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INDONESIA
Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
Published by Perhimpunan Dokter Spesialis Patologi Klinik Indonesia
ISSN : 08544263     EISSN : 24774685     DOI : https://dx.doi.org/10.24293
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience
Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) is a journal published by “Association of Clinical Pathologist” professional association. This journal displays articles in the Clinical Pathology and Medical Laboratory scope. Clinical Pathology has a couple of subdivisions, namely: Clinical Chemistry, Hematology, Immunology and Serology, Microbiology and Infectious Disease, Hepatology, Cardiovascular, Endocrinology, Blood Transfusion, Nephrology, and Molecular Biology. Scientific articles of these topics, mainly emphasize on the laboratory examinations, pathophysiology, and pathogenesis in a disease.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 23 Documents
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Search results for , issue "vol. 32 no. 3 (2026)" : 23 Documents clear
Diagnostic Performance of Fecal pks+ Escherichia coli for Detecting Neoplastic Colorectal Lesions in Suspected Colorectal Cancer Patients Anton Sumarpo; Ida Parwati; Fajar Wasilah; Didik Setyo Heriyanto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 3 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i3.2894

Abstract

Genotoxin-producing pks+ Escherichia coli is implicated in the pathogenesis of colorectal cancer (CRC). This study was designed to evaluate the diagnostic performance of fecal pks+ E. coli as a non-invasive biomarker for CRC screening. In this cross-sectional study, fecal samples from 70 patients with suspected CRC were analyzed by quantitative polymerase chain reaction (qPCR) to detect the presence of pks+ E. coli. The diagnostic accuracy was assessed against colonoscopy and histopathology findings. Against histopathology as the gold standard, fecal pks+ E. coli detected neoplastic lesions with a sensitivity of 70.59% and a specificity of 65.22%. Notably, the relative gene copy number of pks+ E. coli was significantly higher in patients with neoplastic lesions compared to those with non-neoplastic findings. Fecal testing for pks+ E. coli demonstrates potential as a non-invasive biomarker for detecting neoplastic colorectal lesions, though further validations are needed.
ANTI-SARS-COV-2 S ANTIBODY IN CORRELATION WITH NK-CELLS, ABSOLUTE LYMPHOCYTE COUNT, CD4+/CD8+ ¬RATIO AMONG LABORATORY PROFESSIONALS RECEIVING SINOVAC VACCINE Luhut Suryanugraha; Brigitte Rina Aninda Sidharta; Maria Immakulata Diah Pramudianti; Amiroh Kurniati; Tonang Dwi Ardyanto; Ferdy Royland Marpaung
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 3 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i3.2340

Abstract

Medical laboratory professionals are at higher risk of contracting COVID-19, making vaccination a critical preventive strategy. Hence, the Indonesian Government prioritized laboratory professionals for vaccination with inactivated vaccines. The immunogenicity of inactivated COVID-19 vaccines involves both humoral and cellular immune responses. This study aimed to evaluate the relationship between Anti-SARS-CoV-2 S antibody levels and cellular immune markers, including NK cells count, absolute lymphocyte count (ALC), and CD4+/CD8+ T cell ratio following COVID-19 vaccination. An observational cross-sectional study conducted at Dr. Moewardi Hospital, Indonesia, from February 2021 to October 2022. This study included 50 laboratory professionals who had received the first and second doses of the inactivated COVID-19 vaccine. A weak yet statistically significant positive correlation between NK cells count and Anti-SARS-CoV-2 S antibody (p=0.026; r=0.315) was identified. A moderate positive correlation with statistical significance was also observed between the CD4+/CD8+ ratio and the absolute number of lymphocytes with Anti-SARS-CoV-2 S antibody (p=0.002; r=0.421, and p <0.001; r=0.481), respectively. These findings indicated that the first and second doses of the inactivated vaccine stimulated humoral immune response more strongly than a cellular immune response in this population. These findings can be utilized in selecting the vaccine types for healthcare professionals to prevent potential infections from new SARS-CoV-2 variants even after the COVID-19 pandemic has been declared over.
Correlation of NLR and PLR with Estimated Glomerular Filtration Rate in Chronic Kidney Disease Patients Magfira; Ani Kartini; Yuyun Widaningsih
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 3 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i3.2536

Abstract

Chronic Kidney Disease (CKD) is a progressive condition affecting more than 10% of the global population, particularly impacting the elderly, females, and patients with hypertension or diabetes mellitus. This study aimed to evaluate the relationship between the Neutrophil-to-Lymphocyte Ratio (NLR) and the Platelet-to-Lymphocyte Ratio (PLR) and estimated glomerular filtration rate (e-GFR) in CKD patients at Wahidin Sudirohusodo Hospital. This study is important for understanding the role of inflammatory biomarkers in predicting the prognosis of CKD patients. A retrospective, observational, analytic study using medical record data with a cross-sectional design. The samples comprised 320 patients with CKD at Wahidin Sudirohusodo General Hospital, Makassar, from January to December 2022 who met the inclusion criteria. The data were analyzed using Spearman's rank correlation test to evaluate the correlation among NLR, PLR, and e-GFR. This study found a significant positive correlation between NLR and PLR in CKD patients (r = 0.627, p <0.001). In addition, there was a significant negative correlation between NLR and e-GFR (r = -0.348, p < 0.001) and between PLR and e-GFR (r = -0.118, p = 0.035). These results indicate that increased NLR and PLR were associated with decreased kidney function. The results showed that elevated NLR and PLR were closely associated with greater inflammation and reduced kidney function in CKD patients. NLR showed a stronger correlation than e-GFR and PLR, so it can be considered a prognostic indicator in CKD patients.
A Cross-Sectional Study on Antimicrobial Resistance of Enterococcus spp. Isolated From Semarang, Indonesia's Clinical Samples Muhammad Evy Prastiyanto; Afifah Khairunnisa; Mustika Sari H Hutabarat; Vincentia Ade Rizky; Bastian
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 3 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i3.2556

Abstract

The increasing prevalence of multidrug-resistant (MDR) Enterococcus spp. poses a significant public health concern, particularly in Indonesia, where antibiotic misuse is prevalent. This study addresses the urgent need to understand the extent of MDR Enterococcus infections within clinical settings in Semarang, as existing data on this specific issue remains limited. The primary objective of this cross-sectional study was to investigate the prevalence and antimicrobial resistance profiles of MDR Enterococcus spp. isolated from clinical samples in Semarang, Indonesia. A total of 80 clinical samples were collected from patients at the KRMT Wongsonegoro Hospital, Semarang, Indonesia, over three years (January 2022 to December 2024). The identification of Enterococcus spp. was conducted using Gram staining and biochemical assays, followed by antimicrobial susceptibility testing utilizing the VITEK®2 Compact system. Enterococcus spp. was most commonly found in clinical  pus (36.3%), and urine (32.5%) clinical samples. Of 80 Enterococcus spp. isolates, 65 (81.25%) were MDR. Above 90% of the 80 isolates were ampicillin and Tigecycline-sensitive. This investigation also found that Enterococcus spp. isolates were resistant to tetracycline (66.3%), erythromycin (77.5%), and Quinupristin/Dalfopristin (86%). Conclusions: The study underscores the critical implications for healthcare providers and policy makers in addressing MDR Enterococcus infections. Enhanced surveillance and tailored antimicrobial stewardship programs are essential to mitigate the risks associated with these infections, ultimately improving patient outcomes and reducing healthcare burdens in Indonesia.
Concordance Between Sysmex UF-5000 Bacterial Flagging and Urine Culture Results for Differentiating Gram-Positive and Gram-Negative Bacteria Ratna Agustina; Anak Agung Wiradewi Lestari; I Nyoman Wande; Sianny Herawati; Ni Nyoman Mahartini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 3 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i3.2589

Abstract

Urinary tract infections (UTIs) are among the most common infectious diseases globally, accounting for approximately 15% of all hospitalizations. Urine culture is considered the gold standard for diagnosing UTIs. However, this method requires specialized equipment and is time-consuming. In recent years, urine analysis by flow cytometry has begun to be used to detect bacteriuria quickly, accurately, and cost-effectively. The Sysmex UF-5000 uses flow cytometry to differentiate Gram-positive and Gram-negative bacteria, providing “BACT” flagging information. This analytical observational study with a cross-sectional design was conducted at the Integrated Laboratory of Ngoerah Hospital, Denpasar, from April to June 2023. Consecutive urine culture samples with sufficient volume (≥3 mL) were collected for urinalysis. The concordance between the Sysmex UF-5000 flagging and urine culture results was analyzed using Cohen's Kappa test. A total of 50 samples were analyzed. This study demonstrated agreement between the Sysmex UF-5000 flagging results and urine culture findings in differentiating Gram-positive and Gram-negative bacteria, with a Cohen's Kappa coefficient of 0.81. The Sysmex UF-5000 flagging shows excellent agreement or substantial concordance with urine culture results in differentiating Gram-positive and Gram-negative bacteria.
ANALYSIS OF COMPLETE BLOOD COUNT, CBC-DERIVED RATIOS, AND INFLAMMATORY INDICES IN THE DIAGNOSIS OF STROKE TYPES Riskullah Makmur; Darwati Muhadi; Mansyur Arif
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 3 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i3.2684

Abstract

Early differentiation between non-hemorrhagic stroke (NHS) and hemorrhagic stroke (HS) is crucial for appropriate management. However, access to neuroimaging remains restricted in many clinical settings. Complete blood count (CBC) parameters, CBC-derived ratios, and inflammatory indices may offer a rapid and accessible alternative for early diagnosis of stroke types. This study aimed to determine the differences and diagnostic value of the CBC ratio, and CBC-derived inflammatory indices in the early diagnosis of stroke types. This cross-sectional study used secondary data from the medical records of patients with their first acute stroke, treated in the Emergency Department of Wahidin Sudirohusodo Hospital, Makassar, between January 2019 and September 2024. All included subjects underwent a complete blood count (CBC) and either a head Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI) as the diagnostic gold standard. Statistical analysis was performed using SPSS software (version 26.0), employing comparative tests and diagnostic accuracy assessments to evaluate the parameters. A total of 260 stroke patients (144 NHS and 116 HS) were included. The results showed that the values of LYM, EOS, LWR, LMR, EWR, EMR, PWR, and PMR were significantly higher in NHS than in HS (p<0.05). The values of HCT, WBC, NEU, MON, MLR, NLR, dNLR, NMLR, NLPR, WPR, SIRI, SII, and AISI were significantly higher in HS than in NHS (p<0.05). The ROC analysis showed that the values of PWR (AUC=72.7%) with optimal cut-off 19.91 (Sensitivity=83.3%; Specificity=55.2%; PPV=69.8%; NPV=72.7%), WPR (AUC=72.7%) with optimal cut-off 0.05 (Sensitivity=77.1%; Specificity=59.5%; PPV=70.3%; NPV=67.7%), NEU (AUC=71.5%) with optimal cut-off 7.35 (Sensitivity=60.4%; Specificity=75.0%; PPV=75.0%; NPV=60.4%) and WBC (AUC=70.1%) with optimal cut-off 10.15 (Sensitivity=56.2%; Specificity=75.0%; PPV=73.6%; NPV=58.0%) can be a biomarker to differentiate NHS and HS with moderate diagnostic value (AUC=70-80%). This study supports the utility of CBC parameters, CBC-derived ratios, and inflammation indices as potential alternative tools for the early differentiation of acute stroke types.
ADIPOSE TISSUE INSULIN RESISTANCE ANALYSIS IN SUBJECTS WITH OBESITY AND NON-OBESITY Lita Paramitha Apriani; Nurahmi; Liong Boy Kurniawan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 3 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i3.2725

Abstract

Obesity is an increasing global health problem that is closely related to various metabolic complications, including insulin resistance. Adipose Tissue Insulin Resistance (Adipo-IR) is an important indicator that can reflect metabolic dysfunction that occurs in obesity. This study analyzed and compared Adipo-IR values ​​in obese and non-obese subjects, using a cross-sectional design and involving 82 subjects. The study subjects were divided into two groups, namely obese and non-obese groups, based on body mass index (BMI) classified according to Asia-Pacific criteria. Adipo-IR measurements were performed by calculating fasting insulin levels and free fatty acids (FFA). Statistical analysis showed that the obese group had an average fasting insulin level of 20.19±15.07 mIU/L, while the non-obese group was 9.39±6.12 mIU/L, indicating a significant difference in fasting insulin levels in both groups of subjects (p <0.001). The FFA levels of the obese group had an average of 0.25±0.27 mmol/L and the average FFA levels of the non-obese group were 0.21±0.24 mmol/L, indicating that there was no significant difference in the FFA levels of the two groups of subjects (p = 0.212). The Adipo-IR value of the obese group had an average of 4.89±6.27 while the average value of the non-obese group was 2.39±3.67, indicating a significant difference in Adipo-IR values ​​in both groups of subjects (p = 0.003). There was a significant positive correlation between Adipo-IR and BMI values ​​(r = 0.330, p = 0.002), indicating that increased BMI was associated with increased Adipo-IR values. Higher Adipo-IR values ​​in the obese group indicate an increased likelihood that the subject has adipose tissue insulin resistance.
CORRELATION BETWEEN STRESS HORMONE, INFLAMMATORY MARKER, AND ANTIBODY LEVELS IN COVID-19 PATIENTS Dwi Retnoningrum; Meita Hendrianingtyas; Rebriarina Hapsari; Setyo Gundi Pramudo; Edward Kurnia Setiawan Limijadi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 3 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i3.2771

Abstract

Coronavirus disease-19 (COVID-19) is an infection that causes physical and psychological stress. Cortisol and prolactin are hormones that have been studied in association with infectious states. Viral infections trigger the production of acute-phase proteins and antibodies essential for viral elimination. This study aimed to prove the correlation between stress hormone levels and inflammatory markers and antibodies in COVID-19 patients. A cross-sectional approach was employed in this study, with a target population of patients with moderate-to-severe COVID-19. Cortisol, prolactin, and specific antibodies were quantified via ELISA, while CRP and procalcitonin levels were measured using immunoturbidimetric and immunofluorescence assays. Additionally, anti-SARS-CoV-2 antibodies were evaluated using the ECLIA principle. Statistical analysis was performed using the Spearman rank correlation test. Fifty-six subjects were included in this study. The study found correlations between cortisol and prolactin levels and CRP (p=0.007, r=0.357; p=0.132, r=0.204) and procalcitonin (p=0.006, r=0.365; p=0.315, r=0.137). The correlations between cortisol and prolactin levels and IgM were p=0.163, r=-0.189; and p=0.299, r=-0.141. The correlations between cortisol and prolactin levels and IgG were p=0.017, r=-0.317, and p=0.207, r=-0.171. There is a weak positive correlation between cortisol levels and CRP and procalcitonin levels. There is a weak negative correlation between cortisol levels and anti-SARS-CoV-2 IgG.
CLOT WAVE ANALYSIS IN LIVER CIRRHOSIS WITH NORMAL COAGULATION PROFILES : A PRELIMINARY STUDY YAN MARDIAN; SRI SURYO ADIYANTI
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 3 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i3.2821

Abstract

Patients with liver cirrhosis are at risk of developing coagulopathy, particularly bleeding complications. Conventional screening tests, such as Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT), measure only clot formation time, offering limited insight into the comprehensive coagulation dynamics. Clot Wave Analysis (CWA), obtained from photo-optical coagulation analyzers, monitors real-time changes in transmitted light during fibrin formation, providing deeper insights into the coagulation process. Although earlier studies demonstrated CWA's utility in detecting coagulopathy in cirrhotic patients, its role in individuals presenting with normal PT and APTT values, or in early-stage cirrhosis, remains insufficiently explored. This preliminary cross-sectional study aimed to evaluate clot waveform characteristics using CWA in cirrhotic patients exhibiting normal coagulation profiles for the early identification of coagulation abnormalities. Waveforms from PT and APTT assays were qualitatively analyzed for patterns and quantitatively assessed using parameters including maximum velocity (Min 1, dT/dt), maximum acceleration (Min 2), maximum deceleration (Max 2, d²T/dt²), and maximum clot density (Delta, dH). This study enrolled 50 participants (25 cirrhotic patients and 25 healthy controls) with normal PT and APTT values. Qualitatively, cirrhotic patients exhibited flatter waveform slopes compared to controls. Quantitatively, significant reductions were observed in Min 1, Max 2, and Delta in CWA-PT and all parameters in CWA-APTT. CWA shows potential in detecting coagulopathy in cirrhotic patients with normal PT and APTT. Further studies are needed to establish standardized CWA reference values for clinical applications.
Correlation of NS1 Antigen and Dengue Virus Serotype with Infection Status in Dengue Patients Anindya Widyasari; Aryati; Hantoro Gunawan; Puspa Wardhani; Lulut Kusumawati; Nasronudin; Betty Agustina Tambunan; Atika
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 3 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i3.3078

Abstract

Non-structural protein 1 (NS1) antigen is an important biomarker for the early diagnosis of dengue virus infection. However, NS1 detection may be influenced by dengue virus serotype and the host immune response during primary and secondary infections, with inconsistent findings reported across previous studies. To investigate the association between NS1 antigen positivity, dengue virus serotypes, and infection status in patients with RT-PCR-confirmed dengue infection. An analytical cross-sectional study was conducted among 65 hospitalized patients with RT-PCR-confirmed dengue infection. Blood samples were collected within the first five days after fever onset (median, 3 days; range, 1–5 days). Dengue virus serotypes were identified using the STANDARD M10 Arbovirus Panel, while infection status was determined using the STANDARD F Dengue IgM/IgG fluorescence immunoassay. Associations between NS1 antigen positivity, dengue virus serotypes, and infection status were analyzed using Fisher's exact test. Among 65 RT-PCR-confirmed cases, 55 (84.6%) were NS1-positive, and 10 (15.4%) were NS1-negative. Serotype distribution was DENV-1 (36.9%), DENV-2 (21.5%), DENV-3 (29.2%), DENV-4 (9.2%), and mixed DENV-2/DENV-3 infection (3.1%). No significant associations were found between NS1 antigen positivity and dengue virus serotypes (p = 0.969) or infection status (p = 0.456). Although NS1 positivity was higher in primary than secondary infections (86.4% vs. 66.7%), the difference was not statistically significant. NS1 antigen positivity was not significantly associated with dengue virus serotypes or infection status. The high NS1 positivity observed in this study may reflect early specimen collection during the acute phase of illness, regardless of infection status or viral serotype.

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