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Indira Theresia Ongkowidjaja

Perbandingan antara risk of ovarian malignancy algorithm roma dengan risk of malignancy index RMI dalam memprediksi keganasan tumor ovarium epitelial 2012-2014 = Comparison of diagnostic value roma risk of ovarian malignancy algorithm with rmi risk of malignancy index to predict ovarian cancer epitelial type obstetric and gynecology faculty of medicine cipto mangunkusumo hospital 2012 2014

"Penelitian ini bertujuan untuk membandingkan ROMA dengan RMI dalam memprediksi keganasan tumor ovarium epitelial di RS dr. Cipto Mangunkusumo (RSUPNCM). Penelitian ini merupakan uji diagnostik dengan desain potong lintang yang dilakukan di Departemen Obstetri dan Ginekologi, RSUPNCM. Pada penelitian ini, dari 213 subjek diperoleh sensitivitas dan spesifisitas RMI 85.3%, dan 66.3%, Nilai Duga Positif dan Negatif RMI 79.7%, dan 74.3%, Rasio Kemungkinan Positif dan Negatif RMI 2.53, dan 0.22; dan sensitivas dan spesifisitas ROMA 95.4%, dan 32.5%, Nilai Duga Positif dan Negatif 68.9%, dan 81.8%, Rasio Kemungkinan Positif dan Negatif 1.41, dan 0.14. AUC ROMA lebih baik daripada RMI, tetapi tidak bermakna secara statistik (seluruh kelompok: AUC 69.56%>67.49%, perbedaan AUC 0.0207, p 0.526; kelompok pascamenopause: AUC 91.47%>88.97%, perbedaan AUC 0.0250, p 0.0571; kelompok premenopause: AUC 86.20%>78.16%, perbedaan AUC 0.0804, p 0.0571). Pada titik potong ideal (RMI 330, ROMA premenopause 30,4; dan pascamenopause 53.1), ROMA mempunyai sensitivitas dan spesifitas yang lebih baik dibandingkan RMI (sensitivitas 82.31% vs 74.62%; spesifisitas 78.31% vs 75.9%). Dapat disimpulkan bahwa tidak terdapat perbedaan antara ROMA dengan RMI, tetapi sensitivitas dan spesifisitas ROMA lebih baik daripada RMI pada titik potong ideal.

The purpose of this research is to compare ROMA with RMI to predict malignancy of ovarian tumor, epithelial type in Indonesia, especially at the Cipto Mangunkusumo hospital. It was a cross sectional study with a diagnostic design, which was performed in the Oncology Gyneology division. From 213 sampels, the RMI showed a sensitivity of 85.3%, a specificity of 66.3%, a PPV of 79.7%, a NPV of 74.3%, a LR+ of 2.53, LR- 0.22 and an accuracy of 0.77; while ROMA has a sensitivity of 95.4%, a specificity of 32.5%,a PPV 68.9% of, a NPV of 81.8%, a LR+ 1.41, LR- 0.14 and an accuracy of 0.71. Overall AUC ROMA indicated better results compared to those results using the RMI diagnostic method, (all groups: AUC 69.56%>67.49%, p 0.526; as with the postmenopause group: the AUC was 91.47%>88.97%, p 0.0571; and the premenopause group: the AUC 86.20%>78.16%, p 0.0571). At ideal the cut-off point (RMI 330, ROMA premenopause 30,4; and postmenopause 53.1), ROMA has shown better sensitivity and specificity than RMI (sensitivity 82.31% vs 74.62%; specificity 78.31% vs 75.9%). It can be concluded that there is no significantly different between ROMA and RMI, but at ideal cut off, sensitivity and specificity ROMA better than RMI."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2015

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Yuri Feharsal

Perbandingan performa diagnostik sistem skoring international ovarian tumor analysis dengan risk of malignancy index 4 dan indeks morfologi sassone dalam memprediksi keganasan ovarium prabedah = Comparison of diagnostic performance of scoring system of international ovarian tumor analysis with risk of malignancy index 4 and sassone morphology index to predict ovarian malignancy preoperatively

"Penelitian ini membahas perbandingan performa diagnostik sistem skoring International Ovarian Tumor Analysis (IOTA) dengan Risk of Malignancy Index-4 (RMI-4) dan indeks morfologi Sassone dalam memprediksi keganasan ovarium prabedah. Dilakukan uji diagnostik potong-lintang secara retrospektif dengan pasien neoplasma ovarium di RSUPN Dr. Cipto Mangunkusumo dari Januari hingga Desember 2013. Nilai diagnostik dari keempat metode skoring dihitung dengan luaran: sensitivitas, spesifisitas, nilai prediksi positif, nilai prediksi negatif, akurasi dan nilai AUC. Penelitian ini menyimpulkan IOTA simple-rules memiliki performa diagnostik lebih baik dibandingkan IOTA subgroup, RMI-4 dan indeks morfologi Sassone.

This study compared diagnostic performance of scoring system of International Ovarian Tumor Analysis (IOTA) with Risk of Malignancy Index-4 (RMI-4) and Sassone morphology index to predict ovarian malignancy preoperatively. A retrospective study was done involving subject with ovarian neoplasm at National General Hospital Dr. Cipto Mangunkusumo on January to December 2013. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy and AUC value were calculated. This study concluded that diagnostic performance of IOTA simple-rules were significantly better than IOTA subgroup, RMI-4 and Sassone morphology index."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014

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Shirley Mansur

Perbandingan sensitivitas dan spesifisitas dari Skor Gatot, modifikasi Skor Gatot dan Risk Malignancy Index dalam memprediksi Keganasan Ovarium = Comparison of sensitivity and specificity of Gatot Score and its modification also Risk Malignancy Index in predicting Ovarian Malignancies / Shirley Mansur

"Tujuan : Penelitian ini ditujukan untuk mengevaluasi sensitivitas dan spesifisitas dari beberapa metode penapisan keganasan pada tumor ovarium jenis epitelial dengan membandingkan Skor Gatot dan Risk Malignancy Index, serta mengajukan modifikasi Skor Gatot.

Metode : Empat ratus satu pasien dengan kecurigaan keganasan ovarium tipe epithelial dimasukkan sebagai subjek penelitian, dilakukan prosedur anamnesis, pemeriksaan fisik, laboratoris dan ultrasonografi. Dari data tersebut, diambil variabel-variabel yang sesuai dengan Skor Gatot dan Risk Malignancy Index. Dilakukan analisa statistik berupa perhitungan sensitivitas dan spesifisitas serta ROC dan titik potong optimal.

Hasil : Dari 401 subjek penelitian, didapatkan bahwa Skor Gatot memiliki sensitivitas 73.7% dan spesifitas 45.6% (p = 0.000; LR 28.830) sedangkan RMI memiliki nilai sensitivitas 72.4%, spesifisitas 35.94% (p = 0.02, LR 9.588) untuk RMI 1 dan nilai sensitivitas 76%, spesifisitas 30.9% (p = 0.05; LR 7.984) untuk RMI 2. Dilakukan modifikasi pada Skor Gatot dengan pembobotan ulang pada tiap variabel, didapatkan hasil Modifikasi Skor Gatot 1 memiliki titik potong pada nilai 28.5 dengan sensitivitas sebesar 60.4% dan spesifisitas sebesar 61.4% (p= 0.000, LR 44.228) dan Modifikasi Skor Gatot 2 memiliki nilai potong pada titik 5.75 dengan kisaran nilai sensitivitas 49.3 – 69.6% dan sensitivitas 51.6-65.2% ( p = 0.000; LR 36.806).

Kesimpulan : Skor Gatot dan RMI memberikan hasil yang kurang memuaskan dalam melakukan prediksi keganasan ovarium. Dengan melakukan pembobotan ulang pada tiap variabel pada Skor Gatot, sensitivitas dan, terutama, spesifisitas dapat ditingkatkan dalam mendeteksi adanya keganasan ovarium tipe epitelial. Hal ini ditujukan agar dapat meningkatkan prediksi keganasan pada pasien dalam usia reproduksi.

Objective : The study was designed to evaluate the sensitivity and specificity of several methods in detecting ovarian epithelial malignancy by comparing Gatot Score and Risk Malignancy Index, and also proposing the modification of Gatot Score.
Method : Four hundred and one subjects with suspected epithelial ovarian malignancy entered the study and performed anamnesis, physical examinations, laboratories studies and ultrasonography. From the data, we took the variables according to Gatot Score and Risk Malignancy Index. We performed statistic analysis in term of sensitivity, specificity, ROC and optimal cut-off-point.
Results : From 401 observation subjects, revealed that Gatot Score possess the sensitivity of 73.7% and specificity of 45.6% (p = 0.000; LR 28.830), while RMI possess the sensitivity of 72.4% and specificity of 35.94% (p = 0.02, LR 9.588) for RMI 1, and the sensitivity of 76% and specificity of 30.9% (p = 0.05; LR 7.984) for RMI 2. Modification to Gatot Score was performed by re-weighting to its all variables, which resulted in Gatot Score Modification 1 with cut-off point of 28.5, sensitivity of 60.4% and specificity of 35.94% (p= 0.000, LR 44.228) and Gatot Score Modification 2 with cut-off point of 5.75, sensitivity range between 49.3 – 69.6% and specificity range between 51.6-65.2% ( p = 0.000; LR 36.806).
Summary : Both Gatot Score and RMI resulted in unsatisfactory output in predicting the malignancy of ovary. By reassigning the weighting of all variables in Gatot Score, especially the specificity was improved in detecting the malignancy of epithelial type ovary. This measure was directed for patients in reproductive ages, thus increasing the possibility of true malignancy."

Fakultas Kedokteran Universitas Indonesia, 2012

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Liva Wijaya

Prediksi keganasan ovarium dari skor gatot purwoto gp risk malignancy index rmi dan potong beku pada usia muda = Prediction of ovarian malignancy by gatot purwoto score rmi and frozen section in young age

"Penelitian ini bertujuan untuk mengetahui nilai diagnostik skor prabedah dan prosedur potong beku pada pasien keganasan ovarium usia muda. Selain itu, penelitian ini ingin mengetahui apakah potong beku menambah nilai prediksi skor prabedah. Penelitian ini dilakukan dengan mengambil data RSCM dari tahun 2006-2010. Kami mendapatkan 437 pasien dengan diagnosis neoplasma ovarium kistik. Seratus lima puluh tujuh pasien berusia dibawah 40 tahun. Nilai diagnostik skor GP pada keganasan usia muda berturut turut sensitivitas, spesifitas, nilai duga positif, nilai duga negatif, dan akurasi sebesar 77%, 49%, 61%, 68%, dan 63% sedangkan RMI memberikan nilai diagnostik berturut-turut 69%, 49%, 58%, 45%, dan 59%, hasil yang tidak jauh berbeda dengan skor GP. Nilai diagnostik prosedur potong beku pada keganasan usia muda dengan skor GP >4 berturut turut sensitivitas, spesifitas, nilai duga positif, nilai duga negatif, dan akurasi sebesar 81.7%, 87.2% , 90.7%, 75.6%, dan 83%, sedangkan untuk RMI >200 nilai diagnostik berturut-turut adalah 81%, 87%, 89%, 77%, dan 83%. Potong beku menambah 6% dari prediksi prabedah skor GP dan 12% dari prediksi prabedah RMI.

The aim of this paper is to know the diagnostic value of scoring system that taken before surgery and frozen section in the young age patient suspected malignancy. Using that result, we can also know whether the frozen section give additional value to clinical scoring system or not. This research was undergone by using RSCM’s medical record from 2006-2010. From 437 patients suspected ovarian malignancy, we took only 157 patients due to their age. Diagnostic value of GP score are 77%, 49%, 61%, 68%, 63%, while RMI are 69%, 49%, 58%, 45%, 59%, (sensitivity, spesifity, positive prediction value, negative predictive value, and accuracy respectively). Diagnostic value of frozen section in patient suspected malignancy using GP score >4 are 81.7%, 87.2%, 90.7%, 75.6%, 83%, while in patient with RMI > 200 are 81%, 87%, 89%, 77%, 83% (sensitivity, spesifity, positive prediction value, negative predictive value, and accuracy respectively). Frozen section only gave 6% additional value for GP score and 12% for RMI score."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013

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Sarrah Stiafani Afientari

Penggunaan indeks morfometrik ultrasonografi sebagai metode diagnostik keganasan ovarium tipe Epitelial = Ultrasonography morphometric index as a diagnostic method of epithelial ovarian malignancy

"Tujuan: Mengetahui bahwa indeks morfometrik USG merupakan metode yang baik dalam mendiagnosis keganasan ovarium tipe epitelial.

Metode: Penelitian ini merupakan penelitian uji diagnostik yang dilakukan di Rumah Sakit Cipto Mangunkusumo dengan mengambil data retrospektif dari Januari 2016 hingga Desember 2017. Pasien poliklinik rawat jalan ginekologi dengan kecurigaan memiliki neoplasma ovarium kistik direkrut. Standar baku emas adalah temuan histologi dari massa adneksa yang dioperasi. Karakteristik gambaran pola morfometrik ultrasonografi meliputi bilateralitas, jumlah lokus, regularitas dinding dalam (inner wall), tonjolan papiler (papillary projection), bagian padat (solid part), asites, dan doppler blood flow. Analisis ROC dilakukan untuk menentukan seberapa baik model ini digunakan sebagai metode diagnostik keganasan ovarium tipe epitelial. Analisis statistik dihitung, untuk mendapatkan nilai akurasi, sensitivitas, spesifisitas, nilai prediksi positif dan nilai prediksi negatif.

Hasil: Penelitian ini melibatkan 178 pasien, sebanyak 101 kasus (56.74%) adalah k asusjinak dan 77 kasus (43.25%) adalah kasus ganas. Pola karakteristik USG, papillary projection (p-value = 0.000), solid part (p-value = 0.000), inner wall (p-value = 0.000), asites (p-value = 0.000) dan Doppler blood flow (p-value = 0.000) subjek penelitian memiliki hubungan yang bermakna dengan kejadian keganasan ovarium. Pola morfologi papillary projection memiliki nilai sensitifitas yang paling tinggi (83%), kemudian adanya asites (82%), dan iregularitas dinding (81%). Untuk kategori spesifisitas, didapatkan adanya bagian padat (solid part) memiliki nilai spesifisitas yang paling tinggi (93%).Analisis regresi multinomial digunakan untuk menilai gabungan pola karateristik yang bermakna untuk diagnostik keganasan ovarium tipe epitelial dengan AUC 89.40% (95%CI 84.70%-94.00%), Model ini akurat secara statistik (p <0,05).

Kesimpulan: Indeks morfometrik USG merupakan salah satu metode yang baik dalam memprediksi keganasan ovarium.

Objective: To know whether the ultrasound morphometric index is a good method to diagnose epithelial ovarian malignancy.
Materials and methods: This study is a diagnostic test conducted at Cipto Mangunkusumo Hospital, Jakarta, Indonesia. All data were taken retrospectively from January 2016 to December 2017. Gynecological outpatient polyclinic patients with suspicion of having cystic ovarian neoplasms were recruited. Characteristics of ultrasound morphometric patterns include bilaterality, number of loci, inner wall regularity, papillary projection, solid part, ascites, and doppler blood flow.
Results: The study involved 178 patients, 101 cases (56.74%) were malignant and 77 cases (43.25%) were malignant cases. The characteristics of ultrasound, papillary projection, solid part, inner wall, ascites and Doppler blood flow patterns of the study subjects had a significant relationship with the incidence of ovarian malignancy. Multinomial regression analysis was used to assess the combined characteristic patterns for the diagnostic epithelial type ovarian malignancy with AUC 89.40% (95% CI 84.70% -94.00%), this model was statistically accurate (p <0.05).
Conclusion: Morphometric index of ultrasound is a good methods in predicting epithelial ovarian malignancy "

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018

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Mitari Nuzullita

Hubungan CA-125, FOLR1, dan HE4 Sebagai Penanda Keganasan pada Pasien dengan Tumor Ovarium di RSUP Dr. Cipto Mangunkusumo Tahun 2022-2023 = Corelation of CA-125, FOLR1, and HE4 as Malignancy Biomarkers in Patients with ovarian tumor at Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine University Indonesia in 2022-2023

"Latar belakang: Kanker ovarium merupakan jenis kanker ke-3 yang paling sering dialami oleh wanita di Indonesia. Diagnosis yang terlambat berperan besar dalam tingginya angka mortalitas. Metode skrining cepat kanker ovarium semakin penting untuk diteliti, dengan beragam biomarker penanda kanker seperti CA-125, HE4, dan FOLR1 yang menawarkan indeks diagnostik dan kemudahan prosedur yang menjanjikan.

Metode: Studi deskriptif desain potong lintang ini dilakukan di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, Jakarta pada Januari 2022 hingga Januari 2023. Kadar serum CA-125, HE4, dan FOLR1 dianalisis dari 48 subjek yang terbagi dalam kelompok tumor ovarium ganas dan jinak. Diagnosis pasti tumor merujuk hasil pemeriksaan histopatologis dan pencitraan. Data demografis pasien seperti usia, status menopause, ukuran tumor, hingga hasil analisis sitologi cairan asites dikumpulkan.

Hasil: Hasil analisis demografis menunjukkan kecenderungan subjek menopause untuk memiliki tumor ovarium non-maligna (57,6% vs. 26,7%; p < 0,05), dan subjek dengan cairan asites ganas cenderung memiliki tumor ovaium maligna (3,0% vs. 40,0%; p < 0,05). Kadar ketiga biomarker serum meningkat pada kelompok tumor maligna, namun hanya HE4 (median 12,43 vs. 42,03; p < 0,05) yang memiliki perbedaan bermakna (CA-125 median 102,50 vs. 461,85; p = 0,062; FOLR1 median 0,070 vs. 0,172; p=0,213). Area under the curve (AUC) pada hasil analisis kurva receiver operating characteristic (ROC) menunjukkan hasil 0,630, 0,747, dan 0,794 secara berturut-turut untuk biomarker FOLR1, Ca125, dan HE4, dengan analisis beda proporsi signifikan pada titik potong 0,1165 ng/mL (Se 66,7%, Sp 60,6%), 208,00 U/mL (Se 73,3%, Sp 84,8%), dan 19,66 pg/mL (Se 86,7%, Sp 60,6%). Analisis kombinasi biomarker menunjukkan peningkatan sensitifitas namun penurunan spesifisitas.

Kesimpulan: Kadar serum ketiga biomarker memiliki kemampuan yang baik sebagai prediktor keganasan tumor ovarium maligna. Pada populasi penelitian, HE4 secara tunggal memiliki indeks diagnostik terbaik, dan kombinasi biomarker tidak memberikan peningkatan kemampuan diagnostik.

Background : Ovarian cancer is the third most common cancer in women in Indonesia. Late diagnosis significantly contributes to high mortality rates. Rapid screening methods for ovarian cancer are increasingly important, with biomarkers such as CA-125, HE4, and FOLR1 offering promising diagnostic indices and procedural ease.
Methods: This cross-sectional descriptive study was conducted at Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta from January 2022 to January 2023. Serum levels of CA-125, HE4, and FOLR1 were analyzed in 48 subjects divided into malignant and benign ovarian tumor groups. Tumor type diagnosis was based on histopathological examination and imaging. Patient demographic data including age, menopausal status, tumor size, and cytology analysis of ascitic fluid were collected.
Results: Demographic analysis showed tendencies of menopausal subjects to have non-malignant ovarian tumors (57.6% vs. 26.7%; p < 0.05), and subjects with malignant ascitic fluid were more likely to have malignant ovarian tumors (3.0% vs. 40.0%; p < 0.05). Serum levels of all three biomarkers were higher in the malignant group, but only HE4 (median 12.43 vs. 42.03; p < 0.05) showed significant differences (CA-125 median 102.50 vs. 461.85; p = 0.062; FOLR1 median 0.070 vs. 0.172; p = 0.213). The area under the curve (AUC) for the receiver operating characteristic (ROC) curve analysis showed 0.630, 0.747, and 0.794 for FOLR1, CA-125, and HE4, respectively. Significant cut-off points were 0.1165 ng/mL (Se 66.7%, Sp 60.6%), 208.00 U/mL (Se 73.3%, Sp 84.8%), and 19.66 pg/mL (Se 86.7%, Sp 60.6%). Biomarker combination analysis increased sensitivity but decreased specificity.
Conclusion: Serum levels of the three biomarkers are good predictors of malignancy in ovarian tumors. In this study population, HE4 alone had the best diagnostic index, and combining biomarkers did not enhance diagnostic capability."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2024

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Nasution, Hiro Hidaya Danial

Ekspresi Immediate Early Response Gene X-1 (IEX-1) Saliva Sebagai Prediktor Keganasan Pada Tumor Ovarium Epitelial Di RSUPN Dr. Cipto Mangunkusumo Jakarta = Salivary Immediate Early Response Gene X-1 (IEX-1) Expression as a Predictor of Malignancy in Epithelial Ovarian Tumors at RSUPN Dr. Cipto Mangunkusumo Jakarta

"Latar Belakang : Sampai saat ini kanker ovarium masih menjadi salah satu kanker dengan angka mortalitas yang tinggi pada wanita dikarenakan tidak dijumpainya gejala yang khas sehingga lebih banyak kasus terdiagnosis pada stadium lanjut. Belum adanya metode skrining menjadikan pentingnya metode diagnostik yang mempunyai sensitivitas dan spesifisitas yang tinggi. Evaluasi biomarker yang baru diperlukan untuk dapat mendeteksi tumor ovarium ganas pada stadium awal.

Objektif : Penelitian ini dilakukan untuk menilai ekspresi Immediate Early Response Gene X-1 (IEX-1) saliva sebagai prediktor keganasan pada tumor ovarium epitelial.

Metode : Merupakan penelitian uji diagnostik pada pasien tumor ovarium yang direncanakan operasi elektif dengan mengambil 3-5 ml saliva pasien sebelum tindakan operasi. Subjek penelitian yang memenuhi kriteria inklusi dan eksklusi dibagi menjadi dua kelompok berdasarkan hasil histopatologi yaitu tumor ovarium epitelial jinak dan ganas. Dilakukan pemeriksaan ekspresi IEX-1 saliva dengan metode Real Time qPCR.

Hasil : Hasil penelitian ini didapat dari 47 subjek, 22 subjek tumor ovarium epitelial ganas dan 25 subjek merupakan tumor ovarium epitelial jinak. Rerata ekspresi IEX-1 saliva lebih tinggi pada tumor ovarium epitelial jinak (1,976) dibandingkan ganas (0,554) (p<0,001). Didapatkan nilai AUC ekspresi IEX-1 0,949 (IK95% 0,894-1,000), nilai cut off point IEX-1 saliva ≥ 0.9115 dengan sensitivitas 84%, spesifisitas 86,4%, nilai duga positif 82,6% dan nilai duga negatif 87,5%. Terdapat hubungan yang signifikan antara ekspresi IEX-1 saliva dengan kejadian tumor ovarium epitelial ganas (OR 5,031, IK95% 2,039-12,41; p<0,001).

Kesimpulan : Terdapat hubungan yang bermakna antara penurunan ekspresi IEX-1 saliva dengan kejadian tumor ovarium epitelial ganas dengan sensitivitas dan spesifisitas yang cukup baik.

Backgound: Ovarian cancer is still one of the cancers with a high mortality rate in women because there are no typical symptoms so that more cases are diagnosed at an advanced stage. The absence of a screening method makes the importance of a diagnostic method that has high sensitivity and specificity. Evaluation of new biomarkers is needed to detect malignant ovarian tumors at an early stage.
Objectives: This study was conducted to assess the expression of salivary Immediate Early Response Gene X-1 (IEX-1) as a predictor of malignancy in epithelial ovarian tumors.
Methods: This is a diagnostic test study in ovarian tumor patients who are planned for elective surgery by taking 3-5 ml of patient's saliva before surgery. Research subjects who met the inclusion and exclusion criteria were divided into two groups based on the histopathological results, benign and malignant epithelial ovarian tumors. The salivary IEX-1 expression was examined using the Real Time qPCR method.
Results: The results of this study were obtained from 47 epithelial ovarian tumors subjects, 22 malignant tumors and 27 benign tumors. The mean salivary IEX-1 expression was higher in benign epithelial ovarian tumors (1.976) than in malignant (0.554) (p<0.001). The AUC expression value of IEX-1 was 0.949 (95% CI 0.894-1,000), salivary IEX-1 cut off point value was 0.9115 with sensitivity 84%, specificity 86.4%, positive predictive value 82.6% and negative predictive value 87, 5%. There was a significant relationship between salivary IEX-1 expression and the event of malignant epithelial ovarian tumors (OR 5.031, 95% CI 2.039-12.41; p<0.001).
Conclusions: There is a significant correlation between decreased salivary IEX-1 expression and the event of malignant epithelial ovarian tumors with a good sensitivity and specificity."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022

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Yayi Dwina Bilianti Susanto

Perubahan arsitektur dan sitomorfologi sel pada cairan peritoneum sebagai penanda keganasan neoplasma epitelial ovarium = Architectural and cytomorphology changes in peritoneal fluid as a sign of malignancy in ovarian epithelial neoplasm

"Latar belakang: Interpretasi cairan peritoneum yang tepat secara sitopatologi sangat mempengaruhi tatalaksana dan prognosis pasien, padahal pemeriksaan sitopatologi cairan peritoneum masih memiliki nilai negatif palsu dan positif palsu yang cukup tinggi, dan hingga saat ini penelitian tentang arsitektur sitopatologi maupun penanda sitomorfologi yang mengarahkan pada adanya sel neoplasma di cairan peritoneum masih menunjukkan hasil yang beragam.

Bahan dan cara kerja: Penelitian potong lintang dengan data sekunder berupa slaid dan formulir sediaan sitopatologi cairan peritoneum yang memiliki data berpasangan dengan diagnosis histopatologi. Diagnosis klinis berupa neoplasma epitelial ovarium. Slaid dan formulir diambil dari arsip Departemen Patologi Anatomik FKUI/RSCM tahun 2011 - 2012, dilakukan pembacaan ulang semua slaid sitopatologi dengan diagnosis akhir dikategorikan sebagai positif atau negatif, peneliti membaca pula sediaan histopatologi untuk mengetahui morfologi sel pada lesi, kemudiaan dilakukan penilaian terhadap arsitektur sitopatologi berupa: selularitas, sel berkelompok, struktur papiler, intercelular windows, group contours, jisim psamoma, dan penanda sitomorfologi berupa: atipia inti, inti bertumpuk, anak inti, rasio inti:sitoplasma, ukuran inti, dan ukuran sel.

Hasil penelitian: Sampel penelitian sejumlah 47 sediaan sitopatologi dengan diagnosis sitopatologi akhir 34 kasus (72.3%) negatif, 13 kasus (27.7%) positif. Terdapat perbedaan bermakna arsitektur sitopatologi berupa: selularitas (p = 0.017), sel berkelompok (p = 0.001), intercellular windows (p = 0.00), group contours (p = 0.00), dan gambaran sitomorfologi berupa: atipia inti (p = 0.00), inti bertumpuk (p = 0.001), anak inti (p = 0.001), rasio inti:sitoplasma (p = 0.00), ukuran inti (p = 0.00), ukuran sel (p = 0.00) antara cairan peritoneum positif dan negatif. Melalui uji multivariat didapatkan penanda yang paling berpengaruh terhadap diagnosis sitopatologi positif atau negatif yaitu: intercellular windows, atipia inti, dan selularitas.

Kesimpulan: Terdapat tiga penanda yang paling berpengaruh terhadap diagnosis positif ditemukannya sel neoplasma ganas dalam cairan peritoneum pada kasus dengan lesi ovarium, secara berturut - turut yaitu: tidak ditemukannya intercellular windows pada kelompokan sel, sel memiliki atipia inti sedang hingga berat, dan selularitas lebih dari 20 kelompok dari keseluruhan sediaan apus.

Background : Peritoneal fluid cytopathology interpretation profoundly influences patients management and prognosis, however this practice still has high false positive and false negative value, and until now research concerning the architectural and cytomorphology features for detecting malignant cells in peritoneal fluid still has various result.

Materials and Methods : Cross sectional study using secondary data of peritoneal fluid cytopathology and histopathology slides and form, from patients with clinical diagnosis of ovarian epithelial neoplasm. The data was taken from the archive of Anatomical Pathology Department Cipto Mangunkusumo Hospital 2011 - 2012. The researchers examined the cytopathology slides and also examined the histopatology slide for morphology comparison, and then make a final cytopathological diagnosis of positive peritoneal fluid containing neoplastic cells or negative. Architectural features including: cellularity, cells grouping, papillary structure, intercellular windows, group contours, psamoma bodies, and cytomorphology features including: nuclear atypia, overlapping nuclei, nucleoli, nuclei : cytoplasm ratio, the dimension of the nuclei and cells were also examined.

Result : There were 47 samples with final cytopathology diagnosis: 34 cases (72.3%) negative for neoplastic cells in the peritoneal fluid and 13 cases (27.7%) positive. There were significant differences in cytopathology architectural including cellularity (p = 0.017), cells grouping (p = 0.001), intercellular windows (p = 0.00), group contours (p = 0.00) and cytomorphology features including nuclear atypia (p = 0.00), overlapping nuclei (p = 0.001), nucleoli (p =0.001), nuclei : cytoplasm ratio (p = 0.00), the dimension of nuclei (p = 0.00), the dimension of cell (p = 0.00) between the positive and negative peritoneal fluid cytopathology. Using multivariate analysis there were 3 cytological features that have the strongest association with positive or negative peritoneal cytopathology diagnosis, they were: intercellular windows, nuclear atypia, and cellularity.

Conclusion: In peritoneal fluid cytopathology for examining ovarian lesion there were 3 cytological features that have the strongest association with finding neoplastic cells in peritoneal fluid, they were: the absent of intercellular windows, moderate to severe cytological atypia, and cellularity more than 20 groups in all smear preparation."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2015

Ta-Pdf

UI - Tugas Akhir Universitas Indonesia Library

Yayi Dwina Bilianti Susanto

"[ABSTRAK

Latar belakang: Interpretasi cairan peritoneum yang tepat secara sitopatologi sangat

mempengaruhi tatalaksana dan prognosis pasien, padahal pemeriksaan sitopatologi cairan

peritoneum masih memiliki nilai negatif palsu dan positif palsu yang cukup tinggi, dan

hingga saat ini penelitian tentang arsitektur sitopatologi maupun penanda sitomorfologi yang

mengarahkan pada adanya sel neoplasma di cairan peritoneum masih menunjukkan hasil

yang beragam.

Bahan dan cara kerja: Penelitian potong lintang dengan data sekunder berupa slaid

dan formulir sediaan sitopatologi cairan peritoneum yang memiliki data berpasangan dengan

diagnosis histopatologi. Diagnosis klinis berupa neoplasma epitelial ovarium. Slaid dan

formulir diambil dari arsip Departemen Patologi Anatomik FKUI/RSCM tahun 2011 ? 2012,

dilakukan pembacaan ulang semua slaid sitopatologi dengan diagnosis akhir dikategorikan

sebagai positif atau negatif, peneliti membaca pula sediaan histopatologi untuk mengetahui

morfologi sel pada lesi, kemudiaan dilakukan penilaian terhadap arsitektur sitopatologi

berupa: selularitas, sel berkelompok, struktur papiler, intercelular windows, group contours,

jisim psamoma, dan penanda sitomorfologi berupa: atipia inti, inti bertumpuk, anak inti,

rasio inti:sitoplasma, ukuran inti, dan ukuran sel.

Hasil penelitian: Sampel penelitian sejumlah 47 sediaan sitopatologi dengan

diagnosis sitopatologi akhir 34 kasus (72.3%) negatif, 13 kasus (27.7%) positif. Terdapat

perbedaan bermakna arsitektur sitopatologi berupa: selularitas (p = 0.017), sel berkelompok

(p = 0.001), intercellular windows (p = 0.00), group contours (p = 0.00), dan gambaran

sitomorfologi berupa: atipia inti (p = 0.00), inti bertumpuk (p = 0.001), anak inti (p = 0.001),

rasio inti:sitoplasma (p = 0.00), ukuran inti (p = 0.00), ukuran sel (p = 0.00) antara cairan

peritoneum positif dan negatif. Melalui uji multivariat didapatkan penanda yang paling

berpengaruh terhadap diagnosis sitopatologi positif atau negatif yaitu: intercellular windows,

atipia inti, dan selularitas.

Kesimpulan: Terdapat tiga penanda yang paling berpengaruh terhadap diagnosis

positif ditemukannya sel neoplasma ganas dalam cairan peritoneum pada kasus dengan lesi

ovarium, secara berturut - turut yaitu: tidak ditemukannya intercellular windows pada

kelompokan sel, sel memiliki atipia inti sedang hingga berat, dan selularitas lebih dari 20

kelompok dari keseluruhan sediaan apus.

ABSTRACT

Background : Peritoneal fluid cytopathology interpretation profoundly influences patients

management and prognosis, however this practice still has high false positive and false

negative value, and until now research concerning the architectural and cytomorphology

features for detecting malignant cells in peritoneal fluid still has various result.

Materials and Methods : Cross sectional study using secondary data of peritoneal fluid

cytopathology and histopathology slides and form, from patients with clinical diagnosis of

ovarian epithelial neoplasm. The data was taken from the archive of Anatomical Pathology

Department Cipto Mangunkusumo Hospital 2011 ? 2012. The researchers examined the

cytopathology slides and also examined the histopatology slide for morphology comparison,

and then make a final cytopathological diagnosis of positive peritoneal fluid containing

neoplastic cells or negative. Architectural features including: cellularity, cells grouping,

papillary structure, intercellular windows, group contours, psamoma bodies, and

cytomorphology features including: nuclear atypia, overlapping nuclei, nucleoli, nuclei :

cytoplasm ratio, the dimension of the nuclei and cells were also examined.

Result : There were 47 samples with final cytopathology diagnosis: 34 cases (72.3%)

negative for neoplastic cells in the peritoneal fluid and 13 cases (27.7%) positive. There were

significant differences in cytopathology architectural including cellularity (p = 0.017), cells

grouping (p = 0.001), intercellular windows (p = 0.00), group contours (p = 0.00) and

cytomorphology features including nuclear atypia (p = 0.00), overlapping nuclei (p = 0.001),

nucleoli (p =0.001), nuclei : cytoplasm ratio (p = 0.00), the dimension of nuclei (p = 0.00),

the dimension of cell (p = 0.00) between the positive and negative peritoneal fluid

cytopathology. Using multivariate analysis there were 3 cytological features that have the

strongest association with positive or negative peritoneal cytopathology diagnosis, they were:

intercellular windows, nuclear atypia, and cellularity.

Conclusion: In peritoneal fluid cytopathology for examining ovarian lesion there were 3

cytological features that have the strongest association with finding neoplastic cells in

peritoneal fluid, they were: the absent of intercellular windows, moderate to severe

cytological atypia, and cellularity more than 20 groups in all smear preparation, Background : Peritoneal fluid cytopathology interpretation profoundly influences patients

management and prognosis, however this practice still has high false positive and false

negative value, and until now research concerning the architectural and cytomorphology

features for detecting malignant cells in peritoneal fluid still has various result.

Materials and Methods : Cross sectional study using secondary data of peritoneal fluid

cytopathology and histopathology slides and form, from patients with clinical diagnosis of

ovarian epithelial neoplasm. The data was taken from the archive of Anatomical Pathology

Department Cipto Mangunkusumo Hospital 2011 – 2012. The researchers examined the