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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 Kusumadjayanti, Nadytia; Badudu, Dharmayanti Francisca; Hernowo, Bethy S.
Althea Medical Journal Vol 2, No 3 (2015)
Publisher : Althea Medical Journal

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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 patientsâ 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.Â 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 40â55 years. Fifteen out of 30 cases were premenopausal. From 30 cases, 14 patients had tumor size bigger than 5 cm.Â Sixteen cases had stage III tumor.Â 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.Â DOI:Â 10.15850/amj.v2n3.494

Bcl-2 Immunoexpression as Radiotherapy Response Predictor in Undifferentiated Nasopharynx Carcinoma Damayanti, Beby S.; Afiati, .; Hassan, Abdul H.; Hernowo, Bethy S.
Journal of Medicine and Health Vol 1, No 1 (2015)
Publisher : Maranatha Christian University

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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.Â Keywords: Bcl-2, undifferentiated NPC, radiotherapy response

Cytopathology Lymphadenopathy Feature in HIV Positve Patient: Diagnosis Tools Comorbidities Agustina, Hasrayati; Wisudarma, Yenni; Kristiana, Ris; Hernowo, Bethy S.
Journal of Medicine and Health Vol 1, No 3 (2016)
Publisher : Maranatha Christian University

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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

Analysis of Fibronectin and TGF-Î²1 Immunoexpression to Determination of Wound Vitality in Wistar Rats (Rattus norvegicus) Novita, Nita; Agustina, Hasrayati; Hernowo, Bethy S.; Hassan, Abdul H.
Journal of Medicine and Health Vol 1, No 1 (2015)
Publisher : Maranatha Christian University

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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-Î²1 expression in both antemortem and postmortem wounds. This study was an experimental with completely randomized design.Â 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-Î²1 (100%).Â In first hour after wound infliction, 3 samples (75%) showed weakly positive and 1 sample (25%) strongly positive for fibronectin and TGF-Î²1.Â In 2 hour after wound infliction, 1 sample (25%) showed weakly positive and 3 sample (75%) strongly positive for fibronectin and TGF-Î²1.Â In 3 and 4 hour after wound infliction, all of samples strongly positive for fibronectin and TGF-Î²1.Â In postmortem wound, all of samples showed negativity for fibronectin and TGF-Î²1. In conclusion, fibronectin and TGF-Î²1 may be useful in the determination of wound vitality.Â Keywords: wound, fibronectin, TGF-Î²1, vitality

Diagnostic Value of Narrow Band Imaging in Diagnosing Nasopharyngeal Carcinoma Yuniserani, Debbi; Hernowo, Bethy S.; Permana, Agung Dinasti
Althea Medical Journal Vol 4, No 1 (2017)
Publisher : Althea Medical Journal

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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 narrowâband 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):133â7]Â DOI:Â 10.15850/amj.v4n1.1034

Reseptor Vitamin D (VDR) dan Phosphatidylinositol 3-Kinase (PI3K) Secara Independen Memengaruhi Diferensiasi Adenokarsinoma Kolorektal Erida, Yulie; Aminah, Hermin; Yulianti, Herry; Hernowo, Bethy S.
Indonesian Journal of Clinical Pharmacy Vol 4, No 4 (2015)
Publisher : Indonesian Journal of Clinical Pharmacy

Terapi target (targeted therapy) pada karsinoma kolorektal merupakan terapi alternatif yang diharapkan memberikan hasil yang lebih baik diantaranya dengan pemberian metabolit aktif vitamin D, yaitu calcitriol dan inhibitor Phosphatidyl Inositol 3 Kinase (PI3K). Penelitian ini bertujuan untuk mengetahui korelasi imunoekspresi VDR dan PI3K terhadap derajat diferensiasi adenokarsinoma kolorektal. Penelitian ini menggunakan desain potong lintang dengan analisis kategorik dari 30 blok parafin adenokarsinoma kolorektal (kelompok low grade dan high grade masing-masing 15 kasus) dari Departemen Patologi Anatomi Fakultas Kedokteran Universitas Padjadjaran/RSUP Hasan Sadikin Bandung. Analisis Lambda menunjukkan bahwa imunoekspresi VDR dan PI3K masing-masing memengaruhi diferensiasi adenokarsinoma kolorektal (p=0,029, p=0,0225, R= 0,533). Berdasarkan nilai p, PI3K lebih kuat daripada VDR dalam memengaruhi derajat diferensiasi. Analisis Spearman menunjukkan imunoekspresi VDR dan PI3K tidak terbukti berkorelasi dengan diferensiasi (p=0,186, p>0,05, R: 0,248) secara bersamaan/simultan. Imunoekspresi VDR dan PI3K berkorelasi positif dengan kelompok low grade. Disimpulkan bahwa VDR tidak menggunakan jalur MAPK bersama-sama dengan PI3K dalam memengaruhi diferensiasi adenokarsinoma kolorektal.Kata kunci: Adenokarsinoma kolorektal, diferensiasi, imunoekspresi PI3K, imunoekspresi VDRVitamin D Receptor (VDR) and Phosphatidylinositol 3-Kinase (PI3K) Independently Affected Colorectal Adenocarcinoma DifferentiationÂ Targeted therapy in carcinoma colorectal such as is as calcitriol and Phosphatidyl Inositol 3 Kinase (PI3K) is an alternative therapy for better treatment outcome. The aim of this study was to determine the correlation between VDR and PI3K immunoexpression with the degree of differentiation (grading) in colorectal adenocarcinoma. Cross-sectional, categorical analysis of 30 paraffin blocks of colorectal adenocarcinoma (low and high grade group, 15 cases each) obtained from Department of Pathology Faculty of Medicine, Universitas Padjadjaran/Dr Hasan Sadikin General Hospital Bandung. Analysis of Lambda showed that immunoexpression of VDR and PI3K affected differentiation of colorectal adenocarcinoma (p=0.029, p=0.0225, R=0.533). Based on p value, PI3k is stronger than VDR in influencing the degree of differentiation. Spearman analysis showed that simultaneous immunoexpression of VDR and PI3K was not shown to correlate with differentiation (p= 0186, p<0.05, R: 0.248). Positive immunoexpression of VDR and PI3K correlates with low-grade group. It can be concludes that VDR does not use the MAPK pathway together with PI3K to affect differentiation of colorectal adenocarcinoma.Keywords: Colorectal adenocarcinoma, differentiation, PI3K immunoexpression, VDRImmunoexpression

Ekspresi Negatif Melanoma Cell Adhesion Molecule (MCAM) Berkorelasi dengan Metastasis Kelenjar Getah Bening Aksila pada Triple Negative Breast Cancer Nurwenda, Sartika; Dewayani, Birgitta M.; Afiati, Afiati; Hernowo, Bethy S.
Indonesian Journal of Clinical Pharmacy Vol 5, No 3 (2016)
Publisher : Indonesian Journal of Clinical Pharmacy

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Â Â Triple negative breast cancer (TNBC) adalah karsinoma payudara yang memiliki ekspresi negatif untuk estrogen receptor (ER), progesteron receptor (PR), dan Human Epidermal Growth Factor Receptor (HER2). TNBC memiliki sifat agresif, frekwensi metastasis ke Kelenjar Getah Bening (KGB) aksila yang tinggi, prognosis yang buruk, dan rekurensi yang tinggi. Metastasis ke KGB aksila akan mempengaruhi angka kesintasan hidup dan angka rekurensi penderita TNBC. Melanoma cell adhesion molecule (MCAM) adalah membran glikoprotein dari superfamili imunoglobulin, yang terlibat di dalam ikatan antar sel, yang kemudian dikenal sebagai marker untuk progresi dan metastasis melanoma dan karsinoma prostat. Namun, peran MCAM pada karsinoma mammae masih kontroversial. Tujuan penelitian ini untuk menilai korelasi ekspresi MCAM dengan metastasis ke KGB aksila pada TNBC. Penelitian ini dilaksanakan pada periode 1 Januari 2010â31 April 2015 di laboratorium Patologi Anatomi Fakultas Kedokteran, Universitas Padjadjaran. Penelitian ini dilakukan menggunakan desain potong lintang analisis korelasi dengan menggunakan uji korelasi lambda. Pewarnaan imunohistokimia MCAM dilakukan terhadap 56 sampel blok parafin dari kelompok TNBC yang tidak bermetastasis dan telah bemetastasis ke KGB aksila. Sebanyak 22 dari 28 (78,6%) orang TNBC yang telah bermetastasis ke KGB aksila memiliki nilai histoskor MCAM <4 (negatif), sebaliknya 16 dari 28 (57,1%) orang TNBC yang tidak bermetastasis ke KGB aksila memiliki nilai histoskor â¥4 (positif). Ketiadaan ekspresi MCAM berkorelasi dengan metastasis TNBC ke KGB aksila, namun bukan satu-satunya faktor penentu metastasis.Kata kunci: KGB, metastasis, MCAM, triple negative breast cancer Negative Expression of Melanoma Cell Adhesion Molecule (MCAM) Correlated with Axillary Lymph Node Metastasis in Triple Negative Breast Cancer Triple negative breast cancer (TNBC) is breast cancers that demonstrate the absence of oestrogen receptor, progesterone receptor and human epidermal growth factor receptor 2. TNBC has an aggressive behaviour, high frequency of metastases to the axillary lymph nodes and recurrence, and poor prognosis. Metastasis to the axillary lymph nodes will affect the rate of survival and recurrence in TNBC. Melanoma cell adhession molecule (MCAM) is a membrane glycoprotein of the immunoglobulin superfamily, which is involved in the cells binding, which later became known as the marker for the progression and metastasis of melanoma and carcinoma of the prostate. However, MCAM role in mammary carcinoma still kontroversial. The aim of this study was to assess correlation between MCAM expression with incidence of metastatic to axillary lymph nodes in TNBC. This research was conducted during January 1st 2010âApril 31st 2015 at Pathology Anatomy, Faculty of Medicine, Universitas Padjadjaran. This study used a cross-sectional design, using lambda correlation test. MCAM immunohistochemical staining performed on 56 samples of paraffin blocks of TNBC group that did not metastasized and has metastasized to the axillary lymph nodes. A total of 22 of 28 (78.6%) of TNBC metastatic to axillary lymph nodes have histoskor MCAM value <4 (negative), whereas 16 of 28 (57.1%) of TNBC non metastatic have histoskor value â¥ 4 (positive). Negative expression of MCAM correlated with TNBC that had metastasized to axillary lymph nodes, although not the only factor that influenced them.Keywords: Lymph node, metastasis, MCAM, triple negative breast cancer

Imunoekspresi Poly (ADP-Ribose) Polymerase sebagai Petanda Kemoresisten pada Karsinoma Ovarium Westiningrum, Retno; Usman, Hermin A.; Yulianti, Herry; Hernowo, Bethy S.
Indonesian Journal of Clinical Pharmacy Vol 7, No 2 (2018)
Publisher : Indonesian Journal of Clinical Pharmacy

Karsinoma ovarium merupakan keganasan kelima terbanyak dan penyebab kematian ginekologi pertama di dunia. Kemoterapi merupakan modalitas terapi utama karsinoma ovarium dengan stadium lanjut setelah dilakukan pembedahan. Poly (ADP-Ribose) Polymerase (PARP) dan B cell Lymphoma-2 (Bcl-2) merupakan petanda imunohistokimia yang berfungsi dalam proses DNA repair dan anti-apoptosis yang merupakan bagian dari lingkaran mekanisme kerja regimen kemoterapi pada sel tumor. Oleh karena itu dua mekanisme tersebut dianggap memegang peranan penting terhadap terjadinya resisten kemoterapi bahkan rekurensi. Tujuan penelitian ini adalah melihat hubungan imunoekspresi PARP dan Bcl-2 dengan respons kemoterapi pada karsinoma ovarium. Penelitian ini menggunakan desain analisis observasi secara potong lintang dengan menggunakan blok parafin pasien yang didiagnosis sebagai karsinoma ovarium selama periode tahun 2012â2015 di Departemen Patologi Anatomi RSUP Dr Hasan Sadikin Bandung. Jumlah sampel sebanyak 58 kasus yang terdiri atas 30 kasus kemoterapi sensitif dan 28 kasus kemoterapi resisten, keseluruhan sampel dilakukan pulasan imunohistokimia PARP dan Bcl-2. Analisis data menggunakan uji Chi-Square dengan taraf signifikansi 5%. Hasil dari penelitian ini adalah 60% sampel terekspresi PARP kuat dengan proporsi terbesar pada kelompok resisten (p=0,001) dan 74% sampel terekspresi Bcl-2 lemah dengan proporsi sama pada tiap kelompok respon kemoterapi (p=0,45). Respons kemoterapi sangat dipengaruhi oleh proses DNA repair yang dapat dinilai dengan pemeriksaan imunoekspresi PARP. Semakin tinggi imunoekspresi PARP maka semakin tinggi kemampuan DNA repair sehingga semakin tinggi kemungkinan kemoterapi resisten.Kata kunci: Bcl-2, karsinoma ovarium, kemoterapi, PARPÂ Poly (ADP-Ribose) Polymerase Immunoexpression as Chemoresistance Marker in Ovarian CarcinomaAbstractEpithelial ovarian cancer (EOC) is the fifth most common cancer and the main cause of gynecological cancer death worldwide. Chemotherapy is the main therapy in advanced stage of EOC. Poly (ADP-Ribose) Polymerase (PARP) dan B cell Lymphoma-2 (Bcl-2) are immunohistochemistry markers that represent influential factors in chemotherapy response which have roles in DNA repair and anti-apoptosis. The aim of this study was to review the correlation between PARP and Bcl-2 expression with chemotherapy response in EOC. This research was performed as analytic-observational with cross-sectional design using paraffin block of patients diagnosed as EOC in 2012â2015 at Anatomical Pathology Department, Hasan Sadikin Hospital Bandung. Total sample was 58 cases which were divided into chemotherapy sensitive and resistant. All samples were stained by immunohistochemistry PARP and Bcl-2 and analysed using Chi-Square test with significant level of 5%. The results of this study showed that 60% of all samples have strong PARP expression whereas the largest proportion is in chemotherapy resistant group (p=0.001) and 74% of all samples have weak Bcl-2 expression in each group (p=0.45). The conclusion of this study in chemotherapy response was influenced by PARP. Higher PARP immunoexpression showed higher tumour cell ability to repair DNA and higher chemotherapy resistance.Keywords: Bcl-2, chemotherapy, EOC, PARP

Analysis of Fibronectin and TGF-Î²1 Immunoexpression to Determination of Wound Vitality in Wistar Rats (Rattus norvegicus) Novita, Nita; Agustina, Hasrayati; Hernowo, Bethy S.; Hassan, Abdul H.
Journal of Medicine and Health Vol. 1 No. 1 (2015)
Publisher : Universitas Kristen Maranatha

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-Î²1 expression in both antemortem and postmortem wounds. This study was an experimental with completely randomized design.Â 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-Î²1 (100%).Â In first hour after wound infliction, 3 samples (75%) showed weakly positive and 1 sample (25%) strongly positive for fibronectin and TGF-Î²1.Â In 2 hour after wound infliction, 1 sample (25%) showed weakly positive and 3 sample (75%) strongly positive for fibronectin and TGF-Î²1.Â In 3 and 4 hour after wound infliction, all of samples strongly positive for fibronectin and TGF-Î²1.Â In postmortem wound, all of samples showed negativity for fibronectin and TGF-Î²1. In conclusion, fibronectin and TGF-Î²1 may be useful in the determination of wound vitality.Â Keywords: wound, fibronectin, TGF-Î²1, vitality

Cytopathology Lymphadenopathy Feature in HIV Positve Patient: Diagnosis Tools Comorbidities Agustina, Hasrayati; Wisudarma, Yenni; Kristiana, Ris; Hernowo, Bethy S.
Journal of Medicine and Health Vol. 1 No. 3 (2016)
Publisher : Universitas Kristen Maranatha

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

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