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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Kesehatan Reproduksi Indonesian Journal of Biotechnology The Indonesian Biomedical Journal Jurnal Gizi Klinik Indonesia Jurnal Kesehatan Reproduksi Berita Kedokteran Masyarakat Medical and Health Journal
Heru Pradjatmo
Department Of Obstetrics And Gynecology, Faculty Of Medicine, Public Health, And Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Jl. Farmako, Sekip Utara, Yogyakarta 55281
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health

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Hubungan Nilai Rasio Neutrofil-Limfosit Pra Pembedahan dengan Prognosis Kanker Ovarium Jenis Epitelial di RSUP Dr. Sardjito Rifqi, Rifqi; Alkaff, Muhammad Lutfi; Pradjatmo, Heru
JURNAL KESEHATAN REPRODUKSI Vol 10, No 2 (2023)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.65530

Abstract

LATAR BELAKANG: Kanker ovarium merupakan salah satu keganasan pada perempuan yang paling sering dan mematikan. Angka kejadian kanker ovarium di Indonesia mencapai 15 per 100.000 dan menempati urutan kelima penyebab kematian terbanyak akibat kanker pada wanita di Indonesia. Lebih dari 75% pasien kanker ovarium terdiagnosis pada stadium lanjut. Setelah menjalani tatalaksana primer, 50% pasien akan mengalami rekurensi dalam waktu 1 tahun, dan angka 5 years survival rate kurang dari 50%. Secara umum, prognosis kanker ovarium epitelial secara independen dipengaruhi oleh stadium, tipe dan derajat histologis, serta diameter residu maksimum setelah operasi sitoreduktif. Rasio neutrofil-limfosit (RNL), suatu prediktor status inflamasi, telah terbukti menjadi penanda prognostik yang efektif untuk sebagian keganasan, termasuk keganasan ovarium. Nilai RNL yang tinggi menggambarkan kecenderungan peningkatan inflamasi pro-tumor dan penurunan kapasitas imun anti-tumor.TUJUAN: Mengetahui hubungan antara Rasio Neutrofil-Limfosit (RNL) pra pembedahan primer dengan prognosis kanker ovarium epitelial pada pasien kanker ovarium di RSUP Dr. Sardjito, Yogyakarta.METODE: Penelitian ini merupakan penelitian uji prognosis dengan rancangan kohort retrospektif yang melibatkan 106 penderita kanker ovarium di RSUP Sardjito yang memenuhi kriteria inklusi. Sumber data berasal dari data sekunder yang diambil dari Instalasi Catatan Medik (ICM) dalam kurun waktu Januari 2016 sampai dengan Maret 2019.HASIL: Dari 106 subjek, didapatkan rerata usia pasien adalah 48.58 dengan 69.8% subjek merupakan multipara. Sebanyak 50.94% subyek didapatkan dalam stadium lanjut (III dan IV) dan 71.7% merupakan tumor high grade. Risiko relatif subyek dengan RNL ≥ 3,1 yang mengalami Progression Free Survival (PFS) < 12 bulan adalah sebesar 9.896 (CI 95% = 1.646-101.413, p = 0.003). Analisis hubungan antara umur, indeks massa tubuh, paritas, kadar CA-125 pre operatif, stadium, dan tumor grade dengan RNL menunjukkan bahwa secara statistik maupun klinis hanya stadium yang memiliki hubungan yang bermakna dengan RNL (RR = 1.618, CI 95% = 1.179-2.220, p = 0.002). Analisis hubungan antara umur, indeks massa tubuh, paritas, kadar CA-125 pre operatif, stadium, dan tumor grade dengan PFS menunjukkan bahwa secara statistik maupun klinis hanya stadium yang memiliki hubungan yang bermakna dengan PFS (RR = 3.370, CI 95% = 1.187-9.573, p = 0. 012). Hasil analisis multivariat menunjukkan bahwa secara bersamaan RNL > 3.1 dan stadium lanjut berhubungan dengan PFS secara klinis maupun statistik. KESIMPULAN: RNL pra pembedahan > 3.1 berhubungan dengan kejadian PFS <12 bulan pada pasien kanker ovarium epitelial di RSUP Dr. Sardjito. Pasien kanker ovarium epitelial dengan RNL > 3.1 dan stadium lanjut mengalami PFS < 12 bulan.KATA KUNCI: Kanker ovarium epitelial, Rasio Neutrofil-Limfosit, progression free survival.
Changes in CA 125 Level Pre and Post Ovarian Cancer Surgery Aprivinta, Sherlyana Mega; Pradjatmo, Heru; Hadiati, Diah Rumekti
JURNAL KESEHATAN REPRODUKSI Vol 10, No 3 (2023)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.79928

Abstract

Background: Ovarian cancer is one of the gynecological cancers that has a fairly high mortality rate and has a poor prognosis. Ovarian cancer management includes optimal operation followed by chemotherapy, which at follow up will have an effect on decreasing CA 125 levels. But in fact there are several studies showing increased CA 125. Given these differences in findings, this study attempted to evaluate the pre and post operation changes in CA 125 levels in ovarian cancer patients.Objective: This study aims to determine the changes in pre and post operation CA 125 levels in ovarian cancer patients. And to find out the optimal relationship between CA 125 level post operation and post operation.Methods: The type of research is an analytic study with a prospective cohort design. The source comes from secondary data taken from Simetris dr. Sardjito Hospital within 6 months.Results: The distribution of the age < 40 years was 11 and 19 were 40 years old. There was a significant change in pre operation log CA 125 levels (mean = 2,53 or 902,03U/ml) and post operation log CA 125 levels (mean = 1,92 or 406,23 U/ml). With a difference or delta mean of 0,61 or 495,80 U/ml and p value = 0.001. There was a significant difference in post operation log CA 125 levels between optimal and non optimal operation. Based on risk factors, there was a significant change or decrease in log CA 125 levels pre and post operation, but there was no significant difference in log CA 125 levels pre and post operation.Conclusion: There was a significant decrease in log CA 125 levels pre and post operation in patients with ovarian cancer who underwent operation. The post operation log CA 125 level in optimal operation is lower than in non-optimal operation.Keywords: CA 125, Ovarian Cancer, Operation, Optimal
Hubungan Nilai Rasio Platelet-Limfosit Pra Pembedahan pada Kanker Ovarium Epitelial dengan Respon Kemoterapi Berbasis Platinum di RSUP Dr. Sardjito putra, prayuna; Lutfi, Muhammad; Pradjatmo, Heru
JURNAL KESEHATAN REPRODUKSI Vol 11, No 1 (2024)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.94622

Abstract

ABSTRAKLatar Belakang: Respon inflamasi memiliki hubungan yang signifikan terhadap nilai prognostik dari suatu keganasan. Rasio platelet-limfosit (RPL) sebagai salah satu penanda inflamasi pada keganasan sehingga menjadi prediktor terhadap prognosis pasien kanker pada umumnya.Tujuan: Mengetahui hubungan antara RPL pra pembedahan dan respon kemoterapi berbasis platinum pada kanker ovarium epithelial di RSUP DR. Sardjito.Metode: Penelitian kohort retrospektif untuk menilai hubungan antara RPL pra pambedahan dan faktor-faktor risiko terhadap respon kemoterapi berbasis platinum pada pasien kanker ovarium epitelial.Hasil dan Pembahasan: Nilai cut-off RPL pra pembedahan adalah 203 dengan sensitivitas dan spesifitas=76,2%, nilai AUC=0,786, dan akurasi=76,2%. Ditemukan hubungan signifikan antara RPL pra pembedahan dan respon kemoterapi pada pasien kanker ovarium epitelial, p=0,001, RR(CI95%)=3,200(1,815-5,640). Terdapat hubungan yang signifikan antara jenis histologi dan respon kemoterapi, p=0,001, RR(CI95%)=2,384(1,424-3,989).Kesimpulan: Kejadian resisten kemoterapi berbasis platinum pada pasien kanker ovarium epitelial signifikan lebih tinggi pada pasien dengan nilai RPL pra pembedahan ≥203 dan jenis histologi (serosa 2 kali lebih tinggi dan  non serosa 4 kali lebih tinggi yang disertai dengan nilai  RPL ≥203)(efek modifikasi
Microrna Profile of Plasma Exosomes by Nanostrings in Early Onset Compared Late Onset Preeclampsia: Preliminary Study Sumawan, Herman; Pradjatmo, Heru; Hadiati, Diah Rumekti; Mubarika, Sofia; Giantari, Ifrinda
Medical and Health Journal Vol 5 No 1 (2025): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2025.5.1.17598

Abstract

Research on miRNA biomarkers in preeclampsia as part of screening, diagnosis, and prognosis has been widely conducted, but the results show contradictory results and vary based on the type of preeclampsia. This study aims to compare the profile of plasma exosome miRNA in early onset compared late onset as a preliminary study to identify the miRNA profile of preeclampsia patients in Indonesia. The study was conducted at Margono Hospital,Indonesia using plasma exosomes samples of three patients with early-onset preeclampsia and three patients with late-onset preeclampsia and processed with NanoStrings. KEGG was used to identify preeclampsia pathophysiological pathways by bioinformatic analysis of DIANA-miRPath v3.0 and microT-CDS v5.0. The results showed that the characteristics of parity, hemoglobin, systolic and diastolic blood pressure, proteinuria and BMI did not differ between EOPE and LOPE. Significantly different variables were the age of the EOPE (28 ± 5.29) vs LOPE (38.67 ± 2.06 mmHg), pregnancy weight gain (10.0 vs 15.33), and fetal weight in EOPE (1550 ± 132 g) vs LOPE (2693 ± 716 g). The results showed that the 24 miRNAs differed significantly. The three highest expression miRNAs in the EOPE group were miR-196b-5p, miR-190a-5p, and miR-515-3p. In contrast, the three lowest expression miRNAs are miR-3179, miR-181a-5p, and miR-15b-5p. Pathway analysis of the upregulated miRNA involved the ErbB signalling pathway, Proteoglycan in cancer, and Lysin degradation. Downregulated miRNA targets involved in the HIPPO signalling pathway, fatty acid biosynthesis, and TGF-β signalling pathway. Conclusions: The preliminary study results indicated significant differences in miRNA expression, suggesting that EOPE is influenced by aggressive cellular signaling and metabolic dysregulation, while LOPE is more linked to the disruption of growth-inhibiting pathways and fatty acid metabolism. These unique miRNAs establish a robust foundation for subsequent validation studies utilizing bigger samples as a prospective biomarker panel.
Co-Authors Addin Trirahmanto Adelina Amelia Adelina Amelia Adintyo Rahman, Muhammad Nur Afif Fuadi Ahsanuddin Attamimi Ahsanudin Attamimi Akbar Satria Fitriawan Alkaff, Muhammad Lutfi Aprilia Indra Kartika Aprivinta, Sherlyana Mega Ardhanu Kusumanto Ardhanu Kusumanto Attamimi, Ahsanuddin Bob Irsan Bob Irsan Choery Novitasari Dewi Sahfitri Tanjung Deyna Primavita Pahlevi Diah Rumekti Hadiati Djaswadi Dasuki Djaswadi Dasuki Djaswadi Dasuki Emilia Theresia Eny Fatmawati Ery Kus Dwianingsih Fatmawati, Eny Geni, Puti Lenggo H.R. Siswosudarmo Hari Kusnanto Herman Sumawan Ifrinda Giantari Ifrinda Giantari Irianiwati Widodo Irsan, Bob Irwan Taufiqur Rachman Ksyatria, Yudhistya Ngudi Insan Laili Chilmawati Laili Chilmawati Mardiana Mardiana Mardiana Mardiana Moh Nailul Fahmi Mohammad Hakimi Muhammad Lutfi Muhammad Lutfi Muhammad Nur Adintyo Rahman Novitasari, Choery Nuratul Awaliyah Nurul Hikmah Petrana Ova Emilia Pahlevi, Deyna Primavita Petrana, Nurul Hikmah Puti Lenggo Geni putra, prayuna Rifqi, Rifqi Shinta Prawitasari Shinta Prawitasari Siti Nur Chasanah Siti Sholikhah Sofia Mubarika Sofia Mubarika Haryana Sumawan, Herman Syamsul Arifin Teguh Aryandono Tri Gunawan Tri Gunawan, Tri Yudhistya Ngudi Insan Ksyatria