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Relationship of Stromal Tumor Infiltrating Lymphocytes (STILs) with Grading Histopathology in Penis Squamous Cell Carcinoma Sihotang, Marisi Cintya Debby; Intan, T. Kemala; Alferraly, T. Ibnu; Betty, Betty; Soekimin, Soekimin; Delyuzar, Delyuzar
Majalah Patologi Indonesia Vol. 33 No. 2, Mei 2024
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i2.580

ABSTRACT Background:Penile squamous cell carcinoma is the most common penile malignance found in the world. Assessment of stromal tumor infiltrating lymphocytes (STILs) associated with grading against penile squamous cell carcinoma can provide a potential prognostic picture and help determine the action. Method:Cross-sectional analytical study with 32 samples of histopathological preparations diagnosed as penile squamous cell carcinoma at H. Adam Malik Hospital Medan. The assessment of stromal TILs was carried out by assessing the number of lymphocyte inflammatory cells in the peritumoral stroma and then determined the assessment score, zero score no lymphocytes (minimum), score one found 0-10% lymphocytes (moderately), score two found 20-40% lymphocytes (massive) , score three found 50-90% lymphocytes. Grading assessments are categorized into grade I (well differentiated), grade II (moderately differentiated), and grade III (poorly differentiated). Result:The most grading found was grade II (43.8%) and the most STILs found were score three (50.0%). There is a significant relationship between grading and STILs in penile squamous cell carcinoma (p value=0.0001) i.e. the higher the STILs score , the lower the tumor grade. Conclusion:There is a relationship between STILs and histopathological grading in Penile Squamous Cell Carcinoma so that it can be used as an indikasi prognosis in patients with penile squamous cell carcinoma.

Correlation between Reactive Stromal Expression and Histochemical Trichrome Masson Staining with Histopathological Grading in Prostate Adenocarcinoma at Adam Malik Haji Center General Hospital Medan Basrul, Mohd. Yuwanda; Laksmi, Lidya Imelda; Mariedina, Causa Trisna; Lubis, M. Nadjib Dahlan; Intan, T. Kemala; Chrestella, Jessy
Majalah Patologi Indonesia Vol. 33 No. 3, September 2024
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i3.584

Background Adenocarcinoma of the prostate is an invasive carcinoma, composed of neoplastic prostatic epithelial cells with differentiation and secretion arranged in various histomorphological patterns.Quantitative analysis of the elements that make up the stroma in casesprostate adenocarcinomahas been linked to prognostic factors and the Gleason score, which correlates with progression and metastasis, and may contribute to new prognostic feature approaches. Method Descriptive analytic study with 33 paraffin block samples diagnosed as prostate adenocarcinoma at Haji Adam Malik General Hospital Medan.Assessment is done forsee the relationship between reactive stromal expression using Trichrome Masson and histopathological grading gleason score then determine the scoring score for the stroma around the prostate gland adenocarcinoma lesion stained blue with trichrome masson, a positive score of one (+): if 0-15% stroma is stained blue, positive two (++): if >15%-<50% stroma is stained and triple positive (+++): if >50% stroma is stained blue. The histopathological grading was categorized into grade I (well differentiated: Gleason score ≤6), grade II (moderately differentiated: Gleason score 7 (3+4)), and grade III (poorly differentiated: Gleason score 7 (4+3) and 8 -10). Results: Reactive stromal expression the most found was positive three (+++) (69.7%) and the most common histopathological grading was grade III (69.7%). There was a significant correlation between reactive stromal expression and histopathological grading in prostate adenocarcinoma (p-value=0.044), namely the worse the cell differentiation, the higher the positive score of reactive stromal expression. Conclusion Assessment of reactive stromal expression associated with histopathological grading can be used as an indication of prognosis in patients with prostate adenocarcinoma.

Correlation Ki67 Expression With peritumoral budding Tumor Index In the Case of Squamous Cell Carcinoma Cervix NOS And Adenocarcinoma Cervix NOS Wardini, Indah Astri; Alferraly, T. Ibnu; Chrestela, Jessy; Betty, Betty; Intan, T. Kemala; Lubis, H. M. Nadjib Dahlan
Majalah Patologi Indonesia Vol. 33 No. 3, September 2024
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i3.611

Background Cervical cancer is a neoplasm in the cervix due to abnormal cells that damage the surrounding tissue. Cervical cancer from squamous cells is called squamous cell carcinoma cervix NOS and that from glands is called adenocarcinoma cervix NOS. The prognostic of both can be assessed by tumor budding and Ki67 immunohistochemistry, tumor budding is a tumor bud which is ≤ 5 cells in a cluster that grows in front of the parent tumor and immunohistochemistry Ki67 is a labile nonhistone nuclear protein which is expressed in the G1, S, G2 and M phases of the cycle cell. Method This research is an analytical type of research that aims to find out the relationship between Ki67 expression and the peritumoral budding tumor index compared to cases of squamous cell carcinoma cervix NOS and adenocarcinoma cervix NOS with 36 paraffin block samples diagnosed with squamous cell carcinoma NOS and adenocarcinoma NOS at HAM Hospital. Medan. Assessment method of Ki67 expression where low expression (<20%) and high expression (≥20%). Assessment of peritumoral budding tumors in both cases was said to be low buds if < 5 buds and high buds if ≥ 5 buds. Results This study provides a significant appearance (p-value 0.0001) which means that peritumoral budding tumors with HE staining can be accepted as a measuring tool for assessing cervical cancer in addition to assessment using immunohistochemistry Ki67 which is generally used in the prognostic assessment of cervical cancer. Conclusion Assessment in this case can consider peritumoral budding tumor assessment to determine prognostic in cases of squamous cell carcinoma NOS and cervical adenocarcinoma NOS, if Ki67 immunohistochemistry is not available.

Correlation between Matrix Metalloproteinase-9 Matrix Expression and Clinicopathology in Colorectal Adenocarcinoma Not Otherwise Specified Sembiring, Rica Friska; Intan, T. Kemala; Alferraly, T. Ibnu
Majalah Patologi Indonesia Vol. 33 No. 3, September 2024
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i3.629

Background Matrix metalloproteinase-9 (MMP-9) is a member of the metalloproteinase enzyme that is often found in colorectal adenocarcinoma. MMP-9 is able to destroy basement membrane proteins and extracellular matrix which play a role in tumor cell invasion. Method Cross-sectional analytic study with 30 paraffin block samples diagnosed as colorectal adenocarcinoma NOS at H. Adam Malik General Hospital Medan. MMP-9 expression was assessed using immunohistochemical staining in the cytoplasm of tumor cells and cells in the stroma. Expression was assessed using the Quick Score method and was declared weak if the total value was 0-5 and strong if the total value was ≥6. Statistical analysis between MMP-9 expression and depth of invasion was carried out using Fisher's Exact and Mann-Whitney U tests. Results MMP-9 expression was significantly related to stage (p=0.01), depth of invasion (p=0.03), and stromal Tils (p=0.03) and not significantly related to gender (p=0.28) , age (p=0.82), tumor location (p=0.69), grading (p=0.26), lymph node involvement (p=0.53), metastasis (p=0.53), perineural invasion (p=0.25), lymphatic invasion (p=1.00), IMVI (p=0.531.00), EMVI (p=1.00), tumor budding (0.25). Conclusion MMP-9 expression can be used as an indication of prognosis and also helps clinicians, especially in the management of patients with colorectal adenocarcinoma NOS.

The Correlation between Matrix Metalloproteinase-9 (MMP-9) Immunohistochemical Expression and Histopathological Subtypes of Basal Cell Carcinoma: A Correlation between Matrix Metalloproteinase-9 (MMP-9) Immunohistochemical Expression and Histopathological Subtypes of Basal Cell Carcinoma Aisyah, Siti; Intan, T. Kemala; Alferraly, T. Ibnu; Betty, Betty; Soekimin, Soekimin; Laksmi, Lidya Imelda
Majalah Patologi Indonesia Vol. 33 No. 2, Mei 2024
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i2.644

ABSTRACT Background Basal cell carcinoma (BCC) is a non-melanocytic skin cancer originating basal layer of the epidermis and/or hair follicles that shows an increasing global incidence. Disease growth is slow, rarely metastasizes but has the ability to invade and destroy deeper surrounding tissues. Low mortality, but high morbidity. Matrix metalloproteinases are enzymes that can degrade various extracellular matrix components. In skin, MMP-9 expression may be increased by prolonged ultraviolet exposure. UV radiation is one of the causes of BCC. Method Analytic study with a cross sectional approach on 40 surgical samples diagnosed as BCC and then performed with MMP-9 immunohistochemical staining. The data obtained were processed with statistical software and the relationship between the immunohistochemical expression of MMP-9 with histopathological subtypes of basal cell carcinoma was used the Somers'd statistical test. Results The expression of MMP-9 in the lower risk BCC group with the weakest expression was 37.5%, the most common nodular BCC subtype was 27.5%. The higher risk BCC group with the strongest expression was 20.0%, the most common infiltrating BCC was 17.5%. There was a significant relationship between the immunohistochemical expression of MMP-9 with histopathological subtypes of basal cell carcinoma, p value <0.0001 (p<0.05). Conclusion This study proves that there is a significant relationship between the expression of MMP-9 with histopathological subtypes of basal cell carcinoma, so it can be considered as an additional marker to predict the recurrence.

Hubungan Ekspresi Imunohistokimia Matrix Metalloproteinase-9 dengan Tumor Budding Peritumoral dan Subtipe molekuler pada Invasive Breast Carcinoma of No Special Type Indriani Saragih, Septina; Delyuzar, Delyuzar; Intan, T. Kemala
Majalah Patologi Indonesia Vol. 34 No. 1, Januari 2025
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v34i1.642

Abstract Background Breast cancer ranks first most often in the world and is a malignant cancer that often occurs in women. Matrix metalloproteinase-9 (MMP-9) has been the focus of attention in several previous studies in the field of breast cancer. MMP-9 plays a role in the degradation of the extracellular matrix. High expression of MMP-9 is associated with tumor aggressiveness, metastatic potential and poor prognosis. The presence of tumor budding and molecular subtypes also indicates tumor aggressiveness, one of which is the potential for metastasis through extracellular matrix degradation. The aim of this study was to analyze the association of MMP-9 mmunohistochemistry expression with peritumoral tumor budding and molecular subtypes in IBC-NST. Methods This study is an analytic study with a cross sectional approach on 41 samples of paraffin block cases of IBC-NST which had been diagnosed histopathologically and then performed with MMP-9 mmunohistochemistry staining. The correlation between the immunohistochemical expression of MMP-9 with peritumoral tumor buds and molecular subtypes in IBC-NST was tested statistically using Somers'd test and Eta test. Results There was a significant relationship between the immunohistochemistry expression of MMP-9 with peritumoral tumor budding and molecular subtypes. Conclusion Reporting the results of MMP-9 expression on IBC-NST can be one of the prognostic criteria that can be applied in routine examinations. However, the relationship with prognosis cannot be concluded from this study because it is not associated with survival rate

HUBUNGAN DERAJAT TILS INTRATUMORAL DAN STROMAL TERHADAP SUBTIPE TUMOR MUCINOUS OVARIUM DI RSUP H. ADAM MALIK MEDAN: ASSOCIATION BETWEEN INTRATUMORAL AND STROMAL TILS DEGREES AND MUCINOUS OVARIAN TUMOR SUBTYPES AT H. ADAM MALIK GENERAL HOSPITAL MEDAN Kadri, Sayed Muhammad; Delyuzar; Intan, T. Kemala; Soekimin; Lukito, Joko S; Chrestella, Jessy
Jurnal Kedokteran STM (Sains dan Teknologi Medik) Vol. 9 No. 1 (2026): Januari 2026
Publisher : Fakultas Kedokteran Universitas Islam Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30743/stm.v9i1.987

Mucinous ovarian tumors represent a distinct subtype of epithelial ovarian neoplasms with varying biological behaviors and histopathological features. Tumor-infiltrating lymphocytes (TILs), both intratumoral and stromal, have emerged as prognostic biomarkers in various malignancies, including ovarian cancer. Objective of this study is to analyze the association between intratumoral and stromal TILs degrees with mucinous ovarian tumor subtypes at H. Adam Malik General Hospital, Medan. A cross-sectional analytic study was conducted on 42 formalin-fixed paraffin-embedded tissue samples diagnosed as mucinous ovarian tumors. TILs were assessed on H&E-stained slides using criteria from the International TILs Working Group. Statistical analysis employed Chi-square tests. Results of this study show that high intratumoral TILs were predominantly found in benign mucinous tumors, while low intratumoral TILs were common in malignant cases (p = 0.002). Similarly, high stromal TILs were more frequent in benign subtypes, and low stromal TILs were significantly associated with malignant subtypes (p = 0.000). Conclusion of this study is that there is a significant association between intratumoral and stromal TILs degrees and the histological subtypes of mucinous ovarian tumors. Higher TILs levels are more frequently found in benign tumors, suggesting a potential role as a prognostic indicator. AbstrakTumor ovarium mucinous merupakan salah satu subtipe neoplasma epitel ovarium dengan perilaku biologis dan karakter histopatologi yang bervariasi. Tumor-infiltrating lymphocytes (TILs), baik intratumoral maupun stromal, telah diidentifikasi sebagai biomarker prognostik pada berbagai jenis keganasan, termasuk kanker ovarium. Tujuan penelitian ini adalah untuk mengetahui hubungan antara derajat TILs intratumoral dan stromal dengan subtipe histopatologi tumor mucinous ovarium di RSUP H. Adam Malik Medan. Penelitian analitik potong lintang dilakukan terhadap 42 sampel jaringan tumor mucinous ovarium yang telah difiksasi formalin dan diblok parafin. Penilaian TILs dilakukan pada preparat hematoksilin-eosin (HE) berdasarkan pedoman dari International TILs Working Group. Analisis statistik menggunakan uji Chi-square. Hasil penelitian memperlihatkan bahwa derajat TILs intratumoral tinggi paling banyak ditemukan pada tumor mucinous jinak, sedangkan TILs rendah dominan pada tumor mucinous ganas (p = 0,002). Hal serupa ditemukan pada TILs stromal, di mana TILs tinggi lebih sering pada tumor jinak, dan TILs rendah lebih sering pada subtipe ganas (p = 0,000). Kesimpulan penelitian ini adalah terdapat hubungan bermakna antara derajat TILs intratumoral dan stromal dengan subtipe histopatologi tumor mucinous ovarium. Derajat TILs yang lebih tinggi berhubungan dengan subtipe yang lebih jinak, sehingga berpotensi sebagai indikator prognosis.

HSP70 EXPRESSION AND BETHESDA CLASSIFICATION IN BUCCAL MUCOSAL CELLS OF RESIDENTS NEAR MEDAN LANDFILL: EKSPRESI HSP70 DAN KLASIFIKASI BETHESDA PADA SEL MUKOSA BUKAL PENDUDUK SEKITAR TPA MEDAN Ramadansyah; Intan, T. Kemala; Lubis, Nadjib Dahlan; Mariedina, Causa Trisna
Ibnu Sina: Jurnal Kedokteran dan Kesehatan - Fakultas Kedokteran Universitas Islam Sumatera Utara Vol. 25 No. 1 (2026): Januari 2026
Publisher : Faculty of Medicine Universitas Islam Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30743/ibnusina.v25i1.1056

Chronic exposure to pollutants generated from landfill environments may induce oxidative and genotoxic stress in oral epithelial cells, while Heat Shock Protein 70 (HSP70) functions as a key cellular chaperone involved in maintaining proteostasis and mediating adaptive responses to environmental stressors. This study aimed to evaluate the association between HSP70 expression and the Bethesda 2014 cytological classification in buccal mucosal cells of residents living in proximity to the Terjun landfill in Medan, Indonesia. A cross-sectional analytical design was employed involving 100 adult participants, comprising 24 individuals residing within ≤1–3 km of the landfill and 76 residing ≥3 km away. Buccal epithelial samples were collected using sterile cytobrushes, examined using Papanicolaou staining, and assessed immunocytochemically for HSP70 expression using the Immunoreactive Score (IRS), categorized as low (≤4) or high (>4). Statistical analysis was performed with Fisher’s Exact Test at a significance level of p<0.05. The results demonstrated that 98% of samples were classified as NILM and 2% as ASC-US, with high cytoplasmic HSP70 expression identified in 5% of samples, predominantly among the exposed group; however, a statistically significant association was observed between HSP70 expression and Bethesda classification. In conclusion, the overall low HSP70 expression with slight elevation among exposed individuals suggests early adaptive epithelial responses to chronic pollutant exposure, supporting the potential role of HSP70 as a noninvasive biomarker for monitoring environmentally induced epithelial stress.

Relationship of the Number of Black Dots in the Nuclei of Argyrophilic Nucleolar Organizing Regions (AgNORs) Expressed Epithelial Cells with Nottingham Grading System in Invasive Breast Carcinoma of No Special Type (IBC-NST) Basrul, Mohd. Yuwanda; Delyuzar, Delyuzar; Intan, T. Kemala; Soekimin, Soekimin; Alferraly, T. Ibnu
Majalah Patologi Indonesia Vol. 35 No. 1 (2026): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v35i1.669

Background Breast cancer is a malignant disease in women. The high number of breast cancer cases is caused by multiple factors, including barriers to early detection of breast cancer, socio-economic and geographical factors, and the difficulty of affordable, timely and effective health services. IBC-NST has the highest incidence among breast cancer cases with a 10 year survival rate (65-78%). AgNORs parameters have been shown to represent a reliable tool for determining the clinical outcome of cancer diseases, being an independent prognostic factor in many types of tumors. Method Descriptive analytics research was carried out on slides from 31 patients with IBC-NST. Each slide was stained with H&E stainning to assess the Nottingham grading system and stained with AgNORs to assess the number of black dots in epithelial cell nuclei that expressed AgNORs. All clinicopathological data were taken from medical records/pathology archives. Logistic regression test (p<0.005) was used to assess the relationship between the number of black dots in epithelial cell nuclei expressing AgNORs and the Nottingham grading system in IBC-NST. Results The highest cases were in the age group ≤40-50 years (range: 50.1 years), the highest grading was in grade 3 of the Nottingham grading system (48.8%), the lowest number of black dots was 576 dots and the highest was 1,036 dots (mean 798.80, median 710.0 and standard deviation 144.71) and the highest number of black dots was in grade 3 of the Nottingham grading system. Conclusion Assessment of the number of black dots in the nuclei of epithelial cells expressing AgNORs associated with Nottingham grading system can be used as an indication of prognosis in patients with IBC-NST.

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