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PROFIL KLINIKOPATOLOGI DAN METODE DIAGNOSTIK TUMOR METASTASIS PADA TULANG DI RSUD Dr. SAIFUL ANWAR MALANG PERIODE 2016-2020 Norahmawati, Eviana; Nabila, Astrid Hanan; Irsan, Istan Irmansyah
Majalah Kesehatan Vol. 12 No. 1 (2025): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/majalahkesehatan.2025.012.01.8

Tulang merupakan predileksi ketiga tersering dari kejadian metastasis. Pasien dengan tumor metastasis pada umumnya mengalami nyeri hebat yang berpengaruh pada menurunnya mobilitas pasien, fraktur patologis, dan komplikasi metabolik seperti hiperkalsemia. Manajemen penatalaksanaan pasien metastasis pada tulang memerlukan metode diagnostik yang tepat dengan menerapkan prinsip triple diagnostic. Penelitian ini bertujuan untuk mengetahui profil klinikopatologi dan metode diagnostik tumor metastasis pada tulang di RSUD dr. Saiful Anwar Malang periode 2016-2020. Metode penelitian yang digunakan adalah deskriptif cross sectional, dengan mengumpulkan data dari arsip CPC di Laboratorium Patologi Anatomi dan data Tumor Registry Departemen Ortopedi dari pasien dengan tumor metastasis pada tulang di RSUD dr. Saiful Anwar Malang. Didapatkan 104 sampel dalam penelitian ini, dengan hasil rentang usia terbanyak adalah 50-59 tahun (dekade ke-6) (43,2%), dengan mean 53,7 tahun dan median 53,5 tahun. Jenis kelamin terbanyak adalah perempuan (62,5%) dengan rasio perempuan dibanding laki-laki 5:3. Lokasi tumor terbanyak pada tulang apendikular (55,8%), dengan asal tumor primer terbanyak adalah unknown origin (26,9%), disusul dengan karsinoma payudara (20,1%), karsinoma tiroid (19,2%), dan karsinoma paru (13,4%). Metode diagnostik radiologi yang paling banyak digunakan adalah X-ray (95,1%) dan bone survey (67,3%), sedangkan untuk metode diagnostik patologi anatomi terbanyak menggunakan FNAB (83,6%). Diagnosis patologi anatomi untuk jenis tumor metastasis pada tulang yang terbanyak adalah adenocarcinoma (74%). Hasil penelitian ini diharapkan dapat memberikan peran dalam penentuan diagnosis dan tatalaksana yang efektif dan tepat untuk meningkatkan kualitas hidup pasien dengan tumor metastasis pada tulang.

Beyond Tumor Grade: Investigating the Heterogeneity of PD-L1 Expression in Soft Tissue Sarcomas and the Need for Subtype-Specific Analysis Hamka Muhammad Nasir Laitupa; Eviana Norahmawati; RA Rose Khasana Dewi; Rachmad Sarwo Bekti; Diah Prabawati Retnani
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (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.v9i8.1350

Background: Soft tissue sarcomas (STS) represent a diverse group of malignant mesenchymal neoplasms with considerable histological variety and differing degrees of malignancy. Programmed Death-Ligand 1 (PD-L1) expression is a crucial immunotherapy target in various cancers, but its role and expression patterns in STS, particularly within the Indonesian population, remain inadequately defined. This study aimed to investigate the differences in PD-L1 expression between low-grade and high-grade STS and to determine the correlation between PD-L1 expression and histological grading in an Indonesian cohort. Methods: This analytical observational study utilized a cross-sectional design, incorporating 29 archival paraffin-embedded tissue blocks from STS patients diagnosed at Dr. Saiful Anwar Regional General Hospital, Malang, Indonesia. PD-L1 expression was assessed immunohistochemically using the monoclonal antibody clone 22c3, and scoring was performed using the Combined Positive Score (CPS). Statistical analyses, including the Mann-Whitney U test and Spearman correlation, were employed to evaluate differences and correlations. Results: The majority of STS cases (89.7%) exhibited negative PD-L1 expression. The mean PD-L1 CPS was 0.1429 in low-grade STS and 0.233 in high-grade STS. No statistically significant difference in PD-L1 expression was observed between the low-grade and high-grade groups (p=0.620). Furthermore, Spearman correlation analysis revealed no significant association between PD-L1 expression (numeric CPS and categorical positivity) and histological grade (r=0.094, p=0.629 for CPS; r=0.102, p=0.600 for interpretation). Conclusion: This study found no significant difference in PD-L1 expression between low-grade and high-grade soft tissue sarcomas, nor a significant correlation with histological grade in the investigated Indonesian patient cohort. These findings suggest that PD-L1 expression, when assessed independently, may not be a reliable prognostic biomarker based solely on tumor grading in STS. Further research with larger sample sizes, encompassing diverse histological subtypes and incorporating additional immune biomarkers, is warranted.

Beyond Tumor Grade: Investigating the Heterogeneity of PD-L1 Expression in Soft Tissue Sarcomas and the Need for Subtype-Specific Analysis Hamka Muhammad Nasir Laitupa; Eviana Norahmawati; RA Rose Khasana Dewi; Rachmad Sarwo Bekti; Diah Prabawati Retnani
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (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.v9i8.1350

Background: Soft tissue sarcomas (STS) represent a diverse group of malignant mesenchymal neoplasms with considerable histological variety and differing degrees of malignancy. Programmed Death-Ligand 1 (PD-L1) expression is a crucial immunotherapy target in various cancers, but its role and expression patterns in STS, particularly within the Indonesian population, remain inadequately defined. This study aimed to investigate the differences in PD-L1 expression between low-grade and high-grade STS and to determine the correlation between PD-L1 expression and histological grading in an Indonesian cohort. Methods: This analytical observational study utilized a cross-sectional design, incorporating 29 archival paraffin-embedded tissue blocks from STS patients diagnosed at Dr. Saiful Anwar Regional General Hospital, Malang, Indonesia. PD-L1 expression was assessed immunohistochemically using the monoclonal antibody clone 22c3, and scoring was performed using the Combined Positive Score (CPS). Statistical analyses, including the Mann-Whitney U test and Spearman correlation, were employed to evaluate differences and correlations. Results: The majority of STS cases (89.7%) exhibited negative PD-L1 expression. The mean PD-L1 CPS was 0.1429 in low-grade STS and 0.233 in high-grade STS. No statistically significant difference in PD-L1 expression was observed between the low-grade and high-grade groups (p=0.620). Furthermore, Spearman correlation analysis revealed no significant association between PD-L1 expression (numeric CPS and categorical positivity) and histological grade (r=0.094, p=0.629 for CPS; r=0.102, p=0.600 for interpretation). Conclusion: This study found no significant difference in PD-L1 expression between low-grade and high-grade soft tissue sarcomas, nor a significant correlation with histological grade in the investigated Indonesian patient cohort. These findings suggest that PD-L1 expression, when assessed independently, may not be a reliable prognostic biomarker based solely on tumor grading in STS. Further research with larger sample sizes, encompassing diverse histological subtypes and incorporating additional immune biomarkers, is warranted.

Effect of Bengkoang (Pachyrhizus erosus) Extract on Estrogen Receptor-?, Progesterone Receptor Expression, and Follicle-Stimulating Hormone Levels Suryanti; Putri Ardela, Mayasari; Frenty Hadiningsih, Eka; Winarsih, Sri; Noorhamdani; Nurseta, Tatit; Norahmawati, Eviana
Indonesian Journal of Obstetrics and Gynecology Volume 13. No. 3 July 2025
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v13i3.2180

Abstract Objective: Progesterone functions by inhibiting the release of Gonadotropin-Releasing Hormone (GnRH), which decreases Follicle-Stimulating Hormone (FSH) levels and converts them into hypoestrogens. This condition affects the expression of steroid, estrogen, and progesterone receptors, contributing to endometrial proliferation and secretion during the menstrual cycle. Methods: This study aims to demonstrate that Bengkoang extract administration increases the expression of Estrogen Receptor (ER), Progesterone Receptor (PR), and Follicle-Stimulating Hormone (FSH) in Wistar model rats. This study divided 25 female Wistar rats into five groups: one control group without progesterone and Bengkoang extract and four treatment groups injected with progesterone. After exposure, Bengkoang extract was administered to three treatment groups at doses of 70 mg/200 g BW/day (treatment 1), 140 mg/200 g BW/day (treatment 2), and 280 mg/200 g BW/day (treatment 3). Results: The results showed an increase in the expression of Estrogen Receptor- ? (Er?), Progesterone Receptor (PR), and Follicle-Stimulating Hormone (FSH) levels in treatment 1, treatment 2, and treatment 3 groups compared to the KP with p <0.05 Conclusion: The study investigating the effect of Bengkoang (Pachyrhizus erosus) extract on estrogen receptor-? (ER?), progesterone receptor (PR) expression, and follicle-stimulating hormone (FSH) levels has demonstrated significant findings. Keywords: Estrogen, Estrogen receptor-?, Follicle-stimulating hormone, Pachyrhizus erosus, Progesterone, Progesterone receptor

Survival Analysis of Clinicopathology Profile, Risk Factor, and Prognostic Factor in Cervical Carcinomas with Chemoradiation Yahya Irwanto; Ineke Permatasari; Aliesya Patricia; Ainun Ganisia; Eviana Norahmawati
Jurnal Aisyah : Jurnal Ilmu Kesehatan Vol 7, No S1 (2022): Suplement 1
Publisher : Universitas Aisyah Pringsewu

Cervical carcinoma causes several problems like pain and suffering at least death. However, it is the most preventable, curable, and high survival type of cancer. This study aims to analyze the survival of cervical cancer patients based on factors that are considered influential, such as clinicopathological profiles, risk factors, and prognostic factors to order the effectiveness of therapy and improve the quality of life in patients receiving chemoradiation. In an analytical observational retrospective cohort design study, using secondary data, samples contain all patients diagnosed with cervical cancer who received chemoradiation therapy from January to December 2017 which is 151 patients. This study revealed that the 5year survival rate is 57.6%. The lowest Person Time is 3 months and the longest is 60 months, average 45.80 months, standard deviation 18.179 months. There was a significant influence on the clinicopathological profile including Age (0.002), Histopathology (0.012), and Stage (0.000). Risk factors: parity (0.000), Education (0.007), Number of Marriages (0.025), Menstrual Disorders (0.021), Contraception (0.004), Cancer History (0.000), Body Mass Index (0.022), Area of residence (0.009). Prognostic factors: chemoradiation type (0.002), chemotherapy type (0.000), radiation type (0.001), radiation technique (0.007). The results indicate that the survival rate of cervical cancer patients with chemoradiation still has to be concern. Abstrak: Karsinoma serviks menyebabkan masalah kesakitan, penderitaan dan menjadi penyebab kematian. Akan tetapi, juga merupakan jenis kanker yang paling dapat dicegah, disembuhkan dan memiliki kesintasan hidup tinggi. Penelitian ini bertujuan untuk menganalisa kesintasan hidup pasien karsinoma serviks berdasarkan faktor yang dinilai berpengaruh yaitu profil klinikopatologi, faktor risiko, dan faktor prognostik guna menilai efektivitas terapi demi peningkatan kualitas hidup pada pasien yang menerima kemoradiasi. Penelitian ini merupakan studi analisis observasional dengan desain retrospective cohort, menggunakan data sekunder, sampel dalam penelitian ini mencakup semua pasien dengan diagnosa karsinoma serviks yang menerima terapi kemoradiasi dari bulan Januari hingga Desember 2017 sejumlah 151 pasien. Pada penelitian ini didapatkan data 5 tahun kesintasan sebesar 57.6%. Person Time terendah 3 bulan dan terlama 60 bulan dengan nilai rata-rata 45,80 bulan, standar deviasi 18,179 bulan. Terdapat pengaruh signifikan Profil Klinikopatologi meliputi kategori Usia (0.002), Histopatologi (0.012), Stadium (0.000). Faktor Risiko meliputi kategori paritas (0.000), Pendidikan (0.007), Jumlah Pernikahan (0.025), Gangguan Menstruasi (0.021), Kontrasepsi (0.004), Riwayat Kanker (0.000), Indeks Masa Tubuh (0.022), Daerah tinggal (0.009). Faktor Prognostik meliputi Jenis Kemoradiasi (0.002), Jenis Kemoterapi (0.000), Jenis Radiasi (0.001), Teknik Radiasi (0.007). Hasil ini menunjukan bahwa kesintasan hidup pada pasien karsinoma serviks yang mendapat terapi kemoradiasi masih membutuhkan perhatian.

Profil Klinikopatologi Karsinoma Payudara di Instalasi Patologi Anatomi RSUD Dr. Saiful Anwar Malang Ervina, Rita; Norahmawati, Eviana; Angelina, Aina
Jurnal Klinik dan Riset Kesehatan Vol 1 No 1 (2021): Edisi Oktober
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.01.1.3

Kanker payudara pada wanita menempati urutan pertama kanker primer tersering, dengan tingkat kematian tinggi. Penelitian ini bertujuan memberikan data gambaran dasar profil klinikopatologi dan imunohistokimia karsinoma payudara invasif karena belum ada data profil klinikopatologi kanker payudara di RSUD Dr. Saiful Anwar Malang. Penelitian ini observasional deskriptif, teknik total sampling, desain penelitian Cross Sectional. Menggunakan data dari rekam medis di Instalasi Patologi Anatomi RSUD Dr. Saiful Anwar Malang periode Januari 2018 - Maret 2020. Variabel yang diukur usia, lokasi payudara, jenis spesimen, histopatologi, derajat keganasan histopatolgis (grading), dan profil immunohstokimia. Hasil menunjukkan kejadian karsinoma payudara invasif terbanyak pada tahun 2019 sebanyak 270 kasus (50%), rentang usia tertinggi antara 46 - 55 tahun sebanyak 142 orang (28%). Teknik pengambilan sampel dengan cara mastektomi sebesar 316 (58%) dibandingkan biopsi sebanyak 226 (42%), lokasi tersering terjadinya karsinoma tidak didapatkan perbedaan bermakna antara payudara kanan atau kiri. Jenis histopatologi terbanyak Invasif Carcinoma of No Special Type (NST) sebesar 475 kasus (88%) dari 542 kasus karsinoma payudara invasif, derajat keganasan histopatologi terbanyak adalah grade III sejumlah 240 kasus (47%). Berdasarkan profil imunohistokimia, Luminal A merupakan kategori tebanyak sebesar 44 kasus (31%), dibandingkan Luminal B, Ekspresi HER2 ataupun kanker payudara tripel negatif. Kesimpulannya adalah usia terbanyak penderita karsinoma invasif payudara terjadi pada usia 46-55 tahun, tidak terdapat perbedaan distribusi karsinoma payudara pada payudara kanan atau kiri, jenis spesimen terbanyak diambil dari Teknik mastektomi, jenis histopatologi terbanyak yaitu invasive carcinoma of NST, derajat keganasan histopatologi terbanyak pada grade III, luminal A terbanyak pada pemeriksaan imunohistokimia karsinoma payudara invasif.

Profil Klinikopatologi Pasien Osteosarcoma di Instalasi Patologi Anatomi RSUD Dr. Saiful Anwar Malang Periode 2018–2020 prihantoro, teguh; Dewi, Rose; Norahmawati, Eviana
Jurnal Klinik dan Riset Kesehatan Vol 1 No 3 (2022): Edisi Juni
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.01.3.2

Background: Osteosarcoma is the most common primary bone malignancy. Although the primary tumor has been resected, the patient remains at high risk of metastases. The incidence and clinicopathological characteristics of osteosarcoma need to be studied. Aim: To obtain epidemiological data that can help in diagnosis and management of osteosarcoma. Methods: This research was conducted in a retrospective descriptive manner. The data obtained from medical records at the Anatomical Pathology Laboratory, RSU Dr. Saiful Anwar Malang in 2018-2020 which met the inclusion criteria and exclusion criteria. The variables studied included gender, age, location, subtype, grade, Huvos assessment. Results: There were 68 cases of osteosarcoma that met the criterias. Most of the patients were male (52.94%). The age of the patients was spread from 8 years to 79 years. With average age was 24.56 years, the median age was 16 years, and the most in the age range of 11-25 years. The most common location was the lower extremity (82.35%). The most subtype was osteosarcoma NOS (94.12%). The most cases were high grade (94.12%). From all of cases, 3 cases were huvos graded, 1 case were grade 1, and 2 cases were grade 2. Conclusion: Most Osteosarcoma patient are men, most often in the age range of 11-25 years. The most common location is in the lower extremities, the most subtype is osteosarcoma NOS, the most grade is High grade. Most of the cases were not carried out by huvos grading.

Akurasi Pemeriksaan Intraoperatif pada Tumor Muskuloskeletal di Instalasi Patologi Anatomi Rumah Sakit Umum Dr. Saiful Anwar Malang periode 2020-2022 Laitupa, Hamka Muhammad Nasir; Norahmawati, Eviana; Dewi, Rose
Jurnal Klinik dan Riset Kesehatan Vol 4 No 3 (2025): Volume 4 No 3, Juni 2025
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.04.3.2

Background: Frozen section and intraoperative cytology examinations for musculoskeletal tumors are quite necessary, mainly to find out whether a representative specimen can be obtained for a definite diagnosis. Apart from that, it can also be done to determine the radicality of the surgery However, intraoperative pathological examination in musculoskeletal tumours cases as a difficult diagnostic interpretation, one of which may be due to the morphological features of some musculoskeletal tumors are being difficult to differentiate. Aim: To determine the diagnostic accuracy of frozen section and histopathological examination of musculoskeletal tumors. Methods: This study uses a retrospective diagnostic test method which presents the accuracy of frozen section examination compared with histopathological examination as the gold standard in musculoskeletal tumors by determining the sensitivity, specificity, ppv, npv. diagnostic accuracy of musculoskeletal tumors in the Anatomical Pathology Laboratory of Dr. Saiful Anwar Hospital Malang Results: The diagnostic accuracy of frozen section and histopathology examination is 96% with a sensitivity value of 93%, specificity 100%, npp 100%, npn 91.6%. The diagnostic accuracy of imprint cytology and histopathology is 93.7% with a sensitivity value of 93%, specificity 100%, npp 100%, npn 83.3%. The accuracy of intraoperative frozen section and cytology examinations may be influenced by the pathologist's experience, sampling techniques, tissue processing preparations, and the characteristics of the tumor cells themselves. Conclusion: Intraoperative pathological examination can primarily be used to ensure adequate specimens to support the diagnosis of muculoskeletal tumors. Keywords: frozen section; musculoskeletal tumor.

A Rare Case of Chylothorax Manifestation of Gorham’s Disease, Lymphangioma and Tuberculosis Agil Dananjaya; Setyawan, Ungky; Putra, Ngakan; Erawati, Dini; Isharanto, Artono; Norahmawati, Eviana; Irmansyah, Istan
Malang Respiratory Journal Vol. 4 No. 2 (2022): September 2022
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.02.1

Background: Chylothorax is a rare condition caused by accumulation of chyle in the pleural cavity (2-3%). More rare causes are Gorham's disease and tuberculosis Case: A 31-year-old male complained of swelling left arm and shortness of breath with recurrent pleural effusion. Pleural fluid analysis showed chylous. Bone survey showed osteolytic lesions of multiple bones as Gorham's disease. Thoracic CT showed left lung mass, atelectasis, massive fluidothorax, ipsilateral supraclavicular lymphadenopathy, destructive left scapula. Needleaspiration of left humerus revealed lymphangioma. Expert Mtb-Rif examination revealed Mtb detected. We assessed Gorham'sdisease, lymphangioma and lung tuberculosis with complication recurrent chylothorax and was treated anti-tuberculosis, anti-osteolytic and thorax catheter insertion. Conclusion: Difficult and rare case of chylothorax in one patient with Gorham’s disease and tuberculosis, is a poor prognosis. Keywords: Chylothorax, Gorham's Disease, Tuberculosis

Pengaruh Nitrogen Cair terhadap Morfologi dan Jumlah Fibroblas pada Tendon Patela Tikus Wistar Jantan Isma, Satria Pandu Persada; Norahmawati, Eviana; Irsan, Istan Irmansyah; Asmiragani, Syaifullah; Phatama, Krisna Yuarno; Adiwignyo, Dandy Drestanto; Pratama, Yudit Alfa`
Jurnal Biomedika dan Kesehatan Vol 8 No 3 (2025)
Publisher : Fakultas Kedokteran Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar

Introduction: Cryoablation with liquid nitrogen has shown promise in treating bone sarcomas, but its effect on fibroblast morphology and viability in ligament tissues remains unclear. This study aims to evaluate the impact of liquid nitrogen on fibroblasts in the patellar tendon ligament of male Wistar rats. Methods: This experimental study utilized 28 male Wistar rats (6 months old, 300-400 grams) that were randomly divided into four groups. The control group was not exposed to liquid nitrogen, while the experimental groups were exposed to liquid nitrogen for 1, 5, and 10 minutes. After a 7-day acclimatization, the rats were exposed to liquid nitrogen and euthanized. The patellar tendon ligaments were collected for histological analysis, stained with Hematoxylin-Eosin, and examined under a microscope. Statistical analysis was performed using One-Way ANOVA, followed by Tukey post hoc tests to determine the significant differences between the exposure times. Results: Significant changes were observed in fibroblast morphology and count with increasing exposure times. One-way ANOVA analysis revealed significant differences (p < 0.001) in fibroblast count and morphological alterations across exposure groups. Tukey post hoc tests revealed that 10-minute exposure resulted in substantial reductions in fibroblast count and viability, accompanied by progressive morphological changes as exposure time increased. Discussion: Liquid nitrogen exposure significantly impacts fibroblast cells, with longer exposure times causing more severe cellular damage. The exposure duration should be carefully controlled in cryotherapy to optimize therapeutic benefits. Conclusion: Exposure to liquid nitrogen adversely affects fibroblast cells in the patellar tendon ligament, with prolonged exposure resulting in decreased cesll viability and morphological changes.

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