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"Ruang lingkup dan cara penelitian: Karsinoma ovarium merupakan salah satu keganasan yang sangat penting karena menempati urutan ke empat penyebab kematian pada wanita. Di Indonesia dari tahun 1989-1992 terdapat 13% karsinoma ovarium dalam 1.726 kasus. Diagnosis histopatologik memegang peranan penting dalam penanganan tumor ovarium. Saat ini yang masih sering menimbulkan masalah diagnostik adalah membedakan antara tumor borderline dengan kistadenokarsinoma padahal penanganan dan prognostiknya berbeda. AgNOR merupakan salah satu cara penilaian proliferasi dengan menghitung nucleolar organizer region (NOR) yang merupakan lengkung DNA ribosom yang ditranskripsikan menjadi RNA ribosomal dengan bantuan RNA polimerase. Jumlah dan ukuran AgNOR berkorelasi dengan aktivitas proliferasi sel. Peningkatan nilai AgNOR mencerminkan peningkatan aktivitas proliferasi sel atau ploidi. Pada penelitian ini, nilai AgNOR digunakan untuk melihat hubungannya dengan derajat histopatologik tumor ovarium musinosum. Penghitungan nilai AgNOR dilakukan pada 20 kasus kistadenoma, 20 kasus tumor borderline dan pada 20 kasus kistadenokarsinoma dengan dua cara, yaitu rata-rata jumlah AgNOR per nukleus (mAgNOR) dan persentase nukleus dengan AgNOR>1, >2, >3 dan >4 (pAgNOR). Hasil dan kesimpulan: Dari penelitian ini diperoleh nilai mAgNOR dan pAgNOR meningkat dan kistadenoma, tumor borderline dan kistadenokarsinoma (masing-masing 2,14; 3,55 dan 5,18). Nilai pAgNOR pada karsinoma lebih tinggi daripada nilai pAgNOR pada kistadenoma dan pada tumor borderline (pAgNOR>1 pada kistadenoma 69,55%; pada tumor borderline 964% dan pada kistadenokarsinoma 99,95%). Dengan menggunakan analisis varian didapatkan perbedaan bermakna di antara ke tiga jenis tumor tersebut (p=0,00). Dan dengan uji korelasi diperoleh hubungan yang sangat kuat antara nilai AgNOR dan derajat histopatologik tumor ovarium musinosum. Hasil ini menunjukkan bahwa nilai AgNOR dapat digunakan untuk membedakan antara kistadenoma ovarium musinosum, tumor borderline dan kistadenokarsinoma.

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Ovarian carcinomas are one of the most important malignant tumors because it had become the fourth most common cause of female cancer death. In Indonesia from 1989 to 1992, more than 13 % of 1.726 cancer cases were ovarian carcinomas. Histopathologic diagnostic become an important role in treatment of ovarian tumors. However, the main problem in histopathologic diagnostic the difficulties in differentiating ovarian cystadenocarsinomas and borderline tumors. Application of objective method is therefore necessary for the differential diagnosis. Nucleolar organizer region (NOR) are loops of DNA on the short arms of acrocentric chromosomes that presumably are associated with ribosomal RNA activity, protein synthesis and cellular proliferation. NOR are readily demonstrated by means of argyrophilia of their associated proteins, using the so-called AgNOR technique. Increased number of AgNOR may reflect increased proliferative activity of cell or ploidy, i.e., the count of AgNOR per nudeus was higher in malignant than in benign tissues. In this study, the authors tested AgNOR counting method for their ability to discriminate between benign tumour, borderline tumor and carcinoma and to see correlation between histopathologic grades of mutinous ovarian tumors with AgNOR counts. Selective cases of 20 cases cystadenomas, 20 cases of borderline tumors and 20 cases of cystadenocarsinomas were evaluated by 2 AgNOR counting method: 1) the mean number of AgNORs per nucleus (mAgNOR) and 2) the percentages of nuclei with >1, >2, >3 and >4 AgNORs (pAgNOR>1, pAgNOR>2, pAgNOR>3 and pAgNOR>4, respectively).

Result and conclusion: mAgNOR counts demonstrated a progressive increase from cytadenomas to borderline tumours and to cystadenocarcinomas (2,14; 3,55 and 5,18, respectively). pAgNOR counts were higher in carcinoma than in cystadenoma and in borderline tumors (in adenoma, 69.55% have pAgNOR>1, while in borderline and in carcinoma were 96,1% and 99,55%, respectively). Using analysis of variance, both AgNOR counts enabled significant discrimination between cystadenoma, borderline tumours and carcinoma (13=0, 00). The AgNOR counts show statistically significant correlation with histopathological grade of mucinous ovarian tumors. The result indicates that the AgNOR counting procedure may be useful in distinguishing borderline tumours from cytadenocarcinoma and cystadenoma mutinous of ovary."

"Latar belakang: Penderita kanker ovarium umumnya datang berobat pada stadium lanjut, sehingga kekambuhan pasca pembedahan dan pemberian kemoterapi mencapai 70-80%. EGFR mengaktifkan jalur sinyal yang menginduksi onkogenesis dan proliferasi sel. Tujuan penelitian ini adalah untuk menganalisis peran EGFR dalam patogenesis tumor serosum ovarium dan peluangnya untuk digunakan sebagai penanda keganasan.Metode: Penelitian ini menggunakan metode potong lintang. Sampel terdiri atas 15 kasus tumor jinak, 15 kasus borderline dan 15 kasus adenokarsinoma di Departemen Patologi Anatomik FKUI/RSCM tahun 2008-2012. Dilakukan pulasan imunohistokimia EGFR dan penilaian dengan H score.Hasil: Terdapat perbedaan ekspresi EGFR yang bermakna antara kelompok tumor serosum jinak (H score = 15), borderline (H score = 60) dan adenokarsinoma (H score = 120), dengan p=0,000.Kesimpulan. Ekspresi EGFR pada tumor serosum ovarium meningkat seiring peningkatan derajat keganasan.

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Background: Most of ovarian cancer patients are diagnosed in already advanced stage, therefore 70-80% of cases having recurrence after surgical staging and chemotherapy. EGFR activates signaling pathways which induce oncogenesis and cell proliferation. The aim of this study is to analyze the role of EGFR in the pathogenesis of serous ovarian tumors and its possibility to be used as a malignant marker.Methods: This was a cross-sectional study on each 15 cases of benign, borderline and malignant serous ovarian tumors from Anatomical Pathology Department FMUI/CMH in 2008-2012. EGFR status was assessed by immunohistochemistry technique and the expression was evaluated using H score.Results: There was significant difference between EGFR expression in benign (H score = 15), borderline (H score = 60) and malignant serous ovarian tumors (H score = 120), p=0,000.Conclusion: The EGFR immunoexpression was increased along with the higher degree of serous ovarian tumor malignancy."

"Latar belakang: Kesintasan 5 tahun tumor ovarium borderline pada stadium awal cukup baik, sekitar 95-100%. Tatalaksana dari tumor ini adalah dengan pembedahan, pada pasien yang masih ingin mempertahankan fungsi reproduksinya, operasi sebisanya dilakukan dengan tetap meninggalkan uterus dan satu ovariumnya. Kemoterapi tidak dianjurkan untuk tumor ovarium borderline stadium awal. Di Indonesia penelitian tentang kesintasan tumor ovarium borderline masih sangat terbatas, oleh karena itu diperlukan penelitian lebih lanjut. Tujuan: Untuk mengetahui kesintasan tumor ovarium borderline di RSCM. Metode: Studi ini merupakan studi analitik deskriptif. Pasien yang didiagnosis dan dilakukan pembedahan di Departemen Obstetri dan Ginekologi RSCM pada periode Januari 2008-Desember 2010 dengan hasil histopatologi tumor ovarium borderline, di follow up untuk mengetahui kesintasan selama 5 tahun.Hasil: Subyek penelitian didapat 42 orang. Hasil kesintasan tumor ovarium borderline didapat sebesar 97,6%. Pada penelitian ini faktor umur, paritas, riwayat keluarga dan kontrasepsi oral, CA 125, asites, dan tindakan pembedahan didapatkan tidak mempunyai hubungan yang konsisten dengan tumor ovarium borderline. Jenis histopatologi yaitu tumor ovarium borderline serosum dan tatalaksana pembedahan tanpa dilanjutkan tindakan kemoterapi mempengaruhi kesintasan tumor ovarium borderline di RSCM dengan nilai p = 0,000 dan p = 0,001.Kesimpulan: Kesintasan 5 tahun penderita tumor ovarium borderline yang ditatalaksana di RSCM cukup baik. Tatalaksananya dititikberatkan pada pasien dengan jenis histopatologi serosum karena faktor ini mempengaruhi kesintasan 5 tahun pasien tumor ovarium borderline dan tanpa tindakan lanjutan kemoterapi hasilnya cukup baik.

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Background: Five years survival of ovarian borderline tumors at early stage is quite good, about 95-100%. The procedures of this tumor is surgery, for patients who still want to maintain reproductive function, the best procedure by leaving the uterus and ovary. Chemotherapy is not recommended for early-stage borderline ovarian tumors. In Indonesia research on borderline ovarian tumors is limited, therefore more research is needed.Objective: To determine survival of ovarian borderline tumors in RSCM Hospital. Methode: This study is a descriptive analytic. Patients were diagnosed and surgery at Department of Obstetrics and Gynaecology RSCM on January 2008-December 2010 with a borderline ovarian tumor histopathology results, in the follow-up to determine the survival rate for 5 years, simple random sampling. Analysis of survival use Kapplan Meier Analysis.Result: The study gained 42 patients. Borderline ovarian tumor survival results obtained for 97.6%. In this study, age, parity, family history and oral contraceptive, CA 125, surgery, ascites have no consistent relationship with a borderline ovarian tumor's survival. Histopathology and chemotherapy have consistent relationship with p = 0,000 and p = 0,001.Discussion: Five years survival of patients with borderline ovarian tumors were administered in RSCM is good. It is important to pay attention to histopathology result and patient have a good survival without chemotherapy."

"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.

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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."

"ABSTRAK Latar belakang: Endometriosis merupakan kelainan ginekologik yang palingsering ditemukan. Seperti halnya endometrium di uterus juga dapat terjadiberbagai perubahan pada epitel yang melapisi kista endometriosis di ovarium,antara lain metaplasia, hiperplasia, atipia bahkan perubahan ke arah keganasan.Saat ini banyak penelitian yang menghubungkan antara endometriosis dan kankerovarium terutama jenis clear cell dan dikenal dengan istilah endometriosisassociatedovarian carcinoma (EAOC) dan dilaporkan adanya mutasi yangmenginaktifkan gen supresor tumor (ARID1A), sehingga protein BAF250a tidakdiekpresikan pada Clear cell carcinoma (CCC) ovarii.Bahan dan cara: Dilakukan pulasan imunohistokimia ARID1A pada sampel 20kasus endometriosis non atipik, 20 kasus atipik dan 20 kasus CCC ovarii tahun2012 hingga Maret 2015. Dari kelompok kasus CCC didapatkan 9 kasus EAOC.Selanjutnya dilihat adakah perbedaan persentase ekspresi ARID1A padaendometriosis non atipik, atipik, CCC ovarii serta endometriosis disertai CCC(EAOC).Hasil: Pada kelompok kasus endometriosis non atipik, atipik dan CCC adaperbedaan bermakna persentase ekspresi ARID1A (uji Kruskal-Wallis p=0,0035).Selanjutnya dilakukan analisis Post Hoc uji Mann-Whitney dan didapatkanperbedaan bermakna persentase ekspresi ARID1A antara endometriosis non atipikdan atipik dengan CCC ovarii (p=0,001 dan p=0,0015). Pada kelompok kasusendometriosis non atipik, atipik dan endometriosis pada EAOC, didapatkan adaperbedaan bermakna persentase ekspresi ARID1A (Uji Kruskal-Walis p=0,011).Selanjutnya dilakukan analisis Post Hoc uji Mann-Whitney dan ada perbedaanbermakna persentase ekspresi ARID1A antara endometriosis non atipik dan atipikdengan EAOC (p=0,005 dan p=0,008). Kesimpulan: Ekspresi ARID1A pada endometriosis non atipik dan atipik lebihtinggi bermakna dibanding CCC ovarii dan EAOC. Sehingga ekspresi ARID1Akemungkinan dapat digunakan sebagai petanda adanya transformasi ganas padaendometriosis.ABSTRACT Background: Endometriosis is one of the most common gynecologicalabnormalities found. Endometriosis cyst in the ovary also exhibited changes inepithelial cyst just like endometrium in the uterus. Changes in the epithelial cellsalso include metaplasia, hyperplasia, atyphia even changes toward malignancharacteristics. Nowadays, there are some research that linked endometriosis andclear cell ovarian cancer which is known with endometriosis-associated ovariancarcinoma (EAOC) it is reported that there?s a mutation that activated tumorsuppressor gene (ARID1A), so protein BAF250a is not expressed in Clear CellCarcinoma (CCC) in the ovarium.Materials and Methods: Immunohistochemistry staining of ARID1A were donein 20 samples of non-atypical endometriosis, 20 samples of atypicalendometriosis, 20 samples of CCC in the ovarium from the year 2012 until march2015. From the group that experienced CCC we get 9 cases of EAOC. After that,we see if there?s any difference in the percentage of ARID1A expression in nonatypicalendometrosis, atypical endometriosis, CCC in the ovarium andendometriosis with CCC( EAOC).Results: In non-atypical endometriosis, atypical and CCC cases groups there aresignificant differences on the percentage of ARID1A expression (Kruskal-Walistest p=0,0035). Post Hoc analysis were done using Mann-Whitney test and thereare significant differences on ARID1A expression between non-atypical andatypical endometriosis with CCC (p=0,001 and p=0,0015). In non-atypicalendometriosis, atypical and EAOC groups there are significant differences on thepercentage of ARID1A expression (Kruskal-Walis test p=0,011). Post Hocanalysis were done using Mann-Whitney test and there are significant differenceson ARID1A expression between non-atypical and atypical endometriosis withEAOC (p=0,005 and p=0,008).Conclusion: Expression of ARID1A in non atypical and atypical endometriosisare significantly higher compared to ovarian CCC and EAOC. So, we can say thatARID1A may be used as a marker for malignancy transformation inendometriosis.;Background: Endometriosis is one of the most common gynecologicalabnormalities found. Endometriosis cyst in the ovary also exhibited changes inepithelial cyst just like endometrium in the uterus. Changes in the epithelial cellsalso include metaplasia, hyperplasia, atyphia even changes toward malignancharacteristics. Nowadays, there are some research that linked endometriosis andclear cell ovarian cancer which is known with endometriosis-associated ovariancarcinoma (EAOC) it is reported that there?s a mutation that activated tumorsuppressor gene (ARID1A), so protein BAF250a is not expressed in Clear CellCarcinoma (CCC) in the ovarium.Materials and Methods: Immunohistochemistry staining of ARID1A were donein 20 samples of non-atypical endometriosis, 20 samples of atypicalendometriosis, 20 samples of CCC in the ovarium from the year 2012 until march2015. From the group that experienced CCC we get 9 cases of EAOC. After that,we see if there?s any difference in the percentage of ARID1A expression in nonatypicalendometrosis, atypical endometriosis, CCC in the ovarium andendometriosis with CCC( EAOC).Results: In non-atypical endometriosis, atypical and CCC cases groups there aresignificant differences on the percentage of ARID1A expression (Kruskal-Walistest p=0,0035). Post Hoc analysis were done using Mann-Whitney test and thereare significant differences on ARID1A expression between non-atypical andatypical endometriosis with CCC (p=0,001 and p=0,0015). In non-atypicalendometriosis, atypical and EAOC groups there are significant differences on thepercentage of ARID1A expression (Kruskal-Walis test p=0,011). Post Hocanalysis were done using Mann-Whitney test and there are significant differenceson ARID1A expression between non-atypical and atypical endometriosis withEAOC (p=0,005 and p=0,008).Conclusion: Expression of ARID1A in non atypical and atypical endometriosisare significantly higher compared to ovarian CCC and EAOC. So, we can say thatARID1A may be used as a marker for malignancy transformation inendometriosis.;Background: Endometriosis is one of the most common gynecologicalabnormalities found. Endometriosis cyst in the ovary also exhibited changes inepithelial cyst just like endometrium in the uterus. Changes in the epithelial cellsalso include metaplasia, hyperplasia, atyphia even changes toward malignancharacteristics. Nowadays, there are some research that linked endometriosis andclear cell ovarian cancer which is known with endometriosis-associated ovariancarcinoma (EAOC) it is reported that there?s a mutation that activated tumorsuppressor gene (ARID1A), so protein BAF250a is not expressed in Clear CellCarcinoma (CCC) in the ovarium.Materials and Methods: Immunohistochemistry staining of ARID1A were donein 20 samples of non-atypical endometriosis, 20 samples of atypicalendometriosis, 20 samples of CCC in the ovarium from the year 2012 until march2015. From the group that experienced CCC we get 9 cases of EAOC. After that,we see if there?s any difference in the percentage of ARID1A expression in nonatypicalendometrosis, atypical endometriosis, CCC in the ovarium andendometriosis with CCC( EAOC).Results: In non-atypical endometriosis, atypical and CCC cases groups there aresignificant differences on the percentage of ARID1A expression (Kruskal-Walistest p=0,0035). Post Hoc analysis were done using Mann-Whitney test and thereare significant differences on ARID1A expression between non-atypical andatypical endometriosis with CCC (p=0,001 and p=0,0015). In non-atypicalendometriosis, atypical and EAOC groups there are significant differences on thepercentage of ARID1A expression (Kruskal-Walis test p=0,011). Post Hocanalysis were done using Mann-Whitney test and there are significant differenceson ARID1A expression between non-atypical and atypical endometriosis withEAOC (p=0,005 and p=0,008).Conclusion: Expression of ARID1A in non atypical and atypical endometriosisare significantly higher compared to ovarian CCC and EAOC. So, we can say thatARID1A may be used as a marker for malignancy transformation inendometriosis.;Background: Endometriosis is one of the most common gynecologicalabnormalities found. Endometriosis cyst in the ovary also exhibited changes inepithelial cyst just like endometrium in the uterus. Changes in the epithelial cellsalso include metaplasia, hyperplasia, atyphia even changes toward malignancharacteristics. Nowadays, there are some research that linked endometriosis andclear cell ovarian cancer which is known with endometriosis-associated ovariancarcinoma (EAOC) it is reported that there?s a mutation that activated tumorsuppressor gene (ARID1A), so protein BAF250a is not expressed in Clear CellCarcinoma (CCC) in the ovarium.Materials and Methods: Immunohistochemistry staining of ARID1A were donein 20 samples of non-atypical endometriosis, 20 samples of atypicalendometriosis, 20 samples of CCC in the ovarium from the year 2012 until march2015. From the group that experienced CCC we get 9 cases of EAOC. After that,we see if there?s any difference in the percentage of ARID1A expression in nonatypicalendometrosis, atypical endometriosis, CCC in the ovarium andendometriosis with CCC( EAOC).Results: In non-atypical endometriosis, atypical and CCC cases groups there aresignificant differences on the percentage of ARID1A expression (Kruskal-Walistest p=0,0035). Post Hoc analysis were done using Mann-Whitney test and thereare significant differences on ARID1A expression between non-atypical andatypical endometriosis with CCC (p=0,001 and p=0,0015). In non-atypicalendometriosis, atypical and EAOC groups there are significant differences on thepercentage of ARID1A expression (Kruskal-Walis test p=0,011). Post Hocanalysis were done using Mann-Whitney test and there are significant differenceson ARID1A expression between non-atypical and atypical endometriosis withEAOC (p=0,005 and p=0,008).Conclusion: Expression of ARID1A in non atypical and atypical endometriosisare significantly higher compared to ovarian CCC and EAOC. So, we can say thatARID1A may be used as a marker for malignancy transformation inendometriosis."

"Ruang Lingkup dan Cara Penelitian: Stomatitis Aftosa Rekuren (SAR) belum diketahui dengan pasti penyebabnya. Namun ada dugaan gangguan kekebalan melalui mekanisme infeksi dan mekanisme autoimun dapat berperan dalam patogenesisnya. Ketidak-seimbangan jumlah dan proporsi pada subpopulasi limfosit, dapat menyebabkan kelainan kekebalan. Beberapa penelitian terhadap SAR dan hubungannya dengan subpopulasi limfosit tersebut telah dilaporkan, namun hasil yang ditemukam tidak saling mendukung. Keragaman hasil yang dilaporkan para peneliti tersebut, mungkin disebabkan karena para peneliti tidak menggolongkan penderita SAR berdasarkan tipe lasi, yaitu tipe minor dan tipe mayor. Keragaman hasil mungkin pula disebabkan oleh karena sebagian peneliti menggunakan darah lengkap sebagai bahan pemeriksaan. Penelitian yang dilakukan ini bertujuan untuk menetapkan adanya kelainan kekebalan seluler yang ditemukan pada penderita SAR, dengan analisis jumlah dan proporsi subpopulasi limfosit, serta dikaitkan dengan tipe lasi SAR. Pada penelitian ini digunakan sediaan limfosit yang dimurnikan untuk menetapkan proporsi setiap subpopulasi dengan bantuan flow cyrometry. Selain proporsi, jumlah absolut setiap subpopulasi limfosit ditetapkan pula. Subjek penelitian terdiri dari 19 penderita SAR yang terdiri dari 12 penderita SAR tipe minor dan 7 penderita SAR tipe mayor, serta 8 orang normal sebagai kontrol. Hasil penelitian dianalisis secara statistik (uji Mann-Withney) dengan membandingkan proporsi dan jumlah absolut antara kelompok normal dengan penderita SAR dan antara kelompok SAR tipe minor dengan tipe mayor. Hasil dan kesimpulan: Pada kelompok penderita SAR ditemukan nilai yang lebih rendah daripada kelompok normal pada: jumlah absolut sel Th (P< 0.05), proporsi sel Th (P< 0.01) dan nisbahTh/Ts (P<0.01). Proporsi sel Ts pada kelompok penderita SAR lebih tinggi daripada kelompok normal (p< 0.01). Nisbah Th/Ts pada penderita SAR tipe mayor lebih rendah dibandingkan dengan penderita SAR tipe minor (P<0.0 I) dan proporsi sel Ts pada penderita SAR tipe mayor lebih tinggi daripada SAR tipe minor (P< 0.01). Dengan demikian, disimpulkan bahwa pada pendrita SAR ditemukan adanya tanda-tanda kelainan kekebalan seluler yang semakin nyata pada penderita SAR tipe mayor."

"Tujuan: AmpIifikasi dan over-ekspresi c-erbB2 and MRP1 ditemukan pada beberapa tumor dan merupakan hal yang panting daiam menentukan perilaku karsinoma. Tujuan penelitian ini untuk mengevaluasi hubungan antara ekspresi protein c-erbB-2 dan MRPI dengan derajat keganasan karsinoma payudara duktal invasif dan respon kemoterapi neoajuvan CAF.Cara kerja: Ekspresi protein c-erB2 and MRP1 dianalisa secara imunohistokimia pada 27 blok paraffin dari pasien yang telah didiagnosa sebagai karsinoma payudara duktal. Hasilnya dihubungkan dengan derajat keganasan dan respon kemoterapi. Hubungan antara beberapa variabel dianalisa dengan uji analisa statistik non-parametrik Kendall,Hasil: Ekspresi protein C-erbB-2 positif pada 33,3 % tumor. Ekspresi protein MRP1 negatif pads 25,9 %, positif lemah pada 11,1 %, positif sedang pads 37,1 % dan positif kuat pada 25,9 %. Terdapat hubungan yang bermakna antara ekspresi protein C-erbB-2 dengan MRP1 (p=0,020, r=0,370). Tetapi, tidak ada hubungan yang bermakna antara ekspresi protein C-erbB-2 dengan derajat keganasan (p= 0,210) dan respon kemoterapineoajuvan CAF (p=0,168). Tidak ada hubungan yang bermakna antara ekspresi proteinMRPI dengan derajat keganasan (p= 0,144) dan respon kemoterapi neoajuvan CAF (p=0,056). )_ Tidak ada hubungan yang bermakna antara ekspresi protein MRP1 dengan derajat keganasan dengan respon kemoterapi neoajuvan CAF (p-,I30).Kesimpulan: Terdapat hubungan yang bermakna antara ekspresi protein c-erbB-2 dengan MRP1. Tidak ada hubungan yang bermakna antara ekspresi protein c-erbB2 dan MRPI dengan derajat keganasan dan respon kemoterapi. Tetapi, ada kecenderungan bahwa ekspresi protein MRP berhubungan searah dengan derajat keganasan dan respon kemoterapi. Tidak ada hubungan yang bermakna antara derajat keganasan dengan respon kemoterapi.

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Aims: Amplification and over-expression of c-erbB2 and MRP1 gene has been demonstrated in several tumors and thought to be important determinant of behaviors of carcinoma. In this study, correlation between c-erbB-2 and MRPI protein expression with histological grade of invasive ductal carcinoma of the breast and CAF neoadjuvant chemotherapy response were evaluated.

Methods: Paraffin-embedded tissue section from 27 patients who diagnosed as invasive ductal carcinoma of the breast were analyzed immunohistochemically for the expression of c-erbB2 and MRPI. The result was compared with histological grade and CAF neoadjuvant chemotherapy response. The correlation between several variable were analyzed by non-parametric statistical analysis correlation of Kendall.

Result: C-erbB-2 protein expression were positive in 33.3 % of the tumours. MRP1 protein expression were negative in 25.9 %, weak positive in 11.1 %, moderate positive in 37.1 % and strong positive in 25.9 %. There was significant correlation between C-erbB-2 with MRPI protein expression (p(_020, r0.370). However, there was no significant correlation between C-erbB-2 protein expression with histological grade (p= 0.210) and chemotherapy response (p=0.168). There was no significant correlation between MRP I protein expression with histological grade (p= 0.144) and chemotherapy response (p-0.056). There was no significant correlation between histological grade with chemotherapy response (p.41130).

Conclusion C-erbB-2 and MRPI protein expression were weakly correlated with each other. There was no significant correlation among both of the c-erbB2 and MRP I protein with histological grade and CAF neoadjuvant chemotherapy response_ However, there was a tendency that the expression of MRPI protein was related to histological grade and CAF neoadjuvant chemotherapy response. There was no significant correlation between histological grade and CAF neoadjuvant chemotherapy response."

"Latar belakang: Liposarkoma berdiferensiasi baik (LPSBB) merupakan subtipe liposarkoma yang paling sering ditemui dan kadang sulit dibedakan dengan lipoma karena kemiripan gambaran morfologik. Pada penelitian ini akan dilihat overekspresi dan amplifikasi gen murine double minute 2 (MDM2) sebagai alat bantu diagnostik untuk membedakan kedua entitas tersebut serta hubungannya dengan indeks proliferasi Ki67.Bahan dan cara: Dilakukan pulasan imunohistokimia MDM2 dan Ki67 pada 37 tumor lipomatosa, yang terdiri atas 18 LPSBB dan 19 lipoma, dilanjutkan dengan hibridisasi in situ pada 12 kasus terpilih.Hasil: Overekspresi MDM2 ditemukan pada seluruh LPSBB dan pada 3 (16%) lipoma (p=0,000). Amplifikasi MDM2 ditemukan pada seluruh kasus LPSBB yang diperiksa namun terdapat pula pada 1 lipoma (p=0,200). Terdapat korelasi yang kuat antara overekspresi MDM2 dengan indeks proliferasi Ki67 yang lebih tinggi (r=0,645, p=0,000).Kesimpulan: Overekspresi MDM2 dapat digunakan sebagai alat bantu diagnostik dalam membedakan LPSBB dengan lipoma, serta berhubungan dengan indeks proliferasi sel tumor.

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Background: Well differentiated liposarcoma (WDLPS) is the most common type of liposarcoma and sometimes can be difficult to distinguish from lipoma because of the similar morphology. This study propose to evaluate the expression and amplification of murine double minute 2 (MDM2) and determine its correlation with Ki67 proliferation index.Methods: This study enrolled 37 cases of lipomatous tumors. Eighteen cases of WDLPS and 19 cases of lipoma were stained for MDM2 and Ki67 immunohistochemistry. As an addition, in situ hybridization were done in 12 selected cases.Results: Overexpression of MDM2 overexpression was detected in all WDLPS cases and in 3 (16%) of lipoma cases with significance difference (p=0,000), whereas MDM2 amplification was found in all WDLPS and in 1 of lipoma cases (p=0,200). There is a strong correlation between MDM2 overexpression and higher proliferation index (r=0,645, p=0,000).Conclusion: Evaluation of MDM2 overexpression may be used as a useful adjunct to differentiate WDLPS from lipoma and seem to be related with proliferation index."

"Karsinoma serviks uteri merupakan tumor ganas yang sering ditemukan di Indonesia dan pada umumnya penderita datang dalam keadaan ianjut dimana radioterapi merupakan terapi pilih. Penilaian respon radiasi dapat dipelajari secara klinis maupun secara histopatologik. Secara histopatologik, selama ini penilaian dilakukan secara kasar yaiutu dengan melihat ada tidak sel tumor yang viable. Respon radiasi antara lain dipengaruhi oleh tingkat prolifersi sel, penilaiannya dapat dilakukan dengan berbagai metode antara lain dengan metode Ag NOR. AgNOR merupakan Salah satu cam penilaian proliferasi sel dengan cars menghilung nuclear organizer region (NOR).Pada penelitian ini nilai AgNOR digunakan untuk melakukan hubungannya dengan derajat respon radiasi secara hisropomlogik. Penghitungan nilai AfNOR dilakukan dengan 2 cara yaitu (1) rata-rata nilai AgNOR pada nukleus (mAgNOR) dan persentase AgNOR (PAgNOR). Penilaian derajat respon radiasi secara histopalogik dilakukan menurut metode Shimosato yang membuat derajat respon radiasi dari jaringan yang resisten sampai paling sensitif terhadap radiasi dengan gradasi 1A sampai 4C.Hasil dan kesimpulan, dari 20 kasus karsinoma serviks yang diperiksa, didapatkan 2 kasus dengan derajat respon radiasi 1,5 kasus dengan derajat respon radiasi 4B dan 1 kasus dengan derajat respon radiasi 4C. Karena perbandingan kasus yang tidak seimbang, kasus-kasus ini dikemlompokkan lagi menjadi 2 kelompok yaitu: (1) kelompok denga respon radiasi baik (13 kasus) dan (2) kelompok dengan derajat respon radiasi buruk (7 kasus). Walaupun terlihat kecenderungan nilai mAgNOR yang lebih tinggi ppada kasus dengan derajat respon radiasi lebih tinggi, nilai mAgNOR yang tidak berbeda bermakna pada kelompok-kelompok yang diperiksa, kemungkinan disebabkan karena mAgNOR tidak secara sppesifik mewakili fraksi pertumbuhan yang tinggi sehingga tidak langsung terkait dengan radiosensitifitas jaringan.Dari penelitian ini ditemukan nilapAgNOR yang lebih tinggi secara bermakna pada kelompok dengan responn radiasi baik debandinglan dengan kelompok dengan derajat respon radiasi buruk (p=0,05). Hasil ini menunjukkan bahwa nilai pAgNOR lebih spesifik dan ditelti lebih lanjut dengan digabungkan dengan metoda sehic diharapkan dapat dipakai sebagai salah satu cara untuk memprediksi respon radiaso karsinogen serviks uteri.

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Cervical uterine cancer is one of tlte most common malignant tumors in Indonesia, patients usually presented in an advance stage where radiotherapy is a therapy of choice. Evaluation of radiotherapy is done both clinically and histopathologcally. Ust; histopathologic assessment was done roughly bythe presence of viable tumor cells. Radio response is influenced by cell proliferation rate and the assessment can be done with methods. ie. Ag NOR method. AgNOR is one of cell proliferation marker that cour nuclcolar organizer region (NOR).

In this study, AgNOR counts was used to soc corelation with grade ofhistopathological radiation response. AgNOR counts was carried in 2 wajrs: (1) mean of AgNOR counts in the nuclei (mAgNOR0 and (2) percentag AgNOR (PAgNOR). Evaluation of histopathologic radiation response grade was a following Shimosato that made gradation radiation response from radioresistant to alt radiosensitiv tissue in IA to -1C grade.

Result and conclusion, from 20 cases of Cervical cancer studied based on Shimosato method. 2 cases were of grade 1, 5 cases of grade ZA. l case of grade 5, 2 cases of grade 49., 9 cases of grade 4B and 1 of gade 4C . Due to unequal number of cases in each group, it was grouped into 2 groups, good radiation response. which is iound in 13 cases and (2) poor radiation response a cases. Altough there is higher number mAgNOR counts irt group with higher grade radiation response. It was not statistically significant, most likely because in mAgNOR is specitically representing high growth fraction, therefore was not correlated directly with tis radiosonsitivitly. From this study, it was showed that pAgNOR counts was hit significantly in group with good radiation response compared to group with poor radia response (p=0.05).

The result showed that pAgNOR count is more speciiic, therefore it car used in more research combine with another method make this method will used as one method for the prediction of radiation response in cert-?ical uterine carcinoma."

"Tumor ovarium tipe sel benih merupakan tumor tersering pada anak dan remaja putri. Di Indonesia, tumor ovarium merupakan permasalahan yang cukup berarti karena pasien umumnya datang dalam kondisi stadium lanjut akibat tidak adanya metode skrining yang memadai untuk mendeteksi kasus ini secara dini.Tujuan: (1) mengetahui jumlah kasus baru tumor ovarium primer tipe sel benih di Jakarta selama tahun 1997-2006; (2) mengetahui proporsi kasus tumor ovarium primer tipe sel benih dengan tumor genitalia perempuan di Jakarta selama tahun 1997-2006; (3) untuk mengetahui proporsi tumor ovarium primer tipe sel benih terhadap tipe lain tumor ovarium primer selama tahun 1997-2006. (4) untuk mengetahui adanya hubungan antara kelompok usia dengan derajat keganasan tumor ovarium primer tipe sel benih.Metode: Penelitian dilakukan dengan metode potong lintang pada data sekunder kasus tumor ovarium primer di Departemen Patologi Anatomi FKUI/RSUPN-CM tahun 1997-2006 dengan uji Chi-Square (p<0,05).Hasil: jumlah kasus baru tumor ovarium primer tipe sel benih di Jakarta adalah 578 kasus dengan subjek penelitian berasal dari kelompok usia 0-9 tahun hingga 80-89 tahun. Tumor ovarium primer tipe sel benih merupakan 4,79% dari semua tumor genitalia perempuan. Terdapat hubungan yang bermakna (p 0,000) antara kelompok usia dan derajat keganasan tumor ovarium primer tipe sel benih. Tumor sel benih merupakan 25,5% dari semua tumor ovarium primer.Kesimpulan: terdapat hubungan yang bermakna antara usia pasien dengan derajat keganasan tumor ovarium primer tipe sel benih.

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Germ cell ovarian tumour is the most common type of tumour found among children and adolescents in Indonesia. In Indonesia, ovarian tumour has become a major problem since most patients seek medical attention in their late stages because there is no adequate screening method to diagnose ovarian tumour in early stages.Objectives: (1) To analyze the number of most recent diagnosed primary ovarian germ cell tumour's cases in Jakarta in the period of 1997-2006. (2) To analyze the proportion of primary ovarian germ cell tumours within all female's genital tumours. (3) To analyze the proportion of primary ovarian germ cell tumour within all primary ovarian tumours. (4) to know whether there is a relationship between age group and histological grade in primary ovarian germ cell tumours.Methods: based on secondary data from RSCM's Department of Pathology and Anatomy, this research was conducted using cross-sectional method with Chi-Square statistical test (p< 0.05).Result: this research indicates that there were 578 new cases of primary ovarian germ cell tumour, in the RSCM's Department of Pathology and Anatomy for the period of 1997-2006. These cases were distributed among the age group of 0-9 years old until 80-89 years old. The research findings indicates a statistically significant correlation (p<0.000) between the histological grade of primary ovarian germ cell tumour and the patients' age group. Primary ovarian germ cell tumours were found in 4,79% among all the female's genital tumour. Germ cell primary ovarian tumours were 25,5% of all primary ovarian tumours.Conclusion: there is a strong relationship between histological grade of primary ovarian germ cell tumour and the age of patients."