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INDONESIA
Indonesian Journal of Cancer
ISSN : 19783744     EISSN : 23556811     DOI : https://www.doi.org/ 10.33371
Core Subject : Health, Science,
Indonesian Journal of Cancer is a peer-reviewed and open-access journal. This journal is published quarterly (in March, June, September, and December) by Dharmais Cancer Hospital - National Cancer Center. Submissions are reviewed under a broad scope of topics relevant to experimental and clinical cancer research. Articles are original research that needs to be disseminated and written in English. All submitted manuscripts will go through the double-blind peer review and editorial review before being granted acceptance for publication. The journal publishes original research articles, case reports, and review articles under the following categories: cancer management, cancer prevention, cancer etiology, epidemiology, molecular oncology, cancer diagnosis and therapy, tumor pathology, surgical oncology, medical oncology, radiation oncology, interventional radiology, as well as early detection.
Arjuna Subject : Kedokteran - Onkologi
Articles 6 Documents
Search results for , issue "Vol 11, No 3 (2017): July - September 2017" : 6 Documents clear
Hubungan Peritoneal Carcinomatosis Index dan Predictive Index Value Fagotti dengan Kadar Serum Fatty Acid Binding Protein 4 pada Kanker Ovarium Epitel Stadium Lanjut MUHAMMAD RIZKI YAZNIL; BRAHMANA ASKANDAR TJOKROPRAWIRO; DYAH FAUZIAH
Indonesian Journal of Cancer Vol 11, No 3 (2017): July - September 2017
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (873.469 KB) | DOI: 10.33371/ijoc.v11i3.512

Abstract

In advanced ovarian cancer, the main goal of surgery is complete debulking with no visible residual tumor, and predicting it before surgery has become a goal that still unresolved. The ability in advanced ovarian cancer surgery varied between healthcare facilities. Recent discovery put forward the role of fatty acid as one of the main source of energy for ovarian cancer aggresiveness and the role of fatty acid binding protein (FABP) escpecially FABP4 expression as an important biomarker for predicting residual disease in ovarian cancer. There are no data about FABP4 serum in ovarian cancer and it’s role in predicting the extensiveness of advanced stage ovarian cancer. To evaluate correlation between FABP4 serum level with PIV Fagotti Score and Peritoneal Carcinomatosis Index (PCI) in advanced stage ovarian cancer. Analytic observational study. Among 28 subjects, most age groups (46.4%) are 40–45 years of age, 46.4% with normal body mass index, 71.4% with ovarian cancer stage IIIC, 75% with high grade serous adenocarcinoma, average ascites volume 3232.1 ± 2006.9 mL, median CA125 serum 1094 u/mL (12–19425 u/mL). The rate of optimal and complete debulking is 53.5% from 28 subjects. Strong expression of FABP4 on 42.9% subjects. MeanFABP serum 69.6 ± 51.4 ng/mL. Mean PCI score is 14.5 (3–29), mean PIV score is 6 (2–12). There is a significant correlation between FABP4 expression and FABP4 serum level (p<0.05) with moderate power (r=0.55), and a significant correlation with moderate power (r=0.421) between FABP4 serum level with PCI and PIV score. There is a significant correlation with moderate power between rising FABP4 serum and the extent of peritoneal carcinomatosis evaluated by PCI and PIV Fagotti Score in advanced stage ovarian cancer.ABSTRAKPrediksi resektabilitas pada kanker ovarium epitel masih merupakan masalah penting yang belum terpecahkan. Penelitian-penelitian mutakhir mengemukakan peran dari asam lemak sebagai salah satu sumber energi penting bagi progresivitas kanker ovarium. FABP4 sebagai salah satu protein yang berperan dalam transportasi asam lemak merupakan salah satu biomarker yang dijumpai pada kanker ovarium dengan residu tumor. Akan tetapi, penelitian mengenai kadar serum FABP4 pada stadium lanjut belum ada. Selain itu, apakah PCI dan PIV skor Fagotti mempunyai hubungan dengan kadar serum FABP4 pada kanker ovarium stadium lanjut belum pernah diteliti. Penelitian ini bertujuan untuk menilai korelasi antara PIV skor Fagotti dan PCI dengan kadar serum FABP4 pada penderita kanker ovarium stadium lanjut. Observasional analitik digunakan dalam penelitian ini, di mana peneliti ingin melihat korelasi antara nilai skor PIV skor Fagotti dan PCI dengan kadar serum FABP4. Subjek penelitian berjumlah 28 orang dengan karakteristik: kelompok usia terbanyak 40–45 tahun (46,4%); indeks massa tubuh normal (46,4%); stadium FIGO IIIC (71,4%); high grade serous ovarian cancer (75%); jumlah rerata asites 3232,1 ± 2006,9 mL; median kadar serum CA125 1094 u/mL (12–19425 u/mL); 53,5% subjek dapat dilakukan sitoreduksi optimal dan komplit. Ekspresi FABP4 yang kuat terjadi pada 42,9% subjek. Rerata kadar serum FABP4 69,6 ± 51,4 ng/mL. Korelasi signifikan antara ekspresi FABP4 dengan kadar serum FABP4 pada penelitian ini (p<0,05), dengan tingkat korelasi sedang (r=0,55). Rerata PCI total 14,5. Rerata PIV adalah 6 dengan nilai minimum 2 dan maksimum 12.Didapatkan korelasi signifikan (p<0,05) antara kadar serum FABP4 dengan penilaian PCI dan PIV dengan tingkat korelasi sedang (r=0,421, r=0,458). Pada penelitian ini ditemukan korelasi signifikan dengan kekuatan korelasi sedang antara peningkatan skor PIC dan PIV skor Fagotti dengan peningkatan kadar serum FABP4 pada pasien kanker ovarium stadium lanjut.
Mixed Adeno and Neuroendocrine Carcinoma of The Ovary: Case Report KADE YUDI SASPRIYANA; I NYOMAN BAYU MAHENDRA; KETUT SUWIYOGA; LUH PUTU IIN INDRAYANI MAKER; JOHANA SENSY LENI MANNA
Indonesian Journal of Cancer Vol 11, No 3 (2017): July - September 2017
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (922.63 KB) | DOI: 10.33371/ijoc.v11i3.517

Abstract

Reporting two cases of mixed adenocarcinoma and neuroendocrine carcinoma of the ovary. A case report two cases of an ovarian cyst suspect malignancy after complete surgical staging in woman aged 39 year old and 72 year old. By this case report, we want to know prognosis of the malignancy. Mixed adenocarcinoma and neuroendocrine carcinoma of the ovary of the first case arised from mature cystic teratoma, and second case as metastatic process from gastrointestinal tract. Mixed adenocarcinoma and neuroendocrine carcinoma is rare hystologic type of ovarian cancer. Need further exploration to know the survival of this hystologic type.ABSTRAKArtikel ini melaporkan dua kasus, yaitu mixed adenocarcinoma dan neuroendocrine carcinoma ovarium, dua kasus kista ovarium curiga ganas pada pasien berusia 39 tahun dan 72 tahun. Terhadap kedua pasien dilakukan komplit surgical staging. Melalui laporan kasus ini, diharapkan bisa diketahui prognosis kasus. Mixed adenocarcinoma dan neuroendocrine carcinoma ovarium pada kasus pertama timbul dari teratoma matur kistik, sedangkan kasus kedua merupakan penyebaran dari traktus digestivus. Mixed adenocarcinoma dan neuroendocrine carcinoma merupakan tipe histologi kanker ovarium yang jarang. Ia membutuhkan eksplorasi lebih lanjut untuk mengetahui survival dari tipe histologi ini.
Korelasi Ekspresi ezrin dan CD44 dengan Respons Kemoterapi pada Pasien Osteosarkoma CHRISTIAN BAMBANG SULISTIO; SJAHJENNY MUSTOKOWENI; NILA KURNIASARI
Indonesian Journal of Cancer Vol 11, No 3 (2017): July - September 2017
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1060.936 KB) | DOI: 10.33371/ijoc.v11i3.513

Abstract

Osteosarcoma is the most common malignant bone tumor in children and young adults. The process of metastasis and recurrence involves several proteins, including ezrin, and CD44 that are shown to be involved in tumor growth,metastasis and recurrence. To analyse the corelation of ezrin and CD44 expression with chemotherapy responsse in osteosarcoma patient. Cross sectional method on paraffin block of Osteosarcoma in Anatomic Pathology Laboratory of RSUD dr Soetomo, (January 1, 2010 - December 31, 2015). There were 17 out of 26 cases of amputated osteosarcoma which are met the inclusion criteria were performed immunohistochemical staining with ezrin and CD44 antibodies. The corellation of ezrin and CD44 expression with chemotherapy responsse was analyzed using Spearman’s rho test. The coeficient correlation in this experiment p<0.05, there was no corellation of ezrin expression with chemotherapy responsse of osteosarcoma. There was no correlation of CD44 expression with chemotherapy responsse in osteosarcoma. There was no correlation of ezrin and CD44 expression with chemotherapy responsse of osteosarcoma. There was no corellation of ezrin and CD44 expression with chemotherapy responsse of osteosarcoma.ABSTRAKOsteosarkoma merupakan tumor ganas tulang, sering terjadi pada anak-anak dan dewasa muda. Proses metastasis dan rekurensi melibatkan beberapa protein, di antaranya ezrin dan CD44 yang terbukti ikut serta dalam pertumbuhan tumor, metastasis, dan rekurensi. Penelitian ini bertujuan menganalisis hubungan antara ekspresi ezrin dan CD44 dengan respons kemoterapi. Penelitian ini menggunakan metode cross sectional blok parafin osteosarkoma di Laboratorium Patologi Anatomi RSUD Dr. Soetomo (1 Januari 2010–31 Desember 2015). Sebanyak 17 kasus sesuai kriteria inklusi dari 26 kasus osteosarkoma yang telah diamputasi dilakukan seleksi serta pemeriksaan imunohistokimia dengan antibodi ezrin danCD44. Hubungan ekspresi antara ezrin dan CD44 dengan respons kemoterapi dianalisis menggunakan uji Spearman’srho. Pada penelitian ini, nilai koefisien korelasi p<0,05 sehingga tidak terdapat hubungan antara ekspresi ezrin denganrespons kemoterapi pada osteosarkoma, di mana nilai p=0,868 (p>0,05). Tidak terdapat hubungan antara ekspresi CD44 dengan respons kemoterapi pada osteosarkoma di mana nilai p = 0,740 (p> 0,05).Tidak terdapat korelasi antaraekspresi ezrin dengan CD44 dengan respons kemoterapi osteosarkoma, nilai p=0,113 (p>0,05). Tidak terdapat hubungan antara ekspresi ezrin dan CD44 dengan respons kemoterapi pada pasien osteosarkoma.
Perbandingan Kesintasan Tiga Tahun pada Anak Leukemia Limfoblastik Akut antara Protokol Pengobatan 2006 dan 2013 RAHIMUL YAKIN; SYAHRIZAL SYARIF; EDI SETIAWAN TEHUTERU
Indonesian Journal of Cancer Vol 11, No 3 (2017): July - September 2017
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (694.336 KB) | DOI: 10.33371/ijoc.v11i3.515

Abstract

Treatment of children with Acute lymphoblastic leukemia was developing, currently in Indonesia there are several commonly used protocols such as National protocol (Jakarta), WK-LLA 2000 protocol, LLA protocol 2006 and protocol LLA 2013. The purpose of this study to determine the probability of survival 3 years In children with acute lymphoblastic leukemia between protocols 2006 and 2013. This study used a mix method of retrospective cohorts and in-depth interviews. The population in this study were LLA children aged 1–15 years who received protocol 2006 and 2013 in RSKD Jakarta from 2008–2016 is 68 children with research time from April 2016 until June 2016. Data were analyzed using Cox Regression. The result of this study shows that the 3-year survival probability of LLA remission based on the 2006 treatment protocol is 30% and the treatment protocol of 2013 is 27%. A 3-year survival event remission occurred between 2006 and 2013 treatment protocols of HR 1.57 (90% CI 0.577–4,299), but the difference between the two protocols was not statistically significant with p-value 0.456.The results of in-depth interviews were also obtained in protocols 2006 and 2013 in the same principle but there remain some differences between the both of the treatment schedule and doses are cumulatively increased. The conclusions of these two protocols are in principle the same and there is not much difference in inputs and processes.  ABSTRAK Pengobatan pada anak leukemia limfoblastik akut terus dikembangkan. Saat ini, di Indonesia ada beberapa protokol yang lazim digunakan, yaitu protokol Nasional (Jakarta), protokol WK-LLA 2000, protokol LLA 2006, dan protokol LLA 2013. Tujuan studi ini untuk mengetahui probabilitas kesintasan hidup tiga tahun pada anak leukemia limfoblastik akut antara protokol 2006 dan 2013. Studi ini menggunakan mix method, yaitu kohort retrospektif dan wawancara mendalam. Populasi dalam penelitian ini adalah anak LLA usia 1–15 tahun yang mendapatkan protokol 2006 dan 2013 di Rumah Sakit Kanker “Dhramais”/RSKD, Jakarta, dari 2008–2016 sebanyak 68 anak dengan waktu penelitian dari April 2016 sampai Juni 2016. Data dianalisis dengan Cox Regression. Hasil studi menunjukkan probabilitas kesintasan tiga tahun terjadi remisi pada anak LLA berdasarkan protokol pengobatan 2006 sebesar 30% dan protokol pengobatan 2013 sebesar 27%. Peberdaan kesintasan tiga tahun terjadi remisi antara protokol pengobatan 2006 dan 2013 sebesar HR 1,57 (CI 90% 0,577–4,299). Namun, perbedaan antara kedua protokol ini tidak bermakna secara statistik dengan p-value 0,456. Hasil wawancara mendalam juga menunjukkan pada protokol 2006 dan 2013 secara prinsip sama, tetapi tetap ada beberapa perbedaan di antara keduanya, seperti jadwal pengobatan dan dosis secara kumulatif meningkat. Studi ini menyimpulkan bahwa secara prinsip kedua protokol ini sama dan tidak terdapat banyak perbedaan dalam hal input serta proses.
Ekspresi CD44 dan ALDH1 (Penanda Sel Punca Kanker) sebagai Prediktor Respons Kemoterapi Neoadjuvant Cisplatin pada Kanker Serviks Uteri Stadium IIB GUNAWAN RUSULDI; BRAHMANA ASKANDAR
Indonesian Journal of Cancer Vol 11, No 3 (2017): July - September 2017
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1610.351 KB) | DOI: 10.33371/ijoc.v11i3.511

Abstract

Giving neoadjuvant chemotherapy allows stage IIB cervical cancer having surgery with a chance of avoiding radiotherapy. Giving neoadjuvant chemotherapy in several studies produces varied responsses. The method for predicting whether a cervical cancer patient experiences responsse of treatment in neoadjuvant chemotherapy becomes important thing, considering the side effects of chemotherapy, time, and cost. Sub-population of cells called Cancer Stem Cells (CSC) is something which is alleged to be responssible for cancer growth, recurrence and the process of resistance to chemotherapy and radiation. Some researchers proved that this occurrence is due to the cancer stem cell which is surviving after chemotherapy. The presence of cervical cancer stem cells is shown by CD44 and ALDH1. This research proves there is connection between the expression of CD44 and ALDH1 as a marker of cancer stem cells with cisplatin neoadjuvant chemotherapy responsse and correlation in the increasing of expression of CD44 and ALDH1 (a marker of cancer stem cells) against cisplatin neoadjuvant chemotherapy resistance in cervical cancer stage IIB. Design observational analytic form prospectively study with total samples 30 patient cervical cancer IIB from December 2016 until May 2017. Clinical and MRI examination and cervical biopsy to immunohistochemistry examination for CD44 and ALDH1. Administration of neoadjuvant chemotherapy (NAC) cisplatin 50 mg/m2 4 times everyweek. After 2–3 weeks after last NAC, repeat to MRI examination. Assesment responsse therapy with RECIST criteria. Chemotherapy responsse obtained Partial Responsse (PR) 12 pts (40%), Stable Dissease (SD) 12 pts (40%), and Progressive Dissease (PD) 6 pts (20%). There is Relationship Strong Negative Correlation Expression CD44 with chemotherapy responsse (Spearman test rs= - 0.903 and p= 0.000); analysis ROC curve obtained cut off 37.00 and 76.00 with accuration 86,67%. Also there is Relationship Strong Negative Correlation Expression ALDH1 with chemotherapy responsse (Spearman test rs= - 0.893 and p= 0.000); analysis ROC curve obtained cut off 55.00 and 94.00 with accuration 93.33%. Analysis with Spearman there is Strong Correlation between CD44 with ALDH1 (rs= 0.907 and p=0.000). And ALDH1 is more better predictor than CD44 to predict chemoterapy responsse (beta coeficient CD44 = -0.389, ALDH1= -0.551). CD44 and ALDH1 expression can be used a predictor of responsse to neoadjuvant chemotherapy cisplatin in patient with cervical cancer IIB; and ALDH1 more better as predictor than CD44. ABSTRAK Pemberian kemoterapi neoadjuvant memungkinkan kanker serviks stadium IIB dapat dilakukan pembedahan dengan kemungkinan menghindari pemberian radioterapi. Pemberian kemoterapi neoadjuvant pada beberapa penelitian memberikan hasil yang bervariatif. Metode untuk memprediksi apakah seseorang penderita kanker serviks mengalami respons terapi pada kemoterapi neoadjuvant menjadi hal yang penting, mengingat efek samping kemoterapi, waktu, dan biaya. Subpopulasi sel yang dinamakan sel punca kanker/cancer stem cells (CSC) tersebutlah yang diduga bertanggung jawab terhadap terjadinya pertumbuhan kanker, kekambuhan, serta proses resistansi terhadap kemoterapi dan radiasi. Beberapa peneliti membuktikan bahwa kejadian seperti ini disebabkan sel punca kanker yang tetap bertahan hidup pasca-kemoterapi. Keberadaan sel punca kanker serviks ditunjukkan oleh CD44 dan ALDH1. Penelitian ini membuktikan adanya hubungan antara ekspresi CD44 dan ALDH1 sebagai penanda sel punca kanker dengan respons kemoterapi neoadjuvant cisplatin; dan terdapat korelasi peningkatan ekspresi CD44 dan ALDH1 (penanda sel punca kanker) terhadap resistansi kemoterapi neoadjuvant cisplatin pada kanker serviks stadium IIB. Penelitian ini menggunakan rancangan analitik observasional secara prospektif dengan jumlah sampel 30 pasien kanker serviks IIB mulai Desember 2016 sampai Mei 2017. Pemeriksaan klinis dan MRI serta biopsi serviks dilakukan, kemudian dilanjutkan pemeriksaan imunohistokimia CD44 dan ALDH1. Pemberian kemoterapi neoadjuvant (NAC) cisplatin 50 mg/m2 dilakukan 4 kali setiap minggu. Setelah 2–3 minggu NAC terakhir pasien dilakukan pemeriksaan ulang klinis ataupun MRI untuk menilai respons terapi secara kriteria RECIST. Respons kemoterapi menunjukkan partial response (PR) 12 subjek (40%), stable dissease (SD) 12 subjek (40%), and progressive dissease (PD) 6 subjek (20%). Terdapat korelasi negatif kuat antara ekspresi CD44 dengan respons terapi (Spearman test rs= - 0,903 dan p= 0,000). Analisis kurva ROC mendapatkan nilai cut off 37,00 dan 76,00 dengan nilai akurasi sebesar 86,67 %. Juga terdapat korelasi negatif kuat antara ekspresi ALDH1 dengan respons terapi (Spearman test rs= - 0,893 and p= 0,000); dilanjutkan analisis kurva ROC didapatkan nilai cut off 55,00 dan 94,00 dengan nilai akurasi sebesar 93,33%. Analisis dengan Spearman didapatkan hubungan korelasi kuat antara ekspresi CD44 dengan ALDH1 (rs= 0,907 dan p=0,000). ALDH1 merupakan prediktor yang lebih baik daripada CD44 (beta coeficient CD44 = -0,389; ALDH1= -0,551). Ekspresi CD44 dan ALDH1 (penanda sel punca kanker) dapat dipakai sebagai prediktor respons kemoterapi neoadjuvant cisplatin pada kanker serviks IIB. ALDH1 merupakan prediktor yang lebih baik daripada CD44
Ekspresi CD44 (Penanda Sel Punca Kanker) sebagai Faktor Prognostik Kekambuhan pada Kanker Ovarium Tipe Epitel Stadium III PUNGKY MULAWARDHANA; INDRA YULIATI; KETUT SUDIANA
Indonesian Journal of Cancer Vol 11, No 3 (2017): July - September 2017
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1674.793 KB) | DOI: 10.14414/ijoc.v11i3.516

Abstract

Epithelial ovarian cancer is a deadly cancer, cancer recurrence and resistance post surgical staging and chemotherapy are major problems which will eventually occur in most advanced stage ovarian cancer. Recent investigations have unravelled the role of CSC/ Cancer Stem Cell in the cancer recurrence and therapy resistance, CD44 has been reported as a CSC marker in ovarian cancer, investigator wanted to analyse CD44 expression as recurrence prognostic factor in stage III epithelial ovarian cancer. Purpose: to analyse the role of CD44 expression as recurrence prognostic factor in stage III epithelial ovarian cancer. Metode: Hystorical Cohort, ICH CD44 examination was performed on the pathological ovarian cancer sample which diagnosed with platinum resistant recurrence (study sample) and platinum sensitive recurrence (control sample). CD44 expression was measured, the role as recurrence prognostic factor evaluated, influence of CD44 expression increasetowards earlier recurrence analysed, and the CD44 expression differences between 2 groups based on grade; pathological type; and stadium were measured and analysed. Results: 40 research subjects were involved in the research, with 20 among them were platinum resistant and the other 20 were platinum sensitive. Mean CD44 expression in the platinum resistant group was 36,80+29,54; while in the resistant platinum was 7,05+9,58. There was a significant difference of CD44 expression between 2 groups (p=0,000). There was a strong correlation between CD44 expression with the timing of recurrence (p=0,894). With the cut off of12,5; 85% platinum resistant subject had CD44>12,5; 85% platinum sensitive subject had CD44<12,5; with 85% sensitivity and 85% specificity as a good recurrence prognostic factor. Relative Risk (RR) of CD44 Expression is 5,667, RRof tumor residue post surgical staging is 2,513. Through logistic regression analysis, it was concluded that high expression of CD44 and tumor residue are risk factors for recurrences, patient with CD44 expression of ≥ 12,50 has possibility of earlier recurrence (< 6 months) 48,487 times compared with patient with CD44 expression of < 12,50 and patient with tumor residue of < 1cm has possibility of earlier recurrence 13,013 times compared with patient without macroscopic residue.Conclusion: This research found that CD44 expression can be used as recurrence prognostic factor in stage III epithelial ovarian cancer, CD44 expression was significantly higher in the platinum resistant group, there was negative correlationbetween CD44 expression with the timing of recurrence. CD44 expression as recurrence prognostic factor was not influenced with grade and pathologic type, but influenced by stage. Expression of CD44 and tumor residue post surgical staging are good predictors for recurrence timing.ABSTRAKKanker ovarium tipe epitel adalah suatu kanker yang mematikan. Kekambuhan dan resistansi kanker pasca-surgical staging dan kemoterapi merupakan masalah utama yang akan terjadi pada sebagian besar kanker ovarium stadium  lanjut. Penelitian-penelitian terbaru mengemukakan peran CSC (Cancer Stem Cell) dalam proses kekambuhan dan resistansi terapi. CD44 telah dilaporkan sebagai marker CSC pada kanker ovarium. Peneliti ingin meneliti ekspresi CD44 sebagai faktor prognostik kekambuhan kanker ovarium tipe epitel stadium III. Penelitian ini bertujuan menganalisis peran ekspresi CD44 sebagai faktor prognostik kekambuhan pada kanker ovarium tipe epitel stadium III. Metode yang digunakan dalam penelitian ini adalah hystorical cohort, di mana dilakukan pemeriksaan IHC CD44 pada sampel PA pasien kanker ovarium yang mengalami kekambuhan resistan platinum (sampel studi) dan sensitif platinum (sampel pembanding). Ekspresi CD44 diukur, peran sebagai faktor prognostik kekambuhan dievaluasi, pengaruh peningkatan ekspresi CD44 pada kekambuhan yang lebih dini dianalisis, dan perbedaan ekspresi CD44 dinilai pada 2 kelompok berdasarkan grade, tipe PA, dan stadium. Sebanyak 40 subjek penelitian dengan rincian 20 kelompok resistan platinum dan 20 kelompok sensitif platinum diikutkan dalam penelitian ini. Rerata ekspresi CD44 pada kelompok resistan adalah 36,80+29,54 dan kelompok sensitif platinum 7,05+9,58. Didapatkan perbedaan signifikan ekspresi CD44 di antara dua kelompok (p=0,000). Didapatkan pula hubungan yang kuat antara ekspresi CD44 dengan waktu kekambuhan (p=0,894). Dengan cut off 12,5; 85% sampel resistan platinum memiliki CD44>12,5 dan 85% sampel sensitif platinum memiliki CD44<12,5 dengan sensitivitas 85% dan spesifisitas 85% sebagai faktor prognostik kekambuhan yang baik. Didapatkan RR ekspresi CD44 sebesar 5,667, RR residu tumor pasca-surgical staging sebesar 2,513. Melalui analisis regresi logistik, didapatkan bahwa ekspresi CD44 yang tinggi dan adanya residu merupakan faktor risiko kekambuhan. Penderita dengan ekspresi CD44 ≥ 12,50 berisiko kambuh <6 bulan sebesar 48,487 kali penderita dengan ekspresi CD44 < 12,50; dan penderita dengan residu < 1 cm berisiko kambuh <6 bulan sebesar 13,013 kali penderita tanpa residu makroskopik. Penelitian ini menyimpulkan bahwa ekspresi CD44 dapat dipakai sebagai faktor prognostik kekambuhan pada kanker ovarium tipe epitel stadium III, ekspresi CD44 secara signifikan lebih tinggi pada kelompok resistan platinum, serta ada hubungan negatif antara ekspresi CD44 dengan waktu terjadinya kekambuhan. Ekspresi CD44 sebagai faktor prognostik tidak dipengaruhi oleh grade dan tipe PA, tetapi dipengaruhi oleh stadium kanker. Ekspresi CD44 dan residu tumor pasca-surgical staging merupakan indikator prediktif yang baik untuk kecepatan kekambuhan.

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