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All Journal Majalah Kedokteran Bandung Althea Medical Journal Jurnal Farmasi Klinik Indonesia Majalah Patologi Indonesia JK Unila (Jurnal Kedokteran Universitas Lampung) Indonesian Journal of Cancer
Herry Yulianti
Departemen Patologi Anatomi Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Dentistry Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Effects of White Turmeric Infusion on the Liver Cells in Carbon Tetrachloride-Induced Mice Oktaviani, Fitria; Herdiningrat, RB. Soeherman; Yulianti, Herry
Althea Medical Journal Vol 2, No 4 (2015)
Publisher : Althea Medical Journal

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Abstract

Background: The liver is an organ that has important functions in the body. Liver damage can be caused by oxidative stress and free radicals. White turmeric (Curcuma zedoaria L) contains antioxidants that can be used to neutralize the effects of free radicals. This study was conducted to determine the effect of white turmeric infusion on histological appearance of liver cells in male mice induced by carbon tetrachloride (CCl4).Methods: This laboratory experimental study was conducted using male mice (Mus musculus) with Balb/c strain. Thirty-three mice were randomly divided into 3 groups i.e.,group 1 as a control group was given standard food and drink, group 2 was given 10% of CCl4 0.1 ml by intraperitoneal injection on the first day and group 3 was given 10% of CCl4 0.1 mL by  ntraperitoneal injection on the first day, followed by the administration of 50% of white turmeric infusion 0.2 mL. Kruskal-Wallis test method was used to analyse the significant differences of the average percentage of damaged liver cells in the group given CCl4 alone with the group given CCl4 and white turmeric infusion and control group.Results: The percentage of damaged liver cells between groups of mice given CCl4 alone and the group given CCl4 followed by white turmeric infusion were respectively(p <0.05) compared to group1.Conclusions: Administration of white turmeric infusion gave an influence by decreasing the percentage of damaged liver cells in CCl4-induced mice. White turmeric can serve as an alternative antioxidants that can be used to neutralize the effects of free radicals. [AMJ.2015;2(4):506–10] DOI: 10.15850/amj.v2n4.498
Histopathologic Distribution of Appendicitis at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, in 2012 Zhafira, Tara; Yulianti, Herry; Wastaman, Maman
Althea Medical Journal Vol 4, No 1 (2017)
Publisher : Althea Medical Journal

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Abstract

Background: Appendicitis is a medical emergency and a common cause of emergency surgeries worldwide. Its frequency is varied based on many factors, including age and sex. Histopathologic examination is a gold standard for diagnosis, and complications like gangrene formation and perforation lead to high mortality and morbidity in almost all age groups. This study was conducted to describe the distribution pattern of appendicitis according to age, sex, and histopathologic type. Methods: This cross-sectional study was carried out in the Department of Pathology Anatomy, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, from August–October 2013. Secondary data were obtained from medical records of January 1st to December 31st, 2012. A total of 503 out of 516 cases were included to be reviewed. Age, sex, and histopathologic type from medical records were then evaluated. Any specific case and perforation were also noted.Results: Data showed the highest prevalence of appendicitis occurred in the 10- 19 age group (28.4%) and in the female group (52.3%). Acute appendicitis was more common than chronic appendicitis in both sexes and all age groups. Perforation rate was high (41.4%), and was more prevalent in male (54.9%) and in the 0–9 age group (65.7%).Conclusions: Appendicitis, both acute and chronic, is more distributed in the second decade, and is slightly more prevalent in females. Acute cases are more common than chronic. Perforation rate is significant and peaks in the first decade and in males. [AMJ.2017;4(1):36–41]DOI: 10.15850/amj.v4n1.1017
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

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Abstract

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 Differentiation 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
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (338.33 KB) | DOI: 10.15416/ijcp.2018.7.2.115

Abstract

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 2012−2015 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, PARP 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 2012–2015 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
Hubungan Imunoekspresi CD34 dengan Gradasi dan Stadium (Duke) pada Adenokarsinoma Kolorektal Yulianti, Herry; Hernowo, Bethy S.
Majalah Kedokteran Bandung Vol 45, No 4 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Karsinoma kolorektal umum terjadi di Eropa Barat Laut dan Amerika Utara, tetapi rendah di Afrika, Asia, dan Amerika Selatan. Di Indonesia, karsinoma kolorektal merupakan masalah kesehatan masyarakat dan merupakan tiga penyakit kanker terbanyak. Angiogenesis adalah pertumbuhan dan proliferasi pembuluh darah baru dari pembuluh darah yang sudah ada. Secara imuno histokimia, mikrovaskular dapat diidentifikasi dengan menggunakanmonoklonal cluster of differentiation (CD34) antibodi. Pada beberapa penelitian, microvascular density (MVD) berhubungan dengan gradasi histologi, stadium, metastasis, dan prognosis tumor. Tujuan penelitian ini untuk mengetahui hubungan ekspresi CD34 dengan gradasi dan stadium (klasifikasi Duke) pada karsinoma kolorektal. Metode penelitian adalah cross sectional terhadap 40 kasus adenokarsinoma kolorektal yang berasal dari Departemen Patologi Anatomi Rumah Sakit Dr. Hasan Sadikin Bandung-Fakultas Kedokteran Universitas Padjadjaran tahun 2004–2005. Potongan blok parafin dari jaringan kolorektal karsinoma diwarnai dengan hematoksilin eosin untuk evaluasi histologi dan imunohistokimia menggunakan monoclonal CD34 antibody. Penghitungan MVD yang imunoreaktif dilakukan di bawah mikroskop cahaya dengan pembesaran 400x, dihitung rata-rata pada 5 tempat daerah neovaskularisasi yang paling padat. Hasil penelitian menunjukkan hubungan yang signifikan MVD dengan stadium (p<0,01) dan tidak ada hubungan yang signifikan antara MVD dan gradasi (p<0,05). Simpulan, hubungan MVD dengan kedalaman invasi dan metastasis ke kelenjar limfe yang dinilai dengan klasifikasi Duke dan CD34 dapat digunakan untuk memprediksi prognosis, memperkirakan kemungkinan metastasis melalui pembuluh darah, dan memprediksi respons terhadap terapi antiangiogenik. [MKB. 2013;45(4):240–4]Kata kunci: Adenokarsinoma kolorektal, CD34, gradasi, klasifikasi DukeCorrelation between CD34 Immunoexpression and Colorectal Adenocarcinoma Grade and Stage (Duke) Carcinoma colorectal is commonly found in Nortwest Europe and North America, but not frequently found in Africa, Asia and South America. Colorectal cancer (CRC) is a public health problem in Indonesia and currently ranks among the three most common cancers. Angiogenesis is the growth and proliferation of new blood vessels from existing vasculature. Microvessels were identified immunohistochemically using monoclonal cluster of differentiation (CD34) antibody. Several studies have noted that microvascular density (MVD) correlates with stage of disease, histological grade, metastasis, and prognosis in cancers. The aim of this study was to explore the relation between CD34 immunoexpresion and grade and stage (Duke classification) in colorectal adenocarcinoma. This is a cross sectional study with 40 colorectal carcinoma cases from Department of Pathology Anatomy, Dr. Hasan Sadikin General Hospital/Faculty of Medicine, Universitas Padjadjaran Bandung during 2004−2005. A section from paraffin embedded tissue of colorectal carcinoma was stained with hematoxylin eosin for histological and immunohistochemical evaluations using monoclonal CD34 antibody. Microvascular density was counted in five tumor areas with most intensive neovascularization using 400x field light microscopy. A significant correlation was found between the MVD and stage (p<0.01) while no significant relationship found between MVD and different grade (p<0.05). In conclusion, correlations are found between MVD with tumor invation depth and lymph node metastases determined by the Duke’ staging system and CD34 can be used to predict prognosis, possibility of hematogenous metastases and responses to antiangiogenic therapy. [MKB. 2013;45(4):240–4]Key words: Adenocarcinoma colorectal, CD34, Duke clasification, grade DOI: http://dx.doi.org/10.15395/mkb.v45n4.171
Korelasi Ekspresi Reseptor Vitamin D (VDR) dengan Derajat Diferensiasi dan Stadium Adenokarsinoma Kolorektal Usman, Hermin Aminah; Erida, Yulie; Yulianti, Herry; Hassan, Abdul Hadi
Majalah Kedokteran Bandung Vol 48, No 2 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (325.125 KB) | DOI: 10.15395/mkb.v48n2.387

Abstract

Keganasan terbanyak ketiga di dunia pada organ kolorektal adalah karsinoma yang berasal dari lapisan epitel mukosa. Modalitas yang digunakan untuk terapi karsinoma kolorektal stadium lanjut selain operasi adalah kemoterapi dan saat ini dikembangkan terapi target sebagai alternatif terapi, yaitu metabolit aktif vitamin D, calcitriol. Calcitriol bekerja sinergis dengan agen kemoterapi yang aktivitasnya dimediasi oleh vitamin D reseptor (VDR). Penelitian ini bertujuan mengetahui korelasi imunoekspresi VDR dengan stadium dan derajat diferensiasi (grading) pada adenokarsinoma kolorektal. Menggunakan 35 blok parafin adenokarsinoma kolorektal yang diambil dari kolektomi, di Departemen Patologi Anatomi Rumah Sakit Dr. Hasan Sadikin Bandung periode 1 Januari 2009–30 Juni 2014, terbagi dalam 3 kelompok stadium (I, II, dan III) dan 3 kelompok derajat diferensiasi (well, moderately, dan poorly differentiated). Imunohistokimia dilakukan pada sampel untuk melihat ekspresi VDR pada massa tumor menggunakan antibodiprimer VDR. Data dianalisis menggunakan uji statistika korelasi Rank Spearman. Terdapat korelasi imunoekspresi VDR dengan stadium (p=0,045; R=-0,341) dan derajat diferensiasi (p=0,000; R=0,558). Pada penelitian ini VDR berperan dalam menentukan stadium dan derajat diferensiasi adenokarsinoma kolorektal. Hal ini dapat dijadikan pertimbangan dalam pemberian calcitriol sebagai bagian dari terapi target pada adenokarsinoma kolorektal dan acuan untuk penelitian selanjutnya dalam perkembangan terapi target. [MKB. 2016;48(2):123–8]Kata kunci: Adenokarsinoma kolorektal, derajat diferensiasi, stadium, imunoekspresi VDRCorrelation of Vitamin D Receptor (VDR) Expression with Differentiation Staging and Grading in Colorectal AdenocarcinomaColorectal carcinoma (CRC) is a malignancy from mucosal epithelium of the colon/rectum. The treatment modalities used for advance stage colorectal carcinoma therapy is chemotherapy, in addition to surgery. Targeted therapy is currently being developed as an alternative therapy. One of the agents used in this therapy is calcitriol. Calcitriol is an active metabolite of vitamin D. Calcitriol works synergistically with chemotherapeutic agents and its activity is mediated by the vitamin D receptor (VDR). VDR plays a role in the inhibition of tumor progression via induction of cellular differentiation and proliferation inhibition. In this study, imunoexpression of vitamin D receptor was examined in conjunction with the staging and degree of differentiation (grading) of colorectal adenocarcinoma. The study objects include 35 colorectal adenocarcinoma paraffin blocks created from colectomy which were collected at the Department of Patology Anatomic of Dr. Hasan Sadikin General Hospital Bandung from January 2009–June 2014. The blocks were divided into three groups of staging (I, II, and III) and  three groups of grading: well, moderately, and poorly differentiated. Immunostaining was used to evaluate the VDR immunoexspression by histo-score. The data were tested using rank spearman test. There was a weak negative correlation between VDR imunoexpression and staging(p=0.045, R=-0.341), and a moderate positive correlation between VDR imunoexpression and grading (p=0.000, R=0.558). It is concluded that a significant correlation of VDR imunoexpression with staging and grading of colorectal adenocarcinoma is found and this finding can be used as a reference for further studies in the development of targeted therapies. [MKB. 2016;48(2):123–8]Key words: Adenocarcinoma colorectal, grading, staging, VDR imunoexpression
Hubungan Imunoekspresi NF-kB dengan Sinus Rokitansky Aschoff pada Kolesistitis Kronik Yulianti, Herry; Hernowo, Bethy S.
Majalah Kedokteran Bandung Vol 46, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Karsinoma kandung empedu relatif jarang, tetapi merupakan penyakit yang sangat mematikan. Keganasan kandung empedu merupakan 3−4% dari seluruh lesi ganas dan menempati urutan ke-5 di antara tumor sistem pencernaan. Karsinoma kandung empedu sulit dideteksi dan didiagnosis pada stadium awal, karena biasanya gejalanya sangat sedikit atau tanpa gejala. Oleh karena itu sangat penting menegakkan diagnosis secara dini dan mendeteksi pasien risiko tinggi, termasuk batu dan riwayat kolesistitis kronik. Kolesistitis kronik merupakan peradangan kronik pada kandung empedu dan disertai kolelitiasis pada lebih dari 90% kasus. Batu empedu merupakan faktor etiologi yang penting pada karsinoma kandung empedu. Pada gambaran histopatologi kolesistitis kronik ditemukan sinus Rokitansky Aschoff. Pendekatan genetik telah membuktikan komponen inflamasi berperan dalam karsinogenesis, seperti primary inflammatory cytokines, interleukin-1 (IL-1), tumor necrosis factor (TNF), IL-6, dan nuclear factor-kappaB (NF-kB). Tujuan penelitian ini untuk mengetahui hubungan imunoekspresi NF-kB dengan sinus Rokitansky Aschoff pada kolesistitis kronik. Metode penelitian adalah potong lintang terhadap 30 kasus kolesistitis kronik yang berasal dari Departemen Patologi Anatomi Rumah Sakit Dr. Hasan Sadikin Bandung/Fakultas Kedokteran Universitas Padjadjaran tahun 2010−2011. Potongan blok parafin dari jaringan kolesistitis kronik setebal 4 µm diwarnai dengan hematoksilin eosin untuk evaluasi gambaran histopatologi dan pemeriksaan imunohistokimia menggunakan polyclonal NF-kB antibody. Perhitungan sel yang imunoreaktif dilakukan di bawah mikroskop cahaya dengan pembesaran 400x, dihitung rata-rata pada 5 tempat. Hasil penelitian menunjukkan hubungan yang signifikan antara imunoekspresi NFkB dan sinus Rokitansky Aschoff (p=0,000). Simpulan, terdapat hubungan imunoekspresi NFkB dengan sinus Rokitanski Aschoff, semakin tinggi imunoekspresi NFkB semakin banyak sinus Rokitansky Aschoff. [MKB. 2014;46(2):106–11]Kata kunci: Kolesistitis kronik, NFkB, sinus Rokitansky AschoffCorrelation between Immunoexpression of NF-kB and Rokitansky Aschoff Sinuses in Chronic CholecystitisCarcinoma of the gallbladder is relatively uncommon but it is a very lethal disease. Gallbladder cancer constitutes 3−4% of all malignant lesions and ranks 5th among the digestive system tumors. Gallblader carcinoma is difficult to detect and diagnose in early stage because it usually has very slight symptoms or asymptomatic. It becomes increasingly necessary to make early diagnosis and identification of high-risk patient,as well as gallstone and history of chronic cholecystitis. Chronic cholecystitis is a chronic inflammation of gallbladder associated with cholelithiasis in more than 90% of cases. Cholelithiasis is one of the important etiological factors in carcinoma of the gallbladder. The histological examination of chronical cholecystitis shows the presence of Rokitansky Aschoff sinuses. Genetic approaches have proven that the components of inflammation such as primary inflammatory cytokines, interleukin-1 (IL-1), tumor necrosis factor (TNF), IL-6 and nuclear factor-kB (NF-kB) play the key roles in carcinogenesis. The purpose of this study was to understand the correlation between the immunoexpression of NF-kB and Rokitansky Aschoff sinuses in chronic cholecystitis. The method was cross sectional of 30 cases of chronic cholecystitis from Department of Pathology Anatomy of Dr. Hasan Sadikin General Hospital Bandung/Faculty of Medicine Universitas Padjadjaran in 2010−2011. A section from 4 µm-thick paraffin embedded tissue of chronic cholecystitis was stained with hematoxylin eosin for histopatological evaluation and immunohistochemical using polyclonal NF-kB antibody. Immunoreactive cells was counted in five tumor areas of 400x field by light microscopy. The result showed a significant correlation between the immunoexpression of NFkB and Rokitansky Aschoff sinuses (p=0.000). In conclusion, there is a correlation between immunoexpression of NFkB and Rokitansky Aschoff sinuses because as the immunoexpression of NFkB increase, more Rokitansky Aschoff sinuses will be formed. [MKB. 2014;46(2):106–11]Key words: Chronic cholecystitis, NFkB, Rokitansky Aschoff sinuses DOI:  10.15395/mkb.v46n2.282
Hubungan antara Imunoekspresi Ki-67 dan Risiko Agresivitas Tumor pada Gastrointestinal Stromal Tumor Yulianti, Herry; Hernowo, Bethy S.
Majalah Kedokteran Bandung Vol 47, No 4 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Gastrointestinal stromal tumor (GIST)  merupakan tumor mesenkimal yang paling sering terjadi pada traktus gastrointestinal dan berasal dari intestinal cells of Cajal yang terdapat pada lapisan muskularis traktus gastrointestinal yang berfungsi sebagai pacemaker cell dalam mengatur motilitas intestinal. Diperkirakan insidensi GIST 3−5% dari seluruh soft tissue sarcoma. Gastrointestinal stromal tumor  dapat terjadi sepanjang traktus gastrointestinal, terbanyak pada usia pertengahan dan lebih tua, dengan usia rata-rata 50−60 tahun. Secara histologi, terdapat tiga kategori morfologi GIST, yaitu spindle cell, epitheloid, dan mixed type. Marker spesifik GIST adalah cluster of differentiation (CD117) yang mempunyai sensitivitas baik dan imunoreaktif pada 95% GIST. Ekspresi Ki-67 berhubungan dengan aktivitas proliferasi dan dapat dideteksi pada fase G1, S, G2, dan M dari siklus sel, kecuali pada fase G0. Tujuan  penelitian ini adalah mengetahui hubungan risiko agresivitas dengan aktivitas proliferasi yang diukur dengan Ki-67 pada tumor yang telah dikonfirmasi sebagai GIST dengan CD117. Penelitian ini merupakan penelitian analitik potong lintang terhadap 29 kasus GIST dari Departemen Patologi Anatomi Rumah Sakit Dr. Hasan Sadikin/Fakultas Kedokteran Universitas Padjadjaran, Rumah Sakit Santo Borromeus, Rumah Sakit Immanuel, dan Rumah Sakit Santosa Bandung pada tahun 2007−2012. Potongan blok parafin dari 55 kasus GIST diwarnai dengan hematoksilin eosin untuk evaluasi histologi dan evaluasi imunohistokimia menggunakan monoclonal CD117 antibody untuk konfirmasi diagnosis GIST. Terdapat 29 kasus  positif dengan CD117, kemudian diwarnai dengan monoclonal Ki-67 antibody. Sel yang dikategorikan positif CD117 memperlihatkan partikel coklat di dalam sitoplasma dan imunoekspresi Ki-67 dinilai dengan warna coklat pada inti sel tumor. Hasil penelitian  menunjukkan hubungan bermakna antara risiko agresivitas tumor dan imunoekspresi Ki-67 (p<0,001). Simpulan, semakin tinggi nilai ekspresi Ki-67 semakin tinggi skor risiko agresivitas sehingga pada GIST, pemeriksaan imunohistokimia Ki-67 dapat membantu menentukan apakah pasien akan mempunyai prognosis yang buruk. [MKB. 2015;47(4):231–7]Kata kunci: CD117, gastrointestinal stromal tumor, Ki-67Correlation between Ki-67 Immunoexpression and the Tumor Aggressivity Risk in Gastrointestinal Stromal TumorAbstractGastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract, and arises from intestinal cells of Cajal localized in the muscular layer of the digestive tract, which functions as pacemaker cells in regulating intestinal motility. The incidence of GIST is about 3−5% of all soft tissue sarcomas. Gastrointestinal stromal tumor can occur along the gastrointestinal tract and predominantly in middle-aged and older persons, with a median age between 50 and 60 years. Histologically, there are three categories of GIST morphology such as spindle cells, epitheloid, and mixed type. A spesific marker of GIST is cluster of differentiation (CD117), which has good sensitivity and immunoreactive in 95% of GIST. The expression of Ki-67 correlates with proliferative activities and can be detected in G1, S, G2, and M phases of cell cycle but not in G0 phase. The aim of this study was to assessthe correlation between the risk of aggressive behaviors and proliferative activities as measured by Ki-67 in tumors confirmed as GIST by CD117. The method of this study was cross-sectional, performed on 29 cases of GIST from the Department of Pathology Anatomy Dr. Hasan Sadikin General Hospital/Faculty of Medicine Universitas Padjadjaran, Santo Borromeus Hospital, Immanuel Hospital, and Santosa Hospital between 2007−2012. A section from paraffin embedded tissue of 55 cases of GIST was stained with hematoxylin eosin for histological and immunohistochemical evaluations using monoclonal antibody CD117 to confirm the diagnosis of GIST. There were 29 positive cases for CD117. Further staining was performed using monoclonal antibody Ki-67. The categorized positive cells of immunoexpression of CD117 showed brown particles inside cytoplasma and the immunoexpression of Ki-67 was assessed by identification of nuclear brown staining of neoplastic cells. The result showed that there were significant correlations between the risk of tumor aggressive behaviors and immunoexpression of Ki-67 (p<0.001). In conclusion, as the immunoexpression of Ki-67 value increases, the aggressivity risk score becomes higher. Therefore, in GIST, the Ki-67 immunohistochemical analysis may help to decide which patients will have the worst prognosis. [MKB. 2015;47(4):231–7]Key words: CD117, gastrointestinal stromal tumor, Ki-67 DOI: 10.15395/mkb.v47n4.617
Imunoekspresi Lgr5 dan E-cadherin sebagai Faktor Prediksi Metastasis ke Kelenjar Getah Bening Regional pada Adenokarsinoma Kolorektal Sri Dharmayanti; Abdul Hadi Hassan; Herry Yulianti; Bethy Suryawati Hernowo
Majalah Patologi Indonesia Vol 28 No 1 (2019): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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Abstract

Latar belakangKarsinoma kolorektal (KKR) merupakan keganasan dengan morbiditas dan mortalitas yang tinggi di dunia.Lebih dari 90% KKR adalah adenokarsinoma. Tingginya angka kekambuhan dan metastasis pada KKRdisebabkan oleh Cancer Stem Cell (CSC). Metastasis ke kelenjar getah bening merupakan penanda prognosisyang buruk pada KKR. Lgr5 adalah penanda CSC di usus halus dan kolon. E-cadherin berperan pentingmenjaga integritas hubungan antar sel. Imunoekspresi Lgr5 berhubungan dengan prognosis yang buruk.Kehilangan fungsi E-cadherin berhubungan dengan pertumbuhan yang invasif. Tujuan penelitian adalah untukmengetahui apakah Lgr5 dan E-cadherin dapat digunakan sebagai faktor prediksi metastasis ke kelenjar getahbening regional pada KKR.MetodePenelitian ini menggunakan analisis observasi dengan disain potong lintang. Sampel diambil dari blok parafinyang berasal dari jaringan operasi kolon dan rektum dengan jumlah kelenjar getah bening ≥12 buah.Keseluruhan sampel berjumlah 52 dan terbagi menjadi dua kelompok yaitu non metastasis dan metastasisdengan 26 sampel setiap kelompok. Sampel didapatkan dari Depatemen Patologi Anatomik Rumah Sakit DrHasan Sadikin Bandung periode 1 Januari 2010-31 Desember 2015 dan dilakukan pewarnaan imunohistokimiaLgr5 dan E-cadherin. Analisis statistik menggunakan chi-square dengan nilai kemaknaan p<0,05.HasilLgr5 berhubungan dengan metastasis ke kelenjar getah bening regional p=0,001. E-cadherin tidakberhubungan dengan metastasis ke kelenjar getah bening regional p=0,09.KesimpulanLgr5 dapat digunakan sebagai faktor prediksi terjadinya metastasis ke kelenjar getah bening regional padaKKR.
Hubungan Antara Derajat Histopatologik Sarkoma dengan Respon Radioterapi Eny Soesilowati; Afiati; Herry Yulianti; Hermin Aminah; Bethy Surjawathy Hernowo, PhD, SpPA(K)
Majalah Patologi Indonesia Vol 31 No 1 (2022): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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Abstract

BackgroundSarcomas are rare, aggressive tumors originating from mesenchymal tissue. Radiotherapy is currently accepted as thestandard adjuvant to the treatment of high-grade sarcomas, whereas low-grade sarcomas are controversial, but the response ofradiotherapy to sarcomas is up to 50%. The aim of this study was to determine the association between the histopathologicalgrade of sarcoma and the radiotherapeutical response.MethodsThe research design was a cross-sectional study, with retrospective analysis. The sample consisted of 80 paraffin block tissuesfrom biopsy and surgery specimens of sarcoma from January 2013 to December 2019 at Hasan Sadikin Hospital in Bandung,consisting of 45 radiosensitive samples and 35 radioresistant samples. All samples were assessed for histopathological gradeaccording to the FNCLCC. Statistical analysis used the Chi-Square test with a significant value of p <0.05. Data were processedusing SPSS version 24.0 for windows.ResultsIn the radiosensitive group, 15 (33.3%) samples were low grade sarcomas and 30 (66.7%) samples were high grade sarcoma.There was no statistically significant association between histopathological grade and radiotherapeutical response in sarcomasp> 0.05 (p = 0.304).ConclusionIn this study, the radiotherapeutical response was not associated to the histopathological grade of sarcoma. This is because ofthe sensitivity of radiotherapy is influenced by other factors including molecular characteristics.
Co-Authors Abdul Hadi Hassan Abdul Hadi Hassan, Abdul Hadi Adji Kusumadjati Afiati Afiati Afiati Aminah, Hermin Bethy S Hernowo Bethy S. Hernowo Bethy S. Hernowo Bethy S. Hernowo Bethy Surjawathy Hernowo, PhD, SpPA(K) Bethy Suryawathy Hernowo Bethy Suryawati Hernowo Eny Soesilowati Eny Soesilowati Erida, Yulie Erida, Yulie Fitria Oktaviani Fitria Oktaviani, Fitria Hasrayati Agustina Hermin A. Usman Hermin Aminah Hermin Aminah Hermin Aminah Usman Maharani Tasyandita, Raina Maman Wastaman RB. Soeherman Herdiningrat Retno Westiningrum Sri Dharmayanti Suryawathy Hernowo, Bethy Tara Zhafira Usman, Hermin A. Wastaman, Maman Westiningrum, Retno Yasni Iryani Widiasih Yulie Erida Zhafira, Tara