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Hubungan Ekspresi Vascular Endothelial Growth Factor (VEGF) dengan Derajat Diferensiasi dan Invasi Limfovaskular pada Adenokarsinoma Kolorektal Nana Liana; Noza Hilbertina; Loli Devianti; Husna Yetti
Majalah Patologi Indonesia Vol 31 No 1 (2022): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

BackgroundColorectal carcinoma is the third most common malignancy in the world. Colorectal carcinoma is a heterogeneous tumor withdifferent clinical pathologic features and prognostic values. For the same tumor-stage, patients could have difference prognosis andit has been suggested that the angiogenesis might be correlated with the prognosis, especially expression of vascular endothelialgrowth factor (VEGF) as the main pro-angiogenic factor. High VEGF expression in colorectal adenocarcinoma is associated withincreased blood vessels in invasive tumor area, cell proliferation and metastases. However, relation VEGF expression with thedegree of differentiation and lymphovascular invasion is not known.MethodsThis was a retrospective observational study with cross sectional approach. Samples were obtained from 39 paraffin blocks withdiagnosis adenocarcinoma not otherwise specific (NOS) in four Anatomical Pathology Laboratory in West Sumatera 2018 andevaluated for degree of differentiation and lymphovascular invasion. VEGF expressions in tumor cell were analyzed usingimmunohistochemistry staining. Bivariate statistical analysis used Fisher's Exact test and value p<0.05 was considered significant.ResultsColorectal adenocarcinoma with high grade differentiation entirely had high VEGF expression (100%), while low gradedifferantiation with high VEGF expression was 60.7%. Lymphovascular invasion positive was mostly found with high VEGFexpression (80.6%). Statistical analysis showed significant association between VEGF expression with degree of differentiation(p=0.017) and lymphovascular invasion (p=0.028).ConclusionThe conclusion was VEGF expression had significant association with degree of differentiation and lymphovascular invasion ofcolorectal adenocarcinoma.

Correlation between differentiation grade and lymphovascular invasion in colorectal adenocarcinoma Nana Liana; Loli Devianti; Yessy Setiawati; Sri Nani Jelmila; Ruhsyahadati
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 1 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i1.20536

Colorectal carcinoma is the third most common malignant tumor worldwide. It is a heterogeneous disease with diverse clinicopathological and prognostic characteristics. The TNM (tumor, node, metastasis) staging system is currently used as a prognostic predictor. However, its predictive value is limited, as approximately 30% of patients with lymph node-negative disease die due to metastasis progression. It is suspected that other prognostic factors other than TNM staging system, may play a significant role. Differentiation grade and lymphovascular invasion have been proposed as essential prognostic factors for lymph node-negative colorectal carcinoma. This study aimed to evaluate the correlation between differentiation grade and lymphovascular invasion in colorectal carcinoma. It was an observational study with a cross-sectional design. Samples were collected from 4 Anatomical Pathology laboratories in West Sumatera in 2018. A total of 97 paraffin blocks of colorectal adenocarcinoma met the inclusion criteria. Differentiation grade and lymphovascular invasion were evaluated according to the 2019 World Health Organization (WHO) classification. The correlation between differentiation grade and lymphovascular invasion was analyzed using Fisher's Exact test. A p value <0.05 considered statistically significant. The most prevalent age group for cases of colorectal adenocarcinoma was 51–60 yr (36.1%). Low-grade differentiation was the most common grade of differentiation (72.2%). Lymphovascular invasion in small vessels was commonly encountered (73.3%). High-grade differentiation adenocarcinomas had 100% lymphovascular invasion. A significant correlation between differentiation grade and lymphovascular invasion was observed (p = 0.031). This study confirms that lymphovascular invasion is a valuable predictor of colorectal carcinoma progressiveness.

Differential Roles of CD117 and Ki67 in Gastrointestinal Stromal Tumors: Diagnostic Utility Versus Prognostic Power Fitri Nur Handriyani; Noza Hilbertina; Henny Mulyani; Loli Devianti; Avit Suchitra; Husna Yetti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i7.1337

Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the digestive tract, primarily driven by mutations in KIT or PDGFRA genes. CD117 (c-KIT) expression is a key diagnostic marker, while the Ki67 labeling index reflects cellular proliferation. Risk stratification, often using modified NIH criteria based on tumor size, mitotic rate, and location, guides prognosis and treatment. This study investigated the distinct roles of CD117 and Ki67 expression in relation to risk stratification in GIST patients. Methods: This cross-sectional analytical study examined 27 GIST cases diagnosed between January 2021 and December 2024 from three Indonesian hospitals. Formalin-fixed paraffin-embedded tissues were analyzed using immunohistochemistry for CD117 (clone YR145) and Ki67 (clone K2). CD117 positivity was defined as ≥5% tumor cell staining, and high Ki67 expression as >10% nuclear staining. Risk stratification utilized the modified NIH criteria. The Chi-square test assessed correlations (p<0.05 significance). Results: The cohort predominantly comprised patients >50 years (66.7%), males (59.3%), with gastric tumors (51.9%), large tumor size (>5cm in 96.3%), spindle cell morphology (77.8%), and high mitotic rates (74.1%). Most cases (85.2%) were classified as high-risk. CD117 was positive in 81.5% (22/27) of cases but showed no significant correlation with risk stratification (p=0.561). High Ki67 expression was found in 74.1% (20/27) of cases and demonstrated a significant positive correlation with high-risk stratification (p=0.002). The combination of CD117 and Ki67 status also showed a significant association with risk stratification (p=0.001). Conclusion: While CD117 expression remains a cornerstone for GIST diagnosis and targeted therapy selection, it did not correlate significantly with risk stratification in this cohort. Conversely, a high Ki67 labeling index was significantly associated with high-risk GIST, underscoring its potential as a valuable prognostic marker alongside established risk stratification parameters.

Differential Roles of CD117 and Ki67 in Gastrointestinal Stromal Tumors: Diagnostic Utility Versus Prognostic Power Fitri Nur Handriyani; Noza Hilbertina; Henny Mulyani; Loli Devianti; Avit Suchitra; Husna Yetti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i7.1337

Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the digestive tract, primarily driven by mutations in KIT or PDGFRA genes. CD117 (c-KIT) expression is a key diagnostic marker, while the Ki67 labeling index reflects cellular proliferation. Risk stratification, often using modified NIH criteria based on tumor size, mitotic rate, and location, guides prognosis and treatment. This study investigated the distinct roles of CD117 and Ki67 expression in relation to risk stratification in GIST patients. Methods: This cross-sectional analytical study examined 27 GIST cases diagnosed between January 2021 and December 2024 from three Indonesian hospitals. Formalin-fixed paraffin-embedded tissues were analyzed using immunohistochemistry for CD117 (clone YR145) and Ki67 (clone K2). CD117 positivity was defined as ≥5% tumor cell staining, and high Ki67 expression as >10% nuclear staining. Risk stratification utilized the modified NIH criteria. The Chi-square test assessed correlations (p<0.05 significance). Results: The cohort predominantly comprised patients >50 years (66.7%), males (59.3%), with gastric tumors (51.9%), large tumor size (>5cm in 96.3%), spindle cell morphology (77.8%), and high mitotic rates (74.1%). Most cases (85.2%) were classified as high-risk. CD117 was positive in 81.5% (22/27) of cases but showed no significant correlation with risk stratification (p=0.561). High Ki67 expression was found in 74.1% (20/27) of cases and demonstrated a significant positive correlation with high-risk stratification (p=0.002). The combination of CD117 and Ki67 status also showed a significant association with risk stratification (p=0.001). Conclusion: While CD117 expression remains a cornerstone for GIST diagnosis and targeted therapy selection, it did not correlate significantly with risk stratification in this cohort. Conversely, a high Ki67 labeling index was significantly associated with high-risk GIST, underscoring its potential as a valuable prognostic marker alongside established risk stratification parameters.

The Large-Mass Phenotype of Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): A Clinicopathological Analysis of 37 Cases in Indonesia Using WHO 2021 and Modified Stanford Criteria Yuliza Ariani; Henny Mulyani; Noza Hilbertina; Yenita; Aswiyanti Asri; Tofrizal; Loli Devianti; Hera Novianti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 4 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i4.1565

Background: Uterine smooth muscle tumor of uncertain malignant potential (STUMP) presents a diagnostic dilemma, especially in Southeast Asian populations, where delayed presentation often leads to advanced tumor burden. This study aimed to characterize the clinicopathological profile of STUMP in Indonesia using the 2021 WHO Classification and modified Stanford parameters. Methods: A descriptive study analyzed 37 STUMP cases diagnosed between 2023 and 2025 at a tertiary referral center in West Sumatra. A panel of pathologists re-evaluated archival slides for atypia, mitotic activity, necrosis, and growth patterns, establishing inter-observer reliability. Fisher’s Exact Test was employed to correlate tumor size with morphological markers of aggression. Results: The cohort demonstrated a distinct large-mass phenotype, with 54.1% of tumors exceeding 10 cm and a median diameter of 14.5 cm. Pathological review classified 56.8% of cases into WHO Group 4 (atypia with ambiguous mitosis). A statistically significant correlation was identified between tumor size >10 cm and the presence of infiltrative growth margins (81.1%; p=0.034). Conclusion: Indonesian STUMP cases are distinctively characterized by massive size and high rates of infiltrative growth, likely driven by prolonged natural history. The prevalence of ambiguous mitotic figures underscores the utility of the WHO Group 4 category in resource-limited settings. These findings advocate for aggressive surgical management and wider resection margins in large-mass variants to mitigate local recurrence risk.

The Large-Mass Phenotype of Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): A Clinicopathological Analysis of 37 Cases in Indonesia Using WHO 2021 and Modified Stanford Criteria Yuliza Ariani; Henny Mulyani; Noza Hilbertina; Yenita; Aswiyanti Asri; Tofrizal; Loli Devianti; Hera Novianti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 4 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i4.1565

Background: Uterine smooth muscle tumor of uncertain malignant potential (STUMP) presents a diagnostic dilemma, especially in Southeast Asian populations, where delayed presentation often leads to advanced tumor burden. This study aimed to characterize the clinicopathological profile of STUMP in Indonesia using the 2021 WHO Classification and modified Stanford parameters. Methods: A descriptive study analyzed 37 STUMP cases diagnosed between 2023 and 2025 at a tertiary referral center in West Sumatra. A panel of pathologists re-evaluated archival slides for atypia, mitotic activity, necrosis, and growth patterns, establishing inter-observer reliability. Fisher’s Exact Test was employed to correlate tumor size with morphological markers of aggression. Results: The cohort demonstrated a distinct large-mass phenotype, with 54.1% of tumors exceeding 10 cm and a median diameter of 14.5 cm. Pathological review classified 56.8% of cases into WHO Group 4 (atypia with ambiguous mitosis). A statistically significant correlation was identified between tumor size >10 cm and the presence of infiltrative growth margins (81.1%; p=0.034). Conclusion: Indonesian STUMP cases are distinctively characterized by massive size and high rates of infiltrative growth, likely driven by prolonged natural history. The prevalence of ambiguous mitotic figures underscores the utility of the WHO Group 4 category in resource-limited settings. These findings advocate for aggressive surgical management and wider resection margins in large-mass variants to mitigate local recurrence risk.

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