oncoprotein that plays an important role in disrupting the process of apoptosis. Expression of Bcl-2 in biopsy samples of undifferentiated NPC also related to the nature of more aggressive tumor mass and unfavorable clinical radiotherapy response. The purpose of this study was to assess the relationship of Bcl-2 expression with radiotherapy response in undifferentiated NPC. The method of this study areusing 40 samples of paraffin blocks were diagnosed as undifferentiated NPC by histopathologic examination with H&E staining. The samples were divided into 2 groups who respond and do not respond to radiotherapy. All samples examined by Bcl-2 immunohistochemistry and the expression willanalyzed and assess therelationship to radiotherapy response. Of the 40 cases of undifferentiated NPC show imunoekspresi Bcl-2 positive in 39 cases (97.5%) and 1 case (2.5%) negative from response group. The results of statistical analysis of the Bcl-2 obtained significant results with p value <0.05 so we can conclude there is a relationship between Bcl-2 expression with radiotherapy response. Conclusion, Bcl-2 can be used as a predictor for the success of radiotherapy in undifferentiated NPC. Keywords: Bcl-2, undifferentiated NPC, radiotherapy response
Analysis of Fibronectin and TGF-β1 Immunoexpression to Determination of Wound Vitality in Wistar Rats (Rattus norvegicus) Nita Novita; Hasrayati Agustina; Bethy S. Hernowo; Abdul H. Hassan
Journal of Medicine and Health Vol 1 No 1 (2015)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.28932/jmh.v1i1.499

Abstract

Wound examination is indispensable in forensic practice. The scientific field of wound age determination has advanced progressively during recent years.The purpose of this study was to determine the differences of fibronectin and TGF-β1 expression in both antemortem and postmortem wounds. This study was an experimental with completely randomized design.  The skin wounds (vital and postmortem) were taken from fourty Wistar rats and divided into 10 groups of rats. Immunohistochemical staining was performed to determine the differences between antemortem and postmortem wounds. The result showed that in 30 minutes after antemortem wound infliction, all of samples showed weak reactivity for fibronectin and TGF-β1 (100%).  In first hour after wound infliction, 3 samples (75%) showed weakly positive and 1 sample (25%) strongly positive for fibronectin and TGF-β1.  In 2 hour after wound infliction, 1 sample (25%) showed weakly positive and 3 sample (75%) strongly positive for fibronectin and TGF-β1.  In 3 and 4 hour after wound infliction, all of samples strongly positive for fibronectin and TGF-β1.  In postmortem wound, all of samples showed negativity for fibronectin and TGF-β1. In conclusion, fibronectin and TGF-β1 may be useful in the determination of wound vitality. Keywords: wound, fibronectin, TGF-β1, vitality
Cytopathology Lymphadenopathy Feature in HIV Positve Patient: Diagnosis Tools Comorbidities Hasrayati Agustina; Yenni Wisudarma; Ris Kristiana; Bethy S. Hernowo
Journal of Medicine and Health Vol 1 No 3 (2016)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.28932/jmh.v1i3.517

Abstract

Lymphadenopathy is enlarged lymph nodes caused by infection, inflammation or malignancy. On HIV positive patients, lymphadenopathy is one of the most common clinical manifestations and it is usually persistent. Fine-needle aspiration biopsy (FNAB) is an effective cytology technique in determining the diagnosis of lymphadenopathy. This study aimed to describe the cytopathology of lymphadenopathy in HIV positive patients. This is a descriptive study of 21 cases of lymphadenopathy in patients with HIV positive who underwent FNAB examination in Anatomical Pathology Department of Dr.Hasan Sadikin Hospital between 2013-2014. Medical data was taken from the patient medical records including age, sex, location, size and cytopathological diagnosis. Cytopathology overview of FNAB specimens were reassessed by 2 pathologists. In this study, lymphadenopathy in HIV positive patients were mainly found in men (n = 15.71%) with an average age between 20-30 years. The most frequent location was the neck (n = 20.95.2%). The lymph nodes size were found between 0.5-3 cm. Most diagnosis was tuberculous lymphadenitis (n = 15.71%) with the most common cytology feature was granulomatous lymphadenitis (n = 5.33.3%) and suppurative lymphadenitis (n = 5.33.3%). FNAB examination in lymphadenopathy is very helpful to identify the cause of infection in HIV positive patients. Keywords: FNAB, HIV, lymphadenopathy, cytopathology