Hasil Pencarian  ::  Simpan CSV :: Kembali

"[ABSTRAKLatar belakang: Neoplasma sel plasma (NSP) adalah proliferasi sel plasma neoplastik yang tumbuh soliter menjadi plasmasitoma tulang soliter (PTS) dan plasmasitoma ekstrameduler (PEM) serta multipel (MM)). Saat ini perjalanan penyakit dari plasmasitoma menjadi MM sulit diprediksi. Bartl mengklasifikasikan derajat keganasan berdasarkan histomorfologik menjadi rendah, sedang dan tinggi. Penelitian ini bertujuan menggunakan klasifikasi Bartl untuk menilai perjalanan PTS dan PEM menjadi MM dihubungkan dengan ekspresi TP53 dan Ki-67.Bahan dan cara: Pada 32 kasus NSP yang berasal dari PTS 14 kasus, PEM 5 kasus, maupun MM sebanyak 13 kasus, diklasifikasikan menjadi 3 kelompok derajat keganasan menurut Bartl yaitu derajat keganasan ringan, sedang dan tinggi. Selanjutnya dilakukan pulasan IHK TP53 dan Ki-67 pada seluruh kasus dan dihitung persentase positifitas.Hasil: Berdasarkan derajat keganasan, derajat rendah ditemukan pada 10 (31,2%) MM, derajat sedang pada 5 (15,6%) PTS dan derajat tinggi pada 2 (6,2%) PTS dan PEM. Peningkatan ekspresi TP53 ditemukan pada derajat Bartl yaitu median derajat rendah 4%, derajat sedang 16%, dan derajat tinggi 10%. Terdapat perbedaan ekspresi TP53 yang bermakna antara derajat keganasan rendah dan sedang (p=0,004). Rerata indeks proliferasi Ki-67 pada derajat keganasan rendah 57%, derajat sedang 44,6%, dan derajat tinggi 32,6%. Tidak ditemukan perbedaan antara indeks proliferasi Ki-67 dengan derajat keganasan menurut Bartl (p=0,339). Tidak terdapat hubungan antara ekspresi TP53, Ki-67 dengan usia. Kesimpulan: Peningkatan ekspresi TP53 pada NSP sejalan dengan peningkatan derajat keganasan Bartl, terutama pada derajat rendah dan sedang. Klasifikasi Bartl ditambah dengan pulasan TP53 saja tidak cukup untuk memprediksi perkembangan PTS dan PEM menuju MM.

---

ABSTRACTBackground: Plasma cell neoplasm (PCN) is a neoplastic plasma cells proliferation including solitary bone plasmacytoma (SBP) and extramedullary plasmacytoma (EMP) and multiple myeloma (MM). Until now the development of disease to MM is unpredictable. Bartl classifies the degrees of malignancy histomorphologically as low, intermediate and high. This research aims using Bartl's classification and expression of TP53 and Ki-67 to assess the development of SBP and EMP to MM.Materials and methods: In 32 cases of PCN derived from 14 cases of SBP, 5 cases of EMP, and 13 MM case, then classified into 3 groups based on Bartl's degrees of malignancy as low, intermediate, and high. Furthermore all cases stained by IHC TP53 and Ki-67 and evaluated the percentage of positivity. Results: Bartl's low degree was found in 10 (31,2%) MM case, intermediate in 5 (15,6%) SBP and high in 2 (6,2%) SBP and EMP. TP53 expression, obtainable at 4% of low, 16% of intermediate, and 10% of high degree. There is significant difference between TP53 expression in low and intermediate degree (p = 0,004). Mean proliferation index of Ki-67 is 57% in low, 44,6% in intermediate and 32,6% in high degree. There is no significant difference of Ki-67 proliferation indexes among the group (p = 0,339). There is no correlation between expressions TP53, Ki-67 and age.Conclusion: Increasing expression TP53 is in line with Bartl's degrees of malignancy, especially on low and inter.;Background: Plasma cell neoplasm (PCN) is a neoplastic plasma cells proliferation including solitary bone plasmacytoma (SBP) and extramedullary plasmacytoma (EMP) and multiple myeloma (MM). Until now the development of disease to MM is unpredictable. Bartl classifies the degrees of malignancy histomorphologically as low, intermediate and high. This research aims using Bartl?s classification and expression of TP53 and Ki-67 to assess the development of SBP and EMP to MM.Materials and methods: In 32 cases of PCN derived from 14 cases of SBP, 5 cases of EMP, and 13 MM case, then classified into 3 groups based on Bartl?s degrees of malignancy as low, intermediate, and high. Furthermore all cases stained by IHC TP53 and Ki-67 and evaluated the percentage of positivity. Results: Bartl?s low degree was found in 10 (31,2%) MM case, intermediate in 5 (15,6%) SBP and high in 2 (6,2%) SBP and EMP. TP53 expression, obtainable at 4% of low, 16% of intermediate, and 10% of high degree. There is significant difference between TP53 expression in low and intermediate degree (p = 0,004). Mean proliferation index of Ki-67 is 57% in low, 44,6% in intermediate and 32,6% in high degree. There is no significant difference of Ki-67 proliferation indexes among the group (p = 0,339). There is no correlation between expressions TP53, Ki-67 and age.Conclusion: Increasing expression TP53 is in line with Bartl?s degrees of malignancy, especially on low and inter, Background: Plasma cell neoplasm (PCN) is a neoplastic plasma cells proliferation including solitary bone plasmacytoma (SBP) and extramedullary plasmacytoma (EMP) and multiple myeloma (MM). Until now the development of disease to MM is unpredictable. Bartl classifies the degrees of malignancy histomorphologically as low, intermediate and high. This research aims using Bartl’s classification and expression of TP53 and Ki-67 to assess the development of SBP and EMP to MM.Materials and methods: In 32 cases of PCN derived from 14 cases of SBP, 5 cases of EMP, and 13 MM case, then classified into 3 groups based on Bartl’s degrees of malignancy as low, intermediate, and high. Furthermore all cases stained by IHC TP53 and Ki-67 and evaluated the percentage of positivity. Results: Bartl’s low degree was found in 10 (31,2%) MM case, intermediate in 5 (15,6%) SBP and high in 2 (6,2%) SBP and EMP. TP53 expression, obtainable at 4% of low, 16% of intermediate, and 10% of high degree. There is significant difference between TP53 expression in low and intermediate degree (p = 0,004). Mean proliferation index of Ki-67 is 57% in low, 44,6% in intermediate and 32,6% in high degree. There is no significant difference of Ki-67 proliferation indexes among the group (p = 0,339). There is no correlation between expressions TP53, Ki-67 and age.Conclusion: Increasing expression TP53 is in line with Bartl’s degrees of malignancy, especially on low and inter]"

"ABSTRAK Latar Belakang: Selain bergantung pada berbagai faktor prognosis, kesintasan pasien mieloma multipel MM aktif juga ditentukan oleh diagnosis yang lebih dini. Perkembangan kriteria diagnostik MM dari sebelumnya yaitu kriteria Durie-Salmon DS menjadi kriteria International Myeloma Working Group IMWG 2003 dilakukan sebagai upaya mendiagnosis lebih dini MM aktif, namun karena berbagai keterbatasan sumber daya, upaya pemenuhan kriteria diagnostik berdasarkan DS serta IMWG 2003 tidak dapat dilakukan secara konsisten di Indonesia. Berdasarkan hal tersebut, maka perlu diketahui proporsi pemenuhan diagnosis MM berdasarkan kriteria diagnostik DS dan IMWG 2003 serta dampaknya pada kesintasan pasien MM di Indonesia.Tujuan: Mendapatkan data proporsi dan kesintasan pasien MM aktif yang memenuhi kriteria diagnostik DS dan IMWG 2003 di Rumah Sakit Cipto Mangunkusumo RSCM dan Rumah Sakit Kanker Dharmais RSKD .Metode: Penelitian ini menggunakan desain kohort retrospektif dengan teknik analisis kesintasan pada pasien MM aktif yang berobat di RSCM dan RSKD selama tahun 2005-2015. Data disajikan dalam kurva Kaplan Meier dan tabel kesintasan dengan interval kepercayaan IK 95 .Hasil: Studi ini melibatkan 102 pasien MM aktif yang data penunjang diagnosis tersedia dan memiliki kesintasan >1 bulan. Sebesar 56,9 pasien memenuhi kriteria diagnostik DS dan 72,5 memenuhi kriteria IMWG 2003. Median Overall Survival OS pasien berdasarkan kriteria DS sama dengan IMWG 2003yaitu 77,8 bulan. Overall Survival tahun ke-1, ke-3, ke-5 pasien MM yang memenuhi kriteria DS adalah 89,9 , 77,5 , dan 54,8 sedangkan pasien MM yang memenuhi kriteria IMWG 2003 adalah 87,5 , 75,6 , dan 55,9 .Simpulan: Proporsi pasien MM aktif yang memenuhi kriteria diagnostik IMWG 2003 lebih tinggi daripada yang memenuhi kriteria DS. Kesintasan menyeluruh pasien MM aktif yang memenuhi kriteria diagnostik DS sama dengan yang memenuhi kriteria IMWG 2003.ABSTRACT

Background Besides other prognostic factors, survival in active multiple myeloma MM patients is determined by earlier diagnosis. Development of MM diagnostic criteria from Durie Salmon DS to International Myeloma Working Group IMWG 2003 criteria as part of efforts to diagnose earlier active MM patients, unfortunately due to resources constraints, the fullfillment of DS and IMWG 2003 diagnostic criteria can not be done consistently in Indonesia. Therefore, it is important to describe the proportion of fulfillment MM diagnosis based on DS and IMWG 2003 diagnostic criteria as well as its impact on survival of active MM patients in Indonesia.Aim To describe the proportion and survival rate of active MM patients in Cipto Mangunkusumo Hospital and Dharmais National Cancer Hospital based on Durie Salmon and International Myeloma Working Group IMWG 2003 diagnostic criteria.Methods We conducted a retrospective cohort study with survival analysis in active MM patients in RSCM and RSKD during 2005 2015. Data were presented in Kaplan Meier curve and survival table with 95 confidence interval.Results This study involved 102 active MM patients whose initial supporting data were available and who survived 1 month. There were 56.9 patients who met DS criteria and 72.5 patients who met IMWG 2003 criteria. Median overall survival OS based on DS and IMWG 2003 diagnostic criteria were similar 77.8 months . The 1st, 3rd, and 5th year survival of patients who met DS criteria were 89.9 , 77.5 , and 54.8 . The 1st, 3rd, and 5th year survival for patients who met on IMWG 2003 criteria were 87.5 , 75.6 , and 55.9 .Conclusion The proportion of active MM patients who fulfilled IMWG 2003 diagnostic criteria was higher than DS diagnostic criteria. Survival of active MM patiens who met DS and IMWG 2003 criteria were similar.Keywords Active multiple myeloma survival Durie Salmon diagnostic criteria IMWG 2003 diagnostic criteria "