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All Journal Berkala Kedokteran Malang Respiratory Journal
Suryanti Dwi Pratiwi
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Public Health Other

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EPIDERMAL GROWTH FACTOR RECEPTOR (EGFR) AND CARCINOEMBRYONIC ANTIGEN (CEA) RELATIONSHIP OF LUNG ADENOKARSINOMA IN SAIFUL ANWAR HOSPITA MALANG Normawati Normawati; Suryanti Dwi Pratiwi; Nanik Setijowati
Berkala Kedokteran Vol 13, No 2 (2017)
Publisher : Fakultas Kedokteran Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (568.127 KB) | DOI: 10.20527/jbk.v13i2.4073

Abstract

Abstract: EGFR mutations is associated with sensitivity to tyrosine kinase inhibitors (TKI’s) therapy which are found in Lung Adenocarcinoma. There are some limitations in detecting EGFR mutation. CEA is also expected to predict treatment efficiency of EGFR-TKI's therapy. In this study, we investigated the relationship between serum Carcinoembryonic antigen (CEA) and Epidermal Growth Factor Receptor (EGFR) Mutations in Lung Adenocarcinoma patient. Methods : The research was conducted in Dr. Saiful Anwar General Hospital Malang. From May 2014 to November 2015, 54 lung adenocarcinoma patients who had underwent measurements of EGFR  mutation and serum CEA level were retrospectively recruited. None of them had surgery, radiotherapy, chemotherapy and  targeted therapy. EGFR mutation was detected using PCR, serum CEA levels were analyzed using electrochemical luminescence. Result: Abnormal serum levels of CEA were significantly associated with EGFR mutation (95% CI, P=0,043) with an odds ratio of 3.4 (95% CI: 1.010-11.451). The area under the ROC curve for CEA was 0.558 (95% CI, P=0.078). Conclusion: Serum CEA is associated with mutation of EGFR in lung adenocarcinoma patients.  Keywords : Lung cancer, adenocarcinoma, EGFR, CEA
The Role of Surgical Resection as A Salvage Therapy and Immunohistochemical Stain to Confirm Mediastinal Yolk Sac Tumor Dwi Rosa Eka Agustina; Suryanti Dwi Pratiwi; Diah Prabawati Retnani; Artono Isharanto; Rachma Dini Erawati
Malang Respiratory Journal Vol. 2 No. 01 (2020): Shape the Curves
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (800.64 KB) | DOI: 10.21776/ub.mrj.2020.002.01.3

Abstract

Background: Mediastinal germ cell tumors are uncommon, representing less than 1% of all malignancies. They mostly occur in young men after puberty and have a poor prognosis with over all long term survival rate 42%. Case Report: We reported a case report in Saiful Anwar Malang Hospital, Indonesia, a young man, 26 years old with an anterior mediastinum tumor and VCSS The CT scan of the chest showed an anterosuperior mediastinal mass which compress the superior vena cava. The result from transthoracic FNAB with USG guidance showed an extragonadal germ cell tumor which resemble an Embryonal Carcinoma from mediastinum. The AFP serum level was elevated. Patient underwent a radiotherapy and a surgical debulking. The biopsy showed an Endodermal Sinus Tumor (Yolk Sac). Immunohistochemical stain for cytokeratin was positive in the tumor cells while stain for CD30 was negative. These were confirming the diagnosis of primary mediastinal yolk sac tumor. Patient received a combination chemotherapy for a total 6 cycles.Conclusion: Some procedures like biopsy, tumor marker, immunohistochemical stain, could differentiate the subtype of mediastinal germ cell tumor. The multimodality treatment by combining chemotherapy with surgical therapy or radiotherapy could increase the survival outcome of patients.
Case Report Mediastinal Teratoma Resembling Vascular Tumor with Rapid Growth Accompanied by Vena Cava Superior Syndrome and Bilateral Paramalignant Pleural Effusion Ni Made Rini; Suryanti Dwi Pratiwi; Imam Suseno Bayuadi; Dini Rachma Erawati; Hendy Setyo Yudhanto
Malang Respiratory Journal Vol. 2 No. 01 (2020): Shape the Curves
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2020.002.01.6

Abstract

Background: Teratomas are tumors originate from germ cells, consist of well differentiated tissue from more than one of three layers of embryonic cells: ectoderm, mesoderm and endoderm. Teratomas are generally slow-growing and asymptomatic. Mediastinal teratoma is the most common extra-gonadal germ cell tumor. Superior vena cava syndrome and bilateral paramaligant pleural effusion are complications which can occur in mediastinal teratomas. Case: We report a 37-year-old woman presented with shortness of breath since 1 month before admission, chest pain, cough, weight loss,  swolen of face, neck, and right arm. Chest x-ray showed mediastinal tumor. However, no mediastinal tumor had been detected by chest x-ray to examine her heart disease 3 years earlier. Chest computed tomography scan showed anterosuperior mediastinal tumor surrounding great blood vessels and bilateral pleural effusion. Computed tomography guided transthoracic fine needle aspiration biopsy revealed  tumor containing mature squamous epithelial component. Patient underwent open biopsy by sternotomy and histological assessment confirmed the diagnosis as mediastinal teratoma with vascular lesions predominantly resembling vascular tumor.Conclusion: Establishing the diagnosis of mediastinal teratoma is challenging and it requires multi modality approaches.  Keywords: Mediastinal teratoma, vena cava superior syndrome, bilateral paramalignant pleural effusion.
Case Report Recurrent Hemoptysis Post Re-Embolization in a 49 Year-Old Male with Post Tuberculosis Lung Disease (PTLD) and Bronchiectasis Cindy Carrissa Primaputri; Suryanti Dwi Pratiwi; Ahmad Bayhaqi Nasir Aslam
Malang Respiratory Journal Vol. 6 No. 1 (2024): March 2024 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2024.006.01.05

Abstract

Introduction: Hemoptysis is a symptom of lung disease, could be caused by lung infections, structural disorders of the lung, malignancy or disorders from outside of the lung. One of the pulmonary intervention for hemoptysis is embolization with a success rate > 70%, but the recurrence rate reaches 10-55%. The prognosis is poor depending on the amount of bleeding (untreated cases can have a mortality risk of over 50%), etiology and presence of recurrences. Case Illustration: A 49-year-old Male came to the policlinic with recurrent hemoptysis for a year. Non-smoker. History of Lung Tuberculosis (TB), completed treatment 15 years ago. Imaging result showed widening of the right subcostal artery, right posterior intercostal artery, bronchiectasis, active lung tuberculosis and left pulmonary emphysema. First embolization was done during Anti-Tuberculosis Drug (ATD) treatment for 6 months. Symptom of hemoptysis reappeared, then second embolization and fiber optic bronchoscopy (FOB) was performed. From the evaluation, he was diagnosed with infected bronchiectasis and PTLD, therefore given antibiotic medications for 2 weeks. Discussion: Embolization had been done twice in this case, no significant result. Based on literature, recurrent hemoptysis can still occur with a percentage about 10-55% after embolization and in this case, it might be caused by previous lung structural disorder and lung infections (Lung TB and Infected bronchiectasis). Conclusion: Although embolization has a success rate of > 70% for hemoptysis treatment, recurrence can still occur and highly dependent on the cause itself and patient's previous lung condition. Keywords: Hemoptysis, Embolization, Bronchiectasis, FOB, Lung TB, PTLD, ATD
Gene Muatatuion Changes in Adenocarcinoma Lung Cancer Patient With Left Pyopneumothorax Nurandhini, Marsha; Suryanti Dwi Pratiwi; Yani Jane R. Sugiri; Dini Rachma Erawati; Hendy Setyo Yudhanto
Malang Respiratory Journal Vol. 7 No. 1 (2025): March 2025 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2025.007.01.06

Abstract

Introduction: Adenocarcinoma is the most common subtype of lung cancer, around 40% of lung cancer cases worldwide. It’s specific to epidermal growth factor receptor (EGFR) mutation. Lung cancer can be risk factor and increases the mortality rate of pyopneumothorax (12.8% higher in cancer patients). Case Illustration: A 69 year old woman, non smoker, who is diagnosed with lung adenocarcinoma (Exon 18 and 21 mutation) in May 2021 and came to emergency room with complaints of worsening shortness of breath. Cloudy-yellow pleural fluid was drained during thoracocentesis procedure. Imaging study using thorax CT scan showed a left lung mass obliterating bronchial segments 1/2, 3 and left hydropneumothorax. The patient was later diagnosed with pyopneumothorax and thorax drain procedure was performed. Antibiotic therapy was based on culture result. Through a following ctDNA (circulating tumor DNA) test, the mutations change to Exons 19 and 20 T790M. Discussion: Pyopneumothorax in this patient can occur due to disorder in the integrity of the host defense mechanisms, which then develops infection in the pleural cavity. The T790M mutation is found in 50-60% cases that are resistant to tyrosin kinase inhibitors (TKI). Third-generation TKI is main option for this condition, however, platinum-based chemotherapy can be considered, as in the case above, where third-generation chemotherapy cannot be given due to limitation of insurance coverage. Conclusion: Lung cancer can be associated with occurance of pyopneumothorax. Genetic mutation changes can occur due to resistance mechanisms. Giving platinum-based chemotherapy can be considered in such cases. Keywords: lung adenocarcinoma, genetic mutation, pyopneumothorax
Co-Authors Ahmad Bayhaqi Nasir Aslam Artono Isharanto Cindy Carrissa Primaputri Dini Rachma Erawati Dwi Rosa Eka Agustina Hendy Setyo Yudhanto Imam Suseno Bayuadi Nanik Setijowati Ni Made Rini Normawati Normawati Nurandhini, Marsha Rachma Dini Erawati Retnani, Diah Prabawati Yani Jane R. Sugiri