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"Latar belakang: Sinoviosarkoma adalah tumor agresif dan memiliki dua tipe histologi yang sering dijumpai yaitu bifasik dan monofasik. Tumor ini mengalami fusi gen SYT-SSX yang berefek menurunkan ekspresi supresor tumor p53. Prognosisnya berhubungan dengan mitosis dan diameter tumor. Penelitian ini bertujuan mempelajari bagaimana ekspresi p53 dan hubungannya dengan mitosis, diameter tumor, tipe histologi maupun faktor lainnya terkait prognosis sinoviosarkoma.Metode: Dua puluh kasus sinoviosarkoma yang terdiri 4 monofasik dan 16 bifasik di FKUI-RSCM tahun 2005-2011dianalisis kaitan ekspresi p53 dengan mitosis sebagai faktor prognostik. Sediaan hematoksilin-eosin digunakan untuk menghitung mitosis. Sediaan blok parafin digunakan untuk menganalisis ekspresi p53 melalui imunohistokimia dan untuk mengetahui translokasi gen SYT melalui FISH (Fluorescein in situ Hybridization).Hasil: Uji Fisher?s exact menunjukkan ekspresi positif p53 berhubungan dengan diameter tumor <5 cm meskipun tidak berhubungan dengan jumlah mitosis. Tipe histologi sinoviosarkoma tidak berhubungan dengan ekspresi p53 maupun mitosis. Melalui FISH diperoleh hanya 7/19 kasus mengalami translokasi gen SYT.Kesimpulan: Pada sinoviosarkoma ekspresi p53 berhubungan dengan ukuran tumor.

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It has SYT-SSX gene fusion that decreases expression of p53 tumor suppressor. The prognosis is associated with mitosis and tumor diameter. Therefore this study conducted to know the pattern of p53 expresion and its association with mitosis, histological subtype, and other prognosis factors.

Methods: Twenty synovial sarcoma cases consisted of 4 monophasic and 16 biphasic cases from Cipto Mangunkusumo Hospital ? Faculty of Medicine, Universitas Indonesia (CMHospital-FMUI) 2005-2011 were analyzed for association of p53 expression and mitosis as prognostic factor. Haematoxylin-eosin slides were used to count mitosis. Paraffin block materials were used to analyze p53 expression by immunohistochemistry and to detect SYT gene translocation by FISH (Fluorescein in situ Hybridization).

Results: The Fisher?s exact test showed that positive p53 expression was associated with tumor diameter <5 cm although it was not associated with mitosis. The histological subtype has no association with p53 expression and mitosis. Unfortunately, only 7/19 cases were positive for FISH-SYT gene translocation.

Conclusion: In synovial sarcoma, p53 expression is associated with tumor diameter."

"Latar belakang: Tingkat keparahan cedera ginjal iskemia-reperfusi (I/R) berhubungan erat dengan tingginya angka kesakitan dan kematian. Hasil penelitian terdahulu pada manusia dan hewan telah mebuktikan bahwa Neutrophil Gelatinase Associated Lipocalin (NGAL) dapat mendeteksi dan memprediksi terjadinya cedera ginjal I/R dini. Tujuan penelitian ini adalah untuk membuktikan bahwa peningkatan kadar NGAL serum dan urin berhubungan dengan kerusakan epitel tubuli ginjal pada tikus yang mengalami iskemia reperfusi dini.Metode: Peneltian ini menggunakan 28 ekor tikus Sprague-Dawley jantan sebagai hewan model, dikelompokkan dalam 4 kelompok: sham 4 jam (Sham 4), sham 8 jam (Sham 8), iskemia 10 menit reperfusi 4 jam (I/R 4), dan iskemia 10 menit reperfusi 8 jam (I/R 8). Analisis kadar kreatinin serum diperiksa dengan metode Jaffe, sedangkan NGAL serum dan urin menggunakan metode ELISA Direct Sandwich. Evaluasi tingkat kerusakan jaringan ginjal dilakukan secara semi kuantitatif pada sediaan histologi dengan pulasan HE. Deskripsi kelainan tingkat seluler ginjal diperjelas melalui evaluasi menggunakan mikroskop elektron dan Imunohistokimia (IHK).Hasil: Kadar NGAL serum berkorelasi bermakna dengan tingkat kerusakan ginjal (ρSpearman NGAL serum = 0,701, p < 0,001), juga kadar NGAL urin berkorelasi bermakna dengan tingkat kerusakan ginjal (ρSpearman = 0,689, p < 0,001). Tingkat ekspresi NGAL lebih tinggi pada kelompok I/R dibanding sham (t-test, t = -26635,046, p < 0,001), juga tingkat kerusakan ginjal tikus (t-test, t = -5,028, p < 0,001), dan kadar NGAL serum dan urin pada kelompok I/R berbeda nyata dibanding sham (Mann-Whitney, U = 0, p < 0,001). Pada cutoff point 136,95 ng/mL dan 58,69 ng/mL berturut ? turut untuk NGAL serum dan urin diperoleh sensitivitas = 1, spesifisitas = 1.Kesimpulan: Peningkatan kadar NGAL serum dan urin berkorelasi dengan kerusakan epitel tubuli ginjal pada tikus yang mengalami cedera ginjal iskemia reperfusi dini.

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Background: The severity of ischemia-reperfusion (I/R) kidney injury is highly correlated with mortality and morbidity rate. Research on human and animal prove that NGAL predicts kidney injury at early phase. The objective of this study is to prove that the increase in serum and urinary NGAL are correlated with kidney tubular epithelial damage, and this increase has occurred in initiation phase, indicated by rat kidney histopathology in an early I/R model.

Methods: Twenty eight male Sprague-Dawley rats were divided into 4 groups: 4 hour sham (Sham 4), 8 hour sham (Sham 8), 10 minute ischemia 4 hour reperfusion (I/R 4) and 10 minute ischemia 8 hour reperfusion (I/R 8). Blood, urine and kidney samples were collected. Serum creatinine level was analyzed with Jaffe method, while serum and urinary NGAL level were analyzed with direct sandwich ELISA method. Evaluation of kidney damage were measured semi quantitatively in tissue stained with HE. Further evaluation to confirm cellular changes on kidney was performed by electron microscope and immunohistochemistry.

Results: Serum NGAL was found significantly correlated with degree of kidney tissue damage (ρSpearman NGAL serum = 0.701, p < 0.001), also urinary NGAL (ρSpearman = 0.689, p < 0.001). NGAL expression differs significantly between I/R group and sham (t-test, t = -26635.056, p < 0.001), also kidney damage (t-test, t = -5.028, p < 0.001), and serum and urinary NGAL levels (Mann-Whitney, U = 0, p < 0.001). With cutoff points of 136.95 ng/mL and 58.69 ng/mL subsequently for serum and urinary NGAL , it is found that sensitivity = 1, specificity = 1.

Conclusion: Elevation of serum and urinary NGAL are significantly correlated with epithelial tubular kidney damage on rat undergoing early ischaemia reperfusion."

"Latar belakang: Tujuan penelitian ini adalah untuk membandingkan hasil pengobatan antara penggunaan pengobatan konservasi payudara (breast conserving therapy, BCT) dan mastektomi pada pasien kanker payudara T1-2N0.Metode: Penelitian retrospektif ini dilakukan pada pasien kanker payudara T1-2N0 yang menerima pengobatan antara Januari 2001 dan Desember 2010 di Departemen Radioterapi Rumah Sakit Cipto Mangunkusumo dan Jakarta Breast Center. Hasil akhir penelitian ini adalah kesintasan (OS), kekambuhan lokal (LR), kanker payudara kontra lateral (CBC), metastasis jauh (DM), dan disease free survival (DFS).Hasil: Diantara 262 pasien yang memenuhi kriteria, 200 (76,3%) pasien menjalani BCT sedangkan 62 (23,7%) pasien menjalani mastektomi. Tidak ada perbedaan antara kelompok BCT dan mastektomi dalam hal kesintasan 5 tahun (5-year-overall-survival) 5-Y OS (88,2% vs 86,7%, p = 0,743), LR (7,4% vs 2,7%, p = 0,85), CBC (3,4% vs 5,3%, p = 0,906 ), DM (17,7% vs 37,7%, p = 0,212), dan DFS (78,5% vs 60,7%, p = 0,163). Dalam analisis multivariat, grade 3 dikaitkan dengan OS lebih buruk (HR 2,79, 95% CI 1,08-7,21, p = 0,03) dan DFS (HR 2,32, 95% CI 1,06-5,06). Wanita premenopause dikaitkan dengan risiko penurunan DM (HR 0,37, 95% CI 0,17-0,80) dan DFS (HR 0,38, 95% CI 0,19-0,78).Kesimpulan: BCT dan mastektomi menunjukkan hasil yang sama dalam hal OS, LR, CBC, DM, dan DFS.

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Background: This study aimed to compare the treatment outcomes between the use of breast-conserving treatment (BCT) and mastectomy for T1-2N0 breast cancer patients.

Methods: This study retrospectively reviewed T1-2N0 breast cancer patients who received treatment between January 2001 and December 2010 at Department of Radiotherapy Cipto Mangunkusumo Hospital and Jakarta Breast Center. The endpoints of this study were overall survival (OS), local recurrence (LR), contra-lateral breast cancer (CBC), distant metastasis (DM), and disease-free survival (DFS).

Results: Among the 262 eligible patients, 200 (76.3%) patients underwent BCT while 62 (23.7%) patients underwent mastectomy. There were no differences between BCT and mastectomy groups in 5-Y OS (88.2% vs 86.7%, p = 0,743), LR (7.4% vs 2.7%, p = 0.85), CBC (3.4% vs 5.3%, p = 0.906), DM (17.7% vs 37.7%, p = 0.212), and DFS (78.5% vs 60.7%, p = 0.163). In multivariate analysis, grade 3 was associated with worse OS (HR 2.79; 95% CI 1.08 ? 7.21, p = 0.03) and DFS (HR 2.32; 95% CI 1.06 ? 5.06). Premenopausal women were associated with decreased risk of DM (HR 0.37; 95% CI 0.17 ? 0.80) and DFS (HR 0.38; 95% CI 0.19 ? 0.78).

Conclusion: BCT and mastectomy showed similar outcome in terms of OS, LR, CBC, DM, and DFS."

"Tujuan Untuk mengidentifikasi faktor-faktor prediksi dan biomarker dalam perkembangan lesi prakanker leher rahim atau neoplasia serviks intraepitel (CIN).Metode Penelitian dilakukan dari bulan Agustus 2007 hingga September 2008. Desain penelitian adalah kasus-kontrol dengan stratifikasi uji respons dosis. Kasus adalah penderita dengan CIN. Kontrol adalah pasien non CIN. Dilakukan analisis bivariat diikuti dengan analisis multivariat.Hasil Ada 130 pasien, yang terdiri dari 124 pasien yaitu CIN 1, CIN 2 dan CIN 3, dengan jumlah masing-masing 30, 41,33, dan 26 pasien non CIN. Analisis bivariat menunjukkan bahwa umur <41 tahun, pendidikan ≥ 13 tahun, mitra seksual ≥ 2, hubungan HPV DNA positif, ekspresi p16INK4a, Ki-67, MCM5 dan Survivin tinggi merupakan variabel independen untuk terjadinya CIN dengan nilai P <0,05. Namun demikian, hasil analisis multivariat, menunjukkan bahwa variabel independen yang ditemukan adalah umur, pendidikan ≥ 13 tahun, ≥ 2 orang mitra seksual, HPV DNA positif, dan ekspresi berlebih p16INK4a, Ki-67 dan Survivin yang menunjukkan nilai P <0,005. Kesimpulan Usia muda, pendidikan usia ≥ 13 tahun, mitra seksual ≥ 2 orang, HPV DNA positif, ekspresi p16INK4a,Ki-67 dan Survivin tinggi merupakan faktor risiko untuk terjadinya peningkatan CIN, dan digunakan dalam persamaan untuk memprediksi peningkatan lesi prakanker serviks.

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Aim To identify the predictive factors and biomarkers in the progression of cervical precancer lesion or Cervical Intraepithelial Neoplasia (CIN).

Methods The study was conducted from August 2007 to September 2008. Design of the study was case-control with stratifications of test dose response. The cases were patients with CIN. Control patients were non CIN patients. Bivariate analysis followed by multivariate analysis was conducted.

Results There were 130 patients, consisting of 124 CIN patients divided into CIN 1, CIN 2 and CIN 3, with the following numbers of patients: 30, 41, and 33, respectively and 26 patients without CIN (non CIN). Bivariate analysis showed that age < 41 years, education ≥ 13 years, sexual partner ≥ 2, fi rst sexual relationship at age < 22 years, smoking, the presence of sexuallly transmitted infections, positive HPV DNA, high p16INK4a, Ki-67, MCM5 and Survivin expression constituted independent variables for the occurrence of CIN with P value of < 0.05. However, on multivariate analysis, independent variables that emerged were age, education ≥ 13 years, sexual partner ≥ 2 persons, positive HPV DNA, and over expression of p16INK4a, Ki-67 and Survivin that showed a P value of < 0.005. Conclusion Younger ages, education age ≥ 13 years, sexual partner ≥ 2 persons, positive HPV DNA, high p16INK4a,Ki-67 and Survivin expression constituted the risk factors for the occurrence of the progress of CIN, and was used in the equation to predict the progress of cervical precancer lesion."

"Tujuan: untuk menganalisis penanda biologi CXCR4, IL11-RA, TFF1 dan MLF1P, klinikopatologi dan profil ekspresi genetik mRNA sebagai penanda peningkatan kejadian metastasis tulang pada pasien kanker payudara stadium lanjut.Metode: studi ini merupakan penelitian potong lintang. Analisis dilakukan pada total 92 pasien kanker payudara, terdiri atas 46 pasien metastasis tulang dan 46 pasien dengan metastasis nontulang. Analisis imunohistokimia dan microarray, dilakukan pada 81 sampel formalin fixed paraffin embedded (FFPE) dari 81 pasien yang didapat. Data dikumpulkan melalui rekam medis, pemeriksaan imunohistokimia (IHK), dan microarray dengan nanoString nCounterTM.Hasil: artikel ini merupakan bagian satu dari dua tahap pelaporan hasil penelitian. Pada tahap satu diperoleh hasil analisis IHK, IL11-RA dengan cut-off ≥103,5 menunjukkan peningkatan kejadian metastasis tulang, dengan OR 3,803 (95 % interval kepercayaan [IK], 1,375-10,581), p=0,010, dan MLF1P dengan cut-off ≥83,0 menunjukkan peningkatan kejadian metastasis tulang, dengan OR 2,784 (95% IK, 1,009-7,681), p=0,048. Status ER+ menunjukkan peningkatan kejadian metastasis tulang, dengan OR 7,640 (95 % IK, 2,599-22,459), p<0,000. AUC gabungan IL-11RA, MLF1P dan ER+, mempunyai ketepatan hampir 80% (meningkat dibandingkan AUC masing-masing secara terpisah), untuk membedakan dan menjelaskan kejadian metastasis tulang, pada kanker payudara stadium lanjut.Kesimpulan: IL11-RA, MLF1P dan ER+, merupakan determinan peningkatan kejadian metastasis tulang pasien kanker payudara stadium lanjut.

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Aim: to analyze expression of biomarkers CXCR4, IL11-RA, TFF1 and MLF1P, and clinico pathology in advanced breast cancer patients with bone metastatic.Methods: this is a cross-sectional study. Analysis was done against a total of 92 breast cancer patients, including 46 bone metastatic patients and 46 non-bone metastatic patients. Immunohistochemistry and microarray analysis was performed in 81 formalin fixed paraffin embedded (FFPE) samples from 81 patients were used. Data were collected through medical records, immunohistochemistry (IHC), and microarray with nanoString nCounterTM. Results: this article is part one of a two stage reporting research results. In part one we got the results of the IHC analysis, IL11-RA with cut-off ≥103.5 showed OR 3.803 (95 % confidence interval [CI], 1.375-10.581), p=0.010, MLF1P with cut-off ≥83.0 OR 2.784 (95% CI, 1.009-7.681), p=0.048, and ER+ OR 7.640 (95 % CI, 2.599-22.459), p<0.000, were associated with bone metastastic incidences in advanced breast cancer, and were statistically significantly different. A combination of IL-11RA, MLF1P and ER+, showed an accuracy of approaching 80% to discriminate between bone metastatic and non bone metastatic in advanced breast cancer patients.Conclusion: IL11-RA, MLF1P, and ER+ were the determinants that were associated with increasing bone metastasis incidence."