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"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.

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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."

"Latar belakang: Angka ketahanan hidup 5 tahun pasien keganasan ovarium rendah, karena >70% kasus terlambat didiagnosis. Skor Gatot Purwoto merupakan metode prediksi keganasan ovarium pra-bedah. Terdapat rentang yang berbeda cukup jauh antara nilai diagnostik Gatot Purnomo dari beberapa penelitian. Pada aplikasinya penderita tumor ovarium curiga ganas dengan skor prediksi Gatot Purwoto (GP) < 4 (rendah) masih terdapat kecurigaan adanya keganasan ovarium sehingga masih dilakukan prosedur potong beku sebagai alat diagnostik intrabedah.Tujuan: Untuk mengetahui sensitivitas, spesifisitas, nilai duga positif dan nilai duga negatif prosedur potong beku yang dilakukan pada penderita tumor ovarium curiga ganas dengan skor prediksi Gatot Purwoto ≤ 4 dan untuk mengetahui peningkatan nilai diagnostik antara prosedur potong beku dibandingkan dengan skor gatot purwoto pada penderita tumor ovarium curiga ganas dengan skor prediksi Gatot Purwoto ≤ 4Metode: Uji ini adalah uji diagnostik dengan desain potong lintang. Pasien tumor ovarium curiga ganas dengan skor prediksi Gatot Purwoto (GP) < 4 yang dilakukan prosedur potong beku di RSCM selama periode Juli 2008 – Juli 2013 diikutsertakan dalam penelitian ini. Data diambil secara konsekutif dari rekam medik, kemudian dianalisis secara manual dengan menggunakan tabel 2x2 dan rumus parameter diagnostik. Kami menganalisis nilai diagnostik potong beku dibandingkan dengan baku emas yaitu blok parafin. Kemudian kami melihat adakah peningkatan nilai diagnostik prediksi keganasan ovarium jika hanya dilakukan skor GP saja dan jika dilakukan skor GP disertai dengan potong bekuHasil: Dari 160 orang subyek penelitian didapatkan prosedur potong beku memiliki akurasi yang cukup baik dalam mendiagnosis keganasan ovarium yaitu 78,5%. Sensitivitas, spesifisitas, nilai duga positif, nilai duga negatif dan akurasi prosedur potong beku pada penelitian ini berturut turut adalah 84,3%, 92,9%, 75%, 95,9% dan 85,5%. Selain itu prosedur potong beku pada penderita tumor ovarium curiga ganas dengan skor prediksi GP ≤4 secara bermakna memberikan manfaat dalam mendiagnosis keganasan ovarium yaitu meningkatkan nilai diagnostik sebesar 15,9% dibandingkan hanya menggunakan skor GP saja tanpa potong beku.Kesimpulan: Prosedur potong beku memiliki nilai diagnostik yang baik dan masih memberikan manfaat dalam mendiagnosis tumor ovarium curiga ganas dengan skor prediksi GP < 4. Skor prediksi GP memberikan nilai diagnostik yang cukup rendah untuk memprediksi keganasan ovarium, sehingga perlu dilakukan perbaikan sistem penilaian prediksi keganasan ovarium.

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Background: The 5-year survival rate of patients with ovarian cancer is low, because over 70% of cases are diagnosed in a late stage. Gatot Purwoto score is a method to predict ovarian malignancy prior to surgery. There is a variabel range on the diagnostic values of Gatot Purwoto (GP) score from several studies. In its application, patients with GP prediction score < 4 (low) still has a suspicion for ovarian malignancy, therefore frozen section is still performed as an intraoperative diagnostik tool.

Aim: To obtain the sensitivity, specificity, positive predictive value, and negative predictive value of frozen section performed in patients with suspected malignant ovarian tumors with GP score ≤ 4 and to discover the increase of diagnotic value of frozen section compared to GP score in patients with suspected malignant ovarian tumors with GP score ≤ 4.

Methods: This is a diagnostic study with cross sectional design. Patients with suspected malignant ovarian tumors with GP score ≤ 4 who underwent frozen section in RSCM from July 2008 – July 2013 were included in this study. Data were obtained consecutively from medical records, then analyzed manually with 2x2 tables and diagnostik parameter formula. We analyzed frozen section compared to the gold standard (paraffin block). Then we observed if there was an increase of diagnostic value of predicting ovarian malignancy with GP score alone or GP score combined with frozen section.

Result: We obtained 160 subjects. Frozen section had an overall good accuracy in predicting ovarian malignancy (78.5). The sensitivity, specificity, positive predictive value, and negative predictive value of frozen section are 84,3%, 92,9%, 75%, 95,9% and 85,5%, respectively. Frozen section also increased the diagnostic value as much as 15,9% compared to GP score alone without frozen section.

Conclusion: Frozen section had a good diagnostic value and is still useful in diagnosing suspected malignant ovarian tumors with GP score ≤ 4. GP prediction score has a quite low diagnostic value in predicting ovarian malignancy, therefore an improved system to predict ovarian malignancy is needed."

"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.

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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."

"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.

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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."

"Latar belakang: Kanker ovarium yang paling sering terjadi adalah jenis epitel, mayoritas terjadi pada perempuan usia lanjut namun ditemukan 3 - 17 wanita usia muda yaitu kurang dari 40 tahun. Meningkatnya angka survival dari keganasan ovarium maka mempertahankan fertilitas adalah hal yang sangat penting pada pasien usia muda. Prosedur diagnostik yang tepat diperlukan untuk oportunitas fungsi reproduksi pasien kedepannya, yaitu potong beku. Prosedur potong beku dapat mempertajam diagnosis dan penatalaksanaan yang terarah pada neoplasma ovarium suspek ganas dan mencegah terjadinya overprocedure maupun underprocedure. Tujuan : Mengetahui peran prosedur potong beku pada neoplasma ovarium suspek ganas pada usia dibawah 40 tahun di RSUPN dr. Cipto Mangunkusumo. Metode: Penelitian ini bersifat deskriptif dengan studi potong lintang yang dilaksanakan di RSUPN Dr. Cipto Mangunkusumo dengan menggunakan data rekam medik pada pasien neoplasma ovarium suspek ganas usia dibawah 40 tahun yang menjalani pembedahan dengan atau tanpa prosedur potong beku dari tahun 2013 hingga 2018. Hasil: Dari 109 subjek penelitian yang memenuhi kriteria inklusi didapatkan 62 kasus menjalani prosedur potong beku dengan hasil ganas (34,9%), borderline (14,7%) dan jinak (7,3%) sedangkan tanpa prosedur potong beku terdapat 47 kasus. Subjek yang menjalani potong beku didapatkan seluruh prosedur sesuai (100%) dengan kelengkapan prosedur pembedahan konservatif surgical staging, sedangkan tanpa potong beku didapatkan 4,8% outcome dengan hasil overprocedure. Kesimpulan: Tatalaksana konservatif menjadi prioritas utama dalam manajemen neoplasma ovarium suspek ganas usia muda, dengan adanya prosedur potong beku dapat menentukan tatalaksana lebih terarah secara intraoperatif.

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Background: The most common ovarian cancer is the type of epithelium, the majority occur in elderly women but found 3-17 young women that is less than 40 years. The increased survival rate of ovarian neoplasm is to maintain fertility is very important in young patients. Appropriate diagnostic procedures are needed for the future reproductive function of the patient, which is frozen section. Frozen section procedures can diagnose clearly and directed treatment of suspected malignant ovarian neoplasms and prevent overprocedure or underprocedure.

Aim: Knowing the role of frozen section procedures in suspected malignant of ovarian neoplasms under the age of 40 years at RSCM.

Methods: This research is descriptive with a cross sectional study conducted at RSCM using medical record data on patients with suspected of malignant ovarian neoplasms age under 40 years who underwent surgery with or without frozen cut procedures from 2013 to 2018.

Results : 109 study subjects which were taken from the inclusion criteria, 62 cases underwent frozen section procedures with malignant results (34.9%), borderline (14.7%) and benign (7.3%) whereas without procedures frozen section there are 47 cases. Subjects who underwent frozen section obtained all procedures according to (100%) with complete conservative surgical staging procedures, whereas without frozen section obtained 4.8% outcome with overprocedure results.

Conclusions: Conservative management is the main priority in the management of young woman with ovarian neoplasms, with the presence of frozen section procedures can determine management more directed intraoperatively."

"Latar belakang: Kanker ovarium yang paling sering terjadi adalah jenis epitel, mayoritas terjadi pada perempuan usia lanjut namun ditemukan 3-17 wanita usia muda yaitu kurang dari 40 tahun. Meningkatnya angka survival dari keganasan ovarium maka mempertahankan fertilitas adalah hal yang sangat penting pada pasien usia muda. Prosedur diagnostik yang tepat diperlukan untuk oportunitas fungsi reproduksi pasien kedepannya, yaitu potong beku. Prosedur potong beku dapat mempertajam diagnosis dan penatalaksanaan yang terarah pada neoplasma ovarium suspek ganas dan mencegah terjadinya overprocedure maupun underprocedure.Tujuan: Mengetahui peran prosedur potong beku pada neoplasma ovarium suspek ganas pada usia dibawah 40 tahun di RSUPN dr. Cipto MangunkusumoMetode: Penelitian ini bersifat deskriptif dengan studi potong lintang yang dilaksanakan di RSUPN Dr. Cipto Mangunkusumo dengan menggunakan data rekam medik pada pasien neoplasma ovarium suspek ganas usia dibawah 40 tahun yang menjalani pembedahan dengan atau tanpa prosedur potong beku dari tahun 2013 hingga 2018.Hasil: Dari 109 subjek penelitian yang memenuhi kriteria inklusi didapatkan 62 kasus menjalani prosedur potong beku dengan hasil ganas (34,9%), borderline (14,7%) dan jinak (7,3%) sedangkan tanpa prosedur potong beku terdapat 47 kasus. Subjek yang menjalani potong beku didapatkan seluruh prosedur sesuai (100%) dengan kelengkapan prosedur pembedahan konservatif surgical staging, sedangkan tanpa potong beku didapatkan 4,8% outcome dengan hasil overprocedure.Kesimpulan: Tatalaksana konservatif menjadi prioritas utama dalam manajemen neoplasma ovarium suspek ganas usia muda, dengan adanya prosedur potong beku dapat menentukan tatalaksana lebih terarah secara intraoperatif.

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Background: The most common ovarian cancer is the type of epithelium, the majority occur in elderly women but found 3-17 young women that is less than 40 years. The increased survival rate of ovarian neoplasm is to maintain fertility is very important in young patients. Appropriate diagnostic procedures are needed for the future reproductive function of the patient, which is frozen section. Frozen section procedures can diagnose clearly and directed treatment of suspected malignant ovarian neoplasms and prevent overprocedure or underprocedure.

Aim: Knowing the role of frozen section procedures in suspected malignant of ovarian neoplasms under the age of 40 years at RSCM.

Methods: This research is descriptive with a cross sectional study conducted at RSCM using medical record data on patients with suspected of malignant ovarian neoplasms age under 40 years who underwent surgery with or without frozen cut procedures from 2013 to 2018.

Results: 109 study subjects which were taken from the inclusion criteria, 62 cases underwent frozen section procedures with malignant results (34.9%), borderline (14.7%) and benign (7.3%) whereas without procedures frozen section there are 47 cases. Subjects who underwent frozen section obtained all procedures according to (100%) with complete conservative surgical staging procedures, whereas without frozen section obtained 4.8% outcome with overprocedure results.

Conclusions: Conservative management is the main priority in the management of young woman with ovarian neoplasms, with the presence of frozen section procedures can determine management more directed intraoperatively."

"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.

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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."

"Kanker ovarium masih menempati urutan kedua terbanyak dalam keganasan ginekologi dan merupakan penyebab utama kematian akibat kanker pada perempuan. Banyak bukti menunjukkan bahwa kanker ovarium umunya dalam pengaruh stress oksidatif. Dalam penelitian ini bertujuan untuk mengetahui aktivitas stress oksidatif melalui pengukuran enzim Superoxide Dismutase (SOD) dan kadar Malondialdehyde (MDA) pada penderita keganasan ovarium dibandingkan dengan penderita tumor jinak ovarium. Penelitian dilakukan dengan uji potong-lintang yang dilaksanalan di Ruang Rawat Kebidanan Ginekologi RSCM Jakarta, RS Persahabatan Jakarta dan RS Fatmawati Jakarta pada Juli hingga Desember 2018. Seluruh penderita keganasan ovarium dan penderita tumor jinak ovarium yang memenuhi kriteria diikutsertakan dalam penelitian ini. Darah penderita tumor ovarium diambil sebelum dilakukan operasi, lalu sampel dilakukan pengukuran kadar SOD dan MDA. Terdapat 35 penderita keganasan ovarium dan 43 penderita tumor jinak ovarium yang diikutsertakan dalam penelitian ini. Rerata atau median kadar SOD dan MDA pada penderita keganasan ovarium adalah 1,23 (0,24-5,709) dan 0,803 ± 0,316 , sementara rerata atau median kadar SOD dan MDA pada penderita tumor jinak ovarium adalah 0,488 (0,101-1,86) dan 0,634 ± 0,266. Terdapat perbedaan kadar SOD dan MDA yang bermakna antara kedua kelompok. Terdapat perbedaan kadar SOD yang bermakna antara penderita keganasan ovarium stadium awal dengan penderita keganasan ovarium stadium lanjut. Sementara pada pemeriksaan MDA tidak terdapat perbedaan bermakna antara penderita stadium awal dengan stadium lanjut. Kesimpullan pada penelitian ini terdapat perbedaan kadar SOD dan MDA yang bermakna antara penderita keganasan ovarium dengan penderita tumor jinak ovarium.

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Ovarian cancer is the leading cause of death due to gynecological malignancies among women. A lot of evidence shows that ovarian cancer is generally influenced by oxidative stress. In this study aims to determine the activity of SOD enzymes and MDA levels in patients with ovarian malignancies and patients with benign ovarian tumors. The study was conducted by cross-sectional tests carried out in the RSCM Jakarta Gynecology Obstetric Room and Persahabatan Hospital Jakarta and Fatmawati Hospital Jakarta in July to December 2018. All patients with ovarian malignancies and patients with benign ovarian tumors who met the criteria were included in this study. Blood from ovarian tumor patients taken before surgery, then the samples were measured for SOD and MDA levels. There were 35 ovarian malignancies and 43 patients with benign ovarian tumors included in the study. The mean or median level of SOD and MDA in patients with ovarian malignancy is 1.23 (0.24 - 5.709) and 0.803 ± 0.316, while the mean or median level of SOD and MDA in patients with benign ovarian tumors is 0.488 (0.101-1.86) and 0.634 ± 0.266. There were significant differences in SOD and MDA levels between the two groups. There were significant differences in SOD levels between patients with early-stage ovarian malignancies and those with advanced ovarian malignancies. While on MDA examination there were no significant differences between patients with early stages with advanced stages. Conclusion in this study were significant differences in SOD and MDA levels between ovarian malignancies and patients with benign ovarian tumors"

"Latar belakang: Kanker ovarium merupakan penyebab kematian kelima terbanyak karena kanker pada wanita. Diperlukan uji diagnostik preoperatif dan intraoperatif yang tajam dan akurat untuk menurunkan morbiditas dan mortalitas karena kanker ovarium. Tujuan: Mengetahui nilai diagnostik RMI, Skor Purwoto, dan potong beku terhadap pemeriksaan histopatologi pada tumor ovarium suspek ganas. Metode: Penelitian ini menggunakan desain potong lintang (cross-sectional) dari data sekunder yang berasal dari 114 rekam medis pasien suspek keganasan ovarium yang menjalani pembedahan antara bulan Januari 2010 hingga Desember 2010 di RSCM. Hasil: Nilai diagnostik untuk RMI adalah sensitivitas 85%, spesifisitas 63%, NDP 68%, NDN 82%, RKP 2,29, RKN 0,23, akurasi 74%, dan AUC 0,800. Nilai diagnostik untuk Skor Purwoto adalah sensitivitas 80%, spesifisitas 59,3%, NDP 65%, NDN 76%, RKP 1.97, RKN 0,34, akurasi 69%, dan AUC 0,780. Nilai diagnostik untuk potong beku adalah sensitivitas 93%, spesifisitas 98%, NDP 98%, NDN 94%, RKP 54,7, RKN 0,07, akurasi 96%, dan AUC 0,968. Kesimpulan: RMI dan skor Purwoto dapat digunakan untuk evaluasi diagnostik keganasan ovarium praoperatif. Meskipun telah dilakukan evaluasi kemungkinan keganasan praoperatif, tetap diperlukan pemeriksaan potong beku. Hasil evaluasi RMI dan Skor Purwoto jinak dapat ditatalaksana di pusat pelayanan dengan fasilitas yang tidak memerlukan surgical staging. Meskipun hasil evaluasi RMI dan skor Purwoto jinak sebaiknya tetap dilakukan pemeriksaan potong beku untuk menyingkirkan kemungkinan keganasan yang masih belum dapat dibuktikan dengan pasti melalui evaluasi praoperatif.

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Introduction: Ovarian cancer is the fifth leading cause of death from cancer in women. The sharp and accurate preoperative and intraoperative diagnostic tests are needed in reducing morbidity and mortality due to ovarian cancer.

Purpose: This study aims to determine the diagnostic value of RMI, Purwoto Score, and frozen section compared to histopathologic examination in suspected malignant ovarian tumors.

Methods: This study used cross-sectional design of secondary data from the medical records of 114 patients with suspected ovarian malignancy who underwent surgery between January 2010 and December 2010 at Cipto Mangunkusumo Hospital.

Results: The diagnostic value for RMI are sensitivity 85%, specificity 63%, PPV 68%, NPV 82%, positive likelihood ratio 2.29, negative likelihood ratio 0.23, accuracy 74%, and AUC 0,800. Diagnostic value for Purwoto Score are sensitivity 80%, specificity 59.3%, PPV 65%, NPV 76%, positive likelihood ratio 1.97, negative likelihood ratio 0.34, accuracy 69%, and AUC 0.780. Diagnostic value of frozen section are sensitivity 93%, specificity 98%, PPV 98%, NPV 94%, positive likelihood ratio 54.7, negative likelihood ratio 0.07, accuracy 96%, and AUC 0.968.

Conclusion: RMI and Purwoto Score can be used for preoperative diagnostic evaluation of ovarian malignancies. Although it has been performed preoperative evaluation of malignancy, is still required frozen section examination. Benign case of RMI and Purwoto Score can be managed at the service center with facilities that do not require surgical staging and still need to be confirmed with frozen section examination to rule out malignancy that still has not been proven with certainty through preoperative evaluation."

"[ABSTRAKLatar belakang: Interpretasi cairan peritoneum yang tepat secara sitopatologi sangatmempengaruhi tatalaksana dan prognosis pasien, padahal pemeriksaan sitopatologi cairanperitoneum masih memiliki nilai negatif palsu dan positif palsu yang cukup tinggi, danhingga saat ini penelitian tentang arsitektur sitopatologi maupun penanda sitomorfologi yangmengarahkan pada adanya sel neoplasma di cairan peritoneum masih menunjukkan hasilyang beragam.Bahan dan cara kerja: Penelitian potong lintang dengan data sekunder berupa slaiddan formulir sediaan sitopatologi cairan peritoneum yang memiliki data berpasangan dengandiagnosis histopatologi. Diagnosis klinis berupa neoplasma epitelial ovarium. Slaid danformulir diambil dari arsip Departemen Patologi Anatomik FKUI/RSCM tahun 2011 ? 2012,dilakukan pembacaan ulang semua slaid sitopatologi dengan diagnosis akhir dikategorikansebagai positif atau negatif, peneliti membaca pula sediaan histopatologi untuk mengetahuimorfologi sel pada lesi, kemudiaan dilakukan penilaian terhadap arsitektur sitopatologiberupa: 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 dengandiagnosis sitopatologi akhir 34 kasus (72.3%) negatif, 13 kasus (27.7%) positif. Terdapatperbedaan bermakna arsitektur sitopatologi berupa: selularitas (p = 0.017), sel berkelompok(p = 0.001), intercellular windows (p = 0.00), group contours (p = 0.00), dan gambaransitomorfologi 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 cairanperitoneum positif dan negatif. Melalui uji multivariat didapatkan penanda yang palingberpengaruh terhadap diagnosis sitopatologi positif atau negatif yaitu: intercellular windows,atipia inti, dan selularitas.Kesimpulan: Terdapat tiga penanda yang paling berpengaruh terhadap diagnosispositif ditemukannya sel neoplasma ganas dalam cairan peritoneum pada kasus dengan lesiovarium, secara berturut - turut yaitu: tidak ditemukannya intercellular windows padakelompokan sel, sel memiliki atipia inti sedang hingga berat, dan selularitas lebih dari 20kelompok dari keseluruhan sediaan apus.

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ABSTRACTBackground : Peritoneal fluid cytopathology interpretation profoundly influences patientsmanagement and prognosis, however this practice still has high false positive and falsenegative value, and until now research concerning the architectural and cytomorphologyfeatures for detecting malignant cells in peritoneal fluid still has various result.Materials and Methods : Cross sectional study using secondary data of peritoneal fluidcytopathology and histopathology slides and form, from patients with clinical diagnosis ofovarian epithelial neoplasm. The data was taken from the archive of Anatomical PathologyDepartment Cipto Mangunkusumo Hospital 2011 ? 2012. The researchers examined thecytopathology slides and also examined the histopatology slide for morphology comparison,and then make a final cytopathological diagnosis of positive peritoneal fluid containingneoplastic cells or negative. Architectural features including: cellularity, cells grouping,papillary structure, intercellular windows, group contours, psamoma bodies, andcytomorphology 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 weresignificant differences in cytopathology architectural including cellularity (p = 0.017), cellsgrouping (p = 0.001), intercellular windows (p = 0.00), group contours (p = 0.00) andcytomorphology 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 fluidcytopathology. Using multivariate analysis there were 3 cytological features that have thestrongest 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 3cytological features that have the strongest association with finding neoplastic cells inperitoneal fluid, they were: the absent of intercellular windows, moderate to severecytological atypia, and cellularity more than 20 groups in all smear preparation, Background : Peritoneal fluid cytopathology interpretation profoundly influences patientsmanagement and prognosis, however this practice still has high false positive and falsenegative value, and until now research concerning the architectural and cytomorphologyfeatures for detecting malignant cells in peritoneal fluid still has various result.Materials and Methods : Cross sectional study using secondary data of peritoneal fluidcytopathology and histopathology slides and form, from patients with clinical diagnosis ofovarian epithelial neoplasm. The data was taken from the archive of Anatomical PathologyDepartment Cipto Mangunkusumo Hospital 2011 – 2012. The researchers examined thecytopathology slides and also examined the histopatology slide for morphology comparison,and then make a final cytopathological diagnosis of positive peritoneal fluid containingneoplastic cells or negative. Architectural features including: cellularity, cells grouping,papillary structure, intercellular windows, group contours, psamoma bodies, andcytomorphology 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 weresignificant differences in cytopathology architectural including cellularity (p = 0.017), cellsgrouping (p = 0.001), intercellular windows (p = 0.00), group contours (p = 0.00) andcytomorphology 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 fluidcytopathology. Using multivariate analysis there were 3 cytological features that have thestrongest 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 3cytological features that have the strongest association with finding neoplastic cells inperitoneal fluid, they were: the absent of intercellular windows, moderate to severecytological atypia, and cellularity more than 20 groups in all smear preparation]"