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"[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]"

"Kanker ovarium merupakan penyakit ginekologi terbanyak ketiga setelah kanker payudara dan kanker serviks. Kanker ovarium epitelial merupakan tipe paling banyak, dibedakan menjadi low-grade dan high-grade. Faktor kerentanan genetik yang diduga dapat meningkatkan risiko kanker ovarium adalah gen AKNA yang berperan pada respon imun, inflamasi, Epithelial-Mesenchymal Transition (EMT). Penelitian ini bertujuan mengetahui distribusi varian promotor gen AKNA rs10817595 dan ekspresinya tingkat mRNA dan protein pada kanker ovarium epitelial. Sebanyak 63 sampel kanker ovarium dan 65 kontrol digunakan untuk analisis distribusi genotipe dan alel AKNA menggunakan T-ARMS PCR, 35 sampel low-grade, 28 sampel high- grade dianalisis ekspresi mRNA menggunakan qRT-PCR dan dianalisis korelasinya dengan genotipe AKNA. Sebanyak 15 sampel low-grade, 12 sampel high-grade dianalisis level protein AKNA menggunakan imunohistokimia dan dianalisis korelasinya dengan level mRNA AKNA. Hasil penelitian menunjukkan tidak ada perbedaan signifikan frekuensi distribusi genotipe dan alel AKNA, perbedaan signifikan ekspresi mRNA AKNA dan korelasi signifikan ekspresi relatif mRNA AKNA dengan genotipe AKNA, perbedaan signifikan level protein AKNA pada kelompok low-grade, high-grade dibanding kista, tidak ditemukan korelasi signifikan ekspresi relatif mRNA AKNA dengan level protein. Disimpulkan bahwa varian promotor gen AKNA dapat menyebabkan penurunan level mRNA dan protein kelompok low-grade dan high-grade sehingga berpotensi sebagai faktor kerentanan genetik pada kanker ovarium epitelial.

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Ovarian cancer is the third highest gynecological disease after breast and cervical cancer. Epithelial ovarian cancer is common type, divided into low-grade and high- grade. Genetic susceptibility factor that is thought to increase ovarian cancer risk is AKNA gene which plays a role in immune response, inflammation, Epithelial- Mesenchymal Transition (EMT). This study aims to determine the distribution of AKNA (rs10817595) variant gene promotor, its mRNA and protein level in epithelial ovarian cancer. 63 ovarian cancer and 65 controls were used for genotyping using T- ARMS PCR, 35 low-grade and 28 high-grade samples were analyzed for mRNA levels using qRT-PCR and for correlation with AKNA genotype. 15 low-grade and 12 high- grade samples were analyzed for AKNA protein levels using immunohistochemistry and for correlation with AKNA mRNA levels. The results showed that there was no significant difference in AKNA genotypes and alleles, significant differences in mRNA level and significant correlations between mRNA level with AKNA genotypes, significant differences in AKNA protein levels, and no significant correlation of mRNA with protein levels in low-grade, high-grade compared to cyst. Concluded that AKNA gene promotor variant can cause a decrease in mRNA and protein levels in the low-grade and high-grade, it has the potential as one of genetic susceptibility factor for epithelial ovarian cancer."

"Latar Belakang: Kanker ovarium merupakan kanker yang menduduki peringkat kedelapan untuk angka kejadian dan peringkat ketujuh untuk mortalitas pada perempuan di seluruh dunia. Mayoritas pasien akan mengalami rekurensi, terutama pada tiga tahun pertama setelah terapi. Terdapat beragam faktor prognostik klinikopatologis yang mempengaruhi luaran dan rekurensi kanker ovarium, namun hasil penelitian yang telah ada menunjukkan hasil yang tidak konsisten mengenai pengaruh faktor-faktor tersebut.Tujuan: Tujuan penelitian ini adalah mempelajari kejadian rekurensi 3 tahun pasien kanker ovarium epitelial di RSCM dan faktor klinikopatologis yang mempengaruhinya.Metode: Penelitian ini merupakan penelitian kohort retrospektif pada 102 pasien yang menjalani terapi untuk kanker ovarium epitelial di RSCM. Dilakukan pemantauan hingga 3 tahun pasca terapi atau hingga terjadi rekurensi yang didapatkan secara klinis atau radiologis. Dilakukan analisis kesintasan terhadap faktor klinikopatologis yaitu usia, stadium, keberhasilan sitoreduksi, sitologi asites, histopatologi, derajat diferensiasi dan keterlibatan KGB. Faktor yang didapatkan memiliki hubungan bermakna dengan kejadian rekurensi kemudian dianalisis dengan metode regresi Cox.Hasil: Pada penelitian ini didapatkan bahwa rekurensi kanker ovarium epitelial di RSCM pada 1 tahun adalah 17,7%, pada 2 tahun adalah 30,6%, dan pada 3 tahun adalah 36,3%. Median waktu hingga rekurensi adalah 94 minggu. Analisis kesintasan menunjukkan bahwa usia, histopatologi dan derajat diferensiasi tidak memiliki hubungan yang bermakna dengan kejadian rekurensi 3 tahun. Di sisi lain, didapatkan bahwa stadium berdasarkan FIGO, keberhasilan operasi sitoreduksi, sitologi asites dan keterlibatan KGB memiliki hubungan yang bermakna dengan kejadian rekurensi 3 tahun. Setelah dilakukan analisis multivariat, keterlibatan KGB ditemukan sebagai faktor prognostik terhadap kejadian rekurensi 3 tahun pada kanker ovarium epitelial dengan hazard ratio 3,066 (IK 95% 1,186-7,923).Kesimpulan: Angka kejadian rekurensi 3 tahun untuk kanker ovarium epitelial adalah 36,3%. Faktor klinikopatologis yang mempengaruhi rekurensi adalah stadium, keberhasilan operasi sitoreduksi, sitologi asites, dan keterlibatan KGB.

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Background: Ovarian cancer is a cancer that ranks eighth for the incidence and ranks seventh for mortality in women around the world. The majority of patients will experience recurrence, especially in the first three years after therapy. There are a variety of clinopathologic prognostic factors that influence the outcome and recurrence of ovarian cancer, but the results of existing studies show inconsistent results regarding the influence of these factors.

Objective: The purpose of this study was to study the 3-year recurrence rate of epithelial ovarian cancer patients in Cipto Mangunkusumo Hospital and the influencing clinicopathologic factors.

Methods: This study was a retrospective cohort study of 102 patients undergoing treatment for epithelial ovarian cancer in the RSCM. Monitoring is carried out up to 3 years after therapy or until recurrences are obtained clinically or radiologically. Survival analysis of the clinicopathologic factors including age, stage, success of cytoreduction, ascites cytology, histopathology, degree of differentiation and involvement of lymph node was performed. The factors which were found to have a significant relationship with the recurrence event were then analyzed using the Cox regression method.

Results: In this study it was found that the recurrence of epithelial ovarian cancer in the RSCM at 1 year was 17.7%, at 2 years was 30.6%, and at 3 years was 36.3%. The median time to recurrence is 94 weeks. Survival analysis showed that age, histopathology and degree of differentiation did not have a significant relationship with the incidence of recurrence at 3 years. Conversely, it was found that stage based on FIGO, successful cytoreductive surgery, ascites cytology and lymph node involvement had a significant relationship with the incidence of recurrence at 3 years. After multivariate analysis, lymph node involvement was found as a prognostic factor for the incidence of 3-year recurrence in epithelial ovarian cancer with a hazard ratio of 3.066 (95% CI 1.186-7.923).

Conclusion: The 3-year recurrence rate for epithelial ovarian cancer is 36.3%. Clinicopathologic factors that influence recurrence are stage, success of cytoreductive surgery, ascites cytology, and lymph node involvement.

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"Latar belakang: Kanker ovarium menyumbang 152.000 kematian di seluruh duniasetiap tahun. Apendik merupakan organ intraperitoneal yang rentan terhadapmetastasis oleh kanker epitel ovarium. Penentuan keterlibatan apendik merupakansalah satu penentu surgical staging. Surgical staging yang optimal merupakansebuah kunci untuk tatalaksana setelah operasi serta memperoleh prognosis yangbaik, serta peningkatan respon tatalaksana kemoterapi. Oleh karena itu, penelitianini dilakukan untuk melihat keterlibatan apendiks pada pasien-pasien dengankanker epitel ovarium di RSCM yang menjalani pembedahan primer.Tujuan: Mengetahui prevalensi metastasis kanker epitelial ovarium ke apendiksyang dilakukan pembedahan primer di RSCMMetode: Penelitian ini merupakan studi potong lintang menggunakan data rekammedis pasien kanker ovarium epitelial yang menjalani pembedahan primer danapendiktomi pada bulan juli 2009-juli 2019 di RSCM Jakarta yang memenuhikriteria inklusi, dan dilakukan pengambilan data secara acakHasil: Didapatkan 80 subjek penelitian yang memenuhi kriteria inklusi daneksklusi. Dari 80 subjek penelitian, dengan rerata usia 48 tahun. Sebanyak 43subjek (53,8%) sebagai stadium I, 7 subjek (8,8%) sebagai stadium II, 30 subjek(37,5%) stadium III, dan tidak terdapat stadium IV (0%). Dari 80 subjek yangmenjalani apendiktomi, didapatkan 8 subjek (10%) anak sebar ke apendiks, 19subjek (23,8 %) apendisitis kronis, 53 subjek (66,3%) tidak terdapat anak sebar.Dari 8 subjek yang terdapat anak sebar ke apendik dengan temuan histologi 4musinosum, 2 serosum, 2 endometroid. Sebanyak enam dari delapan subjekterdiagnosis pada stadium klinis stadium III dan dua lainnya pada stadium klinissatu. Dua subjek yang terdiagnosis dari stadium klinis satu memiliki temuanhistologi musinosum.Kesimpulan: Terdapat 10 persen pasien kanker epitelial ovarium yang dilakukanpembedahan primer di RSCM memiliki metastasis ke apendiks yang terbagi atasjenis musinosum, serosum, dan endometrioid. Oleh karena itu, apendektomi dapatdipertimbangkan dilakukan pada pembedahan baik stadium awal maupun stadiumlanjut.

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Background: Around 152,000 women were death every year because of ovariancancer. Appendix is an intraperitoneal organ which prone to ovarian epithelialcancer metastasis. Appendix involvement is one of surgical staging scoring.Optimal surgical staging is one of key point to determine post operation treatment,accurate prognosis, and better chemotherapy response. This research was done tosee appendix involvement from primary surgery in ovarian epithelial cancer atRSCMAim: To determine prevalence of metastasis to the appendix from primary surgeryin ovarian epithelial cancer at RSCMMethod: This cross sectional study used ovarian epithelial cancer patient medicalrecord which primary surgery and appendectomy were conducted on July 2009-July 2019 at RSCM. Inclusion and exclusion criteria were counted and consecutiverandom sampling were used.Result: Eighty subjects which were taken from inclusion and exclusion criteria hasaverage age on 48 years old. Out of 80, 43 subjects (53.8%) were defined as stadiumI patient, 7 subjects (8.8%) as stadium II, 30 subjects (37.5%) as stadium III, andnone of them as stadium IV. Appendectomy were done and eight subjects (10%)has metastasis to the appendix. On the other hand, 19 subjects (23.8%) have chronicappendicitis and 53 subjects (66.3%) doesnt have metastasis to the appendix. Fromeight subjects which has appendix involvement, four were defined have mucinoushistology, two serous, and two endometrioid. Six out of eight were diagnosed atclinical stadium III and two were diagnosed at stadium I. These two stadium Isubjects has mucinous histology.Conclusion: There are 10 percent appendix metastases from primary surgery inovarian epithelial cancer at RSCM which consist of mucinous, serous, andendometrioid histological types. Based on this research, appendectomy can beconsidered done on surgery whether in early or late stadium."

"ABSTRAKLatar Belakang: Endoksifen merupakan terapi baru pada pengobatan sel kanker payudara yang responsif terhadap endokrin. Studi terdahulu menunjukkan bahwa paparan endoksifen jangka panjang dapat menyebabkan resistensi melalui mekanisme Epithelial-Mesenchymal Transition (EMT). EMT adalah sebuah proses dimana suatu sel epithelial berubah menjadi sel mesenkimal. Proses EMT ditandai dengan adanya modulasi marker-marker epitelial seperti E-cadherin, vimentin dan TGF-β1. Berbagai penelitian telah menunjukan bahwa paparan singkat kurkumin dapat memperbaiki marker-marker EMT. Namun, kurkumin memiliki keterbatasan karena bioavailabilitasnya yang rendah. Oleh karena itu, pada penelitian ini kami menggunakan nanokurkumin untuk mencegah jalur EMT.Metode: ini merupakan penelitian in vitro menggunakan sel MCF-7. Kami membagi sel menjadi beberapa kelompok yaitu: Endoksifen 1000 nM+β-estradiol 1 nM, Endoksifen 1000 nM+β-estradiol 1 nM + nanokurkumin (8.5 μM dan 17 μM), Endoksifen 1000 nM+β-estradiol 1 nM+kurkumin 17 μM dan DMSO selama 8 minggu. Sel kemudian dipanen dan dihitung setiap minggu. Setelah minggu ke-4 dan ke-8 paparan, ekspresi E-cadherin, TGFβ1 dan vimentin diukur menggunakan two-step qRT PCR. Pada minggu ke-8, kadar protein TGF-β1 diukur dengan ELISA, sementara morfologi sel MCF-7 diamati menggunakan mikroskop konfokal.Hasil: Terdapat peningkatan viabilitas sel pada kelompok Endoksifen 1000 nM+β-estradiol 1 nM. Viabilitas sel menurun secara signifikan pada kelompok nanokurkumin dan kurkumin 17 μM, tetapi tidak pada kelompok nanokurkumin 8.5 μM. Analisis marker EMT pada minggu ke-8 menunjukkan terdapat peningkatan ekspresi mRNA vimentin dan TGF-β1 sementara ekspresi mRNA E-cadherin dan kadar protein TGF-β1 tampak menurun. Hasil menunjukkan bahwa pemberian nanokurkumin pada semua dosis tidak mampu memperbaiki ekspresi vimentin, TGF-β1, dan E-cadherin. Tidak tampak perbedaan yang signifikan antara nanokurkumin dan kurkumin terhadap modulasi marker-marker EMT pada sel kanker payudara yang dipaparkan endoksifen berulang. Pengamatan morfologi menggunakan mikroskop konfokal menunjukkan adanya sel mesenkimal baik pada kelompok endoksifen+β-estradiol maupun kelompok yang mendapat nanokurkumin/kurkumin.Kesimpulan: nanokurkumin tidak mampu mencegah aktivasi EMT walaupun dapat menurunkan viabilitas sel pada penggunaan jangka panjang. Meskipun nanokurkumin lebih terakumulasi di dalam sel. tidak tampak perbedaan potensi dibandingkan dengan kurkumin dalam menurunkan marker EMT.

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ABSTRACT

Background: Endoxifen is a novel therapy in the treatment of endocrine responsive type of breast cancer. Previous study showed that long-term exposure of endoxifen may lead to resistance through the mechanism of Epithelial-Mesenchymal Transition (EMT). EMT is a process where epithelial cells turn into mesenchymal cells. EMT is characterized by the modulation of epithelial markers such as E-cadherin, vimentin and TGF-β. Various studies have shown that short term treatment with curcumin may improve EMT markers. However, the efficacy of curcumin is limited by its low bioavailability. In this study, we use nanocurcumin to prevent the activation of EMT.

Methods: This is an in vitro study in MCF-7. We exposed the cells to several groups, which are: endoxifen 1000nM + β-estradiol 1 nM, endoxifen 1000nM + β-estradiol 1 nM + nanocurcumin (8.5 μM and 17 μM), endoxifen 1000nM + β-estradiol 1 nM + curcumin 17 μM and DMSO, for 8 consecutive weeks. Cells were then harvested and counted weekly. After 4 and 8 weeks of treatments, E-cadherin, TGF-β and vimentin expressions were measured using a two-step qRT PCR. At week 8, protein level of TGF-β1 was measured by ELISA, while MCF-7 cell morphology was observed using confocal microscope.

Results: MCF-7 cell viability was increased in endoxifen + β-estradiol group. Cell viability was significantly decreased in nanocurcumin and curcumin 17 μM, but not in nanocurcumin 8.5 μM group. Analysis of EMT markers at week 8 indicates that there were increase in vimentin and TGF-β mRNA expressions, while E-cadherin mRNA expressions and TGF-β1 protein concentrations were shown to decrease. The results showed that administration of nanocurcumin in all the dose administered were incapable improving the expressions of vimentin, TGF-β1 and E-cadherin. There were no significant differences between nanocurcumin and curcumin on the modulation of EMT?s markers in breast cancer cells exposed to repeated endoxifen and estradiol. Morphological observation using confocal microscope showed the presence of mesenchymal cells both in the endoxifen+β-estradiol group and the group given nanocurcumin/curcumin.

Conclusion: nanocurcumin is incapable to prevent the activation of EMT, although it may reduce cell viability on a long-term use. Although nanocurcumin are more accumulated in the cells, they show no difference in efficacy compared with curcumin in reducing EMT markers."

"Latar Belakang: IBD adalah penyakit gastrointestinal inflamasi kronis yang ditandai dengan sistem kekebalan yang melemah. Ini dibagi menjadi dua jenis utama: penyakit Crohn dan colitis ulserativa. Indonesia memiliki 0,55 per 100,00 UC, 0,33 per 100.000 CD, dan 0,88 per 100.000 pasien IBD. IBD adalah faktor risiko utama kanker kolorektal. Etiologi IBD adalah kombinasi rumit dari genetik, respon imunologi, dan komponen mikroba. Penelitian ini bertujuan untuk mengetahui jumlah TNF-α yang diekspresikan setelah pemberian Lunasin. Metode: Sebanyak 26 ekor mencit webster jantan secara acak dimasukkan ke dalam empat kelompok. Terdiri dari normal, dan dalam tiga kelompok yang diinduksi dengan dekstran natrium sulfat (DSS). Subjek pada kelompok kontrol negatif tidak diberikan Lunasin, sedangkan dosis rendah dan dosis tinggi diberikan Lunasin (masing-masing 12,5 mg/kgBB dan 25 mg/kgBB) selama empat minggu. Pewarnaan imunohistokimia akan digunakan untuk kolon dan akan dilakukan pewarnaan counter dengan pewarnaan Hematoxylin dan eosin (H&E). Bercak kuning kecoklatan akan diperiksa dengan mikroskop dan software “Indomicroview”. Hasilnya akan dianalisis dengan plugin ImageJ “IHC profiler”. Hasil: Penelitian ini menemukan bahwa ekspresi tumor necrosis factor (TNF)-± menurun setelah pemberian Lunasin dengan dosis 12,5 mg/kgBB dan 25 mg/kgBB. Namun 12,5 mg/kgBB dalam penelitian ini lebih signifikan dibandingkan dengan 25 mg/kgBB. Kesimpulan: Studi menunjukkan bahwa, Lunasin dapat menurunkan ekspresi TNF-a pada mencit yang telah dirangsang oleh dekstran natrium sulfat setelah 4 minggu pemberian dosis. Pengujian lebih lanjut dari ekspresi TNF-α dengan cara yang berbeda. Misalnya, tingkat serum TNF-±.

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Introduction: IBD is a chronic, inflammatory gastrointestinal disease characterised by a weakened immune system. It is split into two primary types: Chron's disease and ulcerative colitis. Indonesia has 0.55 per 100.00 UC, 0.33 per 100.000 CD, and 0.88 per 100.000 IBD patients. IBD is a major colorectal cancer risk factor. IBD's aetiology is a complicated combination of genetic, immunological response, and microbial components. This study aims to investigate the amount of TNF-± expressed after the administration of Lunasin. Method: A total of 26 male webster mice were randomly put into four groups. The consist of normal, and in three group that is induced with dextran sodium sulfate (DSS). The subject in the negative control group were not given Lunasin, while the low dose and high dose are given lunasin (12,5 mg/kgBW and 25 mg/kgBW respectively) for four weeks. Immunohistochemical stained will be used for the colon and will be counter stained with Hematoxylin and eosin (H&E) stain. Yellow-brown spot will be investigated with microscope and “Indomicroview” software. The result will be analyzed with ImageJ plugin “IHC profiler”.Results: This study found that the expression of tumor necrosis factor (TNF)-± decreased after the administration of Lunasin with 12.5 mg/kgBW and 25 mg/kgBW. However, 12.5 mg/kgBW (p = 0.022) in this research is more effective in suppressing the TNF-α expression compared to 25 mg/kgBW(p = 0.206), in Tukey Post-Hoc Test. Conclusion: In conclusion, Lunasin can lower the expression of TNF-a in mice that has been stimulated by dextran sodium sulphate after 4 weeks of dosing. Further testing of TNF-α expression in a different way. For instance, serum TNF-± level."

"Latar belakang: Kanker ovarium menyumbang 152.000 kematian di seluruh dunia setiap tahun. Apendik merupakan organ intraperitoneal yang rentan terhadap metastasis oleh kanker epitel ovarium. Penentuan keterlibatan apendik merupakan salah satu penentu surgical staging. Surgical staging yang optimal merupakan sebuah kunci untuk tatalaksana setelah operasi serta memperoleh prognosis yang baik, serta peningkatan respon tatalaksana kemoterapi. Oleh karena itu, penelitian ini dilakukan untuk melihat keterlibatan apendiks pada pasien-pasien dengan kanker epitel ovarium di RSCM yang menjalani pembedahan primer.Tujuan: Mengetahui prevalensi metastasis kanker epitelial ovarium ke apendiks yang dilakukan pembedahan primer di RSCM Metode: Penelitian ini merupakan studi potong lintang menggunakan data rekam medis pasien kanker ovarium epitelial yang menjalani pembedahan primer dan apendiktomi pada bulan juli 2009-juli 2019 di RSCM Jakarta yang memenuhi kriteria inklusi, dan dilakukan pengambilan data secara acakHasil: Didapatkan 80 subjek penelitian yang memenuhi kriteria inklusi dan eksklusi. Dari 80 subjek penelitian, dengan rerata usia 48 tahun. Sebanyak 43 subjek (53,8%) sebagai stadium I, 7 subjek (8,8%) sebagai stadium II, 30 subjek (37,5%) stadium III, dan tidak terdapat stadium IV (0%). Dari 80 subjek yang menjalani apendiktomi, didapatkan 8 subjek (10%) anak sebar ke apendiks, 19 subjek (23,8 %) apendisitis kronis, 53 subjek (66,3%) tidak terdapat anak sebar. Dari 8 subjek yang terdapat anak sebar ke apendik dengan temuan histologi 4 musinosum, 2 serosum, 2 endometroid. Sebanyak enam dari delapan subjek terdiagnosis pada stadium klinis stadium III dan dua lainnya pada stadium klinis satu. Dua subjek yang terdiagnosis dari stadium klinis satu memiliki temuan histologi musinosum.Kesimpulan: Terdapat 10 persen pasien kanker epitelial ovarium yang dilakukan pembedahan primer di RSCM memiliki metastasis ke apendiks yang terbagi atas jenis musinosum, serosum, dan endometrioid. Oleh karena itu, apendektomi dapat dipertimbangkan dilakukan pada pembedahan baik stadium awal maupun stadium lanjut.

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Background: Around 152,000 women were death every year because of ovarian cancer. Appendix is an intraperitoneal organ which prone to ovarian epithelial cancer metastasis. Appendix involvement is one of surgical staging scoring. Optimal surgical staging is one of key point to determine post operation treatment, accurate prognosis, and better chemotherapy response. This research was done to see appendix involvement from primary surgery in ovarian epithelial cancer at RSCM Aim: To determine prevalence of metastasis to the appendix from primary surgery in ovarian epithelial cancer at RSCM Method: This cross sectional study used ovarian epithelial cancer patient medical record which primary surgery and appendectomy were conducted on July 2009-July 2019 at RSCM. Inclusion and exclusion criteria were counted and consecutive random sampling were used. Result: Eighty subjects which were taken from inclusion and exclusion criteria has average age on 48 years old. Out of 80, 43 subjects (53.8%) were defined as stadium I patient, 7 subjects (8.8%) as stadium II, 30 subjects (37.5%) as stadium III, and none of them as stadium IV. Appendectomy were done and eight subjects (10%) has metastasis to the appendix. On the other hand, 19 subjects (23.8%) have chronic appendicitis and 53 subjects (66.3%) doesn't have metastasis to the appendix. From eight subjects which has appendix involvement, four were defined have mucinous histology, two serous, and two endometrioid. Six out of eight were diagnosed at clinical stadium III and two were diagnosed at stadium I. These two stadium I subjects has mucinous histology. Conclusion: There are 10 percent appendix metastases from primary surgery in ovarian epithelial cancer at RSCM which consist of mucinous, serous, and endometrioid histological types. Based on this research, appendectomy can be considered done on surgery whether in early or late stadium."

"Latar Belakang: IBD saat ini merupakan epidemi global. Prevalensi IBD di Indonesia adalah 1,16% hingga 26,5%. Mucin-1 melindungi permukaan epitel usus besar. Namun inflamasi menyebabkan terjadinya overekspresi Mucin-1 dan berkontribusi pada progresi kanker. Lunasin dari kedelai telah terbukti dapat mengurangi inflamasi. Penelitian ini bertujuan untuk menentukan apakah Lunasin dapat menurunkan kadar Mucin-1. Metode: Hewan coba yang digunakan adalah mencit Swiss Webster, jantan, usia 12 minggu, BB 25 g yang dibagi dalam 4 kelompok yaitu Normal, Negatif (Terinduksi DSS 2%), Kelompok Perlakuan 1 dan 2 merupakan kelompok yang diinduksi DSS dan diberi terapi Lunasin 12,5 mg atau 25 mg/hari. Setelah 6 minggu perlakuan, mencit dimatikan dan jaringan usus besarnya diambil. Pewarnaan imunohistokimia akan memberikan coklat kekuningan untuk Mucin-1. Kemudian pewarnaan ini akan difoto menggunakan mikroskop cahaya dan program Indomikromme. Setelah itu, kadar Mucin-1 akan dianalisis menggunakan plugin profiler IHC ImageJ. ‘ Hasil: Uji ANOVA p<0,05. Tes post hoc kelompok normal dengan tiga kelompok lainnya nilai p<0.05. Kelompok kontrol negatif dengan kelompok perlakuan 1 menunjukkan nilai p=0.168 dibanding pada kelompok perlakuan 2 dengan nilai p=0.045. Kelompok perlakuan 1 dan 2 memperlihatkan nilai p=0.872. Kesimpulan: Lunasin dosis menurunkan konsentrasi dan kuantitas Mucin-1 pada sel epitel kolon Crypts of Lieberkühn , namun tidak terlalu berpengaruh pada dosis yang diberikan.

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Background: IBD is a global epidemic. Indonesia has a 1.16-26% IBD prevalence. IBD can cause colorectal cancer. Mucin-1 protects the large intestine epithelium. However, inflammation overexpresses Mucin-1, which promotes malignancy. Soybean rich-lunasin decreases colitis. This study measures Mucin-1 levels to see if Lunasin reduces colon Mucin-1. Methods: Swiss Webster mice, 12 weeks old, 25 g, were utilised as experimental animals and separated into four groups: Normal, Negative (2 % DSS-induced), Treatment Groups 1 and 2, induced by DSS and administered Lunasin, 12.5 mg or 25 mg/day respectively. The lege artist method uses mice with large intestinal tissue on glass slides. Mucin-1 positive, H&E-stained slides are yellowish-brown. Next, we will photograph the staining with a light microscope and Indomicromme. Next, the IHC ImageJ plugin profiler will check Mucin-1 levels. Result: This study used unpaired numerical comparison. Normality, ANOVA, and post hoc tests were used on the four groups. Shapiro-Wilk normality test p>0.05. P<0.05 in ANOVA. The post hoc test compared the standard group to the other three groups with a p<0.05. The negative group's p-value for treatment group 1 was 0.168, whereas group 2's was 0.045. p=0.872 for treatment groups 1 and 2. Conclusion: Lunasin dose lowered Mucin-1 expression in Crypts of Lieberkühn colonic epithelial cells but did not significantly affect the dose."

"Latar belakang: Malaria masih menjadi masalah kesehatan dunia dan masih menjadi penyakit endemik di Indonesia. Selain mortalitas yang masih tinggi, resistensi obat juga menjadi masalah yang semakin memburuk. Sambiloto (Andrographis paniculata) dan spirulina (Spirulina platensis) merupakan dua bahan antimalaria potensial. Sambiloto dan spirulina juga memiliki khasiat sebagai antioksidan dan antiinflamasi yang mampu menekan morbiditas akibat inflamasi sistemik malaria, termasuk proliferasi di kolon. Penyelidikan lebih lanjut dengan menggunakan biomarka spesifik diperlukan untuk meningkatkan pemahaman mengenai aktivitas kedua bahan potensial ini. Tujuan penelitian ini untuk mengetahui hubungan pemberian ekstrak sambiloto dan spirulina terhadap ekspresi protein Ki-67 pada sel epitel kolon media mencit terinfeksi Plasmodium berghei. Metode: Sampel kolon media diperoleh dari 30 ekor mencit Swiss-Webster jantan terinfeksi P. berghei yang dibagi dalam lima kelompok uji yaitu kelompok kontrol negatif (CMC), kelompok kontrol positif (DHP), kelompok ekstrak sambiloto (AP), kelompok kombinasi ekstrak sambiloto dengan ekstrak spirulina (AP+ES) dan dengan spirulina serbuk (AP+PS). Organ kolon kemudian diproses dengan imunohistokimia untuk mendeteksi Ki-67. Ekspresi protein dinilai berdasarkan H- score menggunakan aplikasi ImageJ®.Hasil: Ditemukan perbedaan ekspresi Ki-67 di antara kelima kelompok uji (p=0,001). Rerata H-score ekspresi Ki-67 pada kelompok CMC adalah 135,503 ± 6,723. Ekspresi terendah berada pada kelompok AP+PS dengan rerata H-score 110,941 ± 7,079. Pemberian ekstrak sambiloto saja tidak memberikan hasil yang signifikan dibanding kelompok CMC (p=0,514), begitu pula dengan kelompok AP+ES (p=0,234).Simpulan: Pemberian kombinasi ekstrak sambiloto dan spirulina serbuk mampu menurunkan ekspresi Ki-67 pada sel epitel kolon media mencit terinfeksi P. berghei.

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Background: Malaria remains a global health concern and an endemic disease in Indonesia. Aside from the high mortality rate, drug resistance has become a bigger problem. Creat (Andrographis paniculata) and spirulina (Spirulina platensis) are two potential antimalarial agents. Creat and spirulina also act as antioxidants and antiinflammatories that can suppress morbidities during chronic inflammation in the setting of malaria, such as proliferation in colon. Further investigation using specific biomarker is necessary to enhance the understanding of these ingredients’ effectivity. The aim of this study is to investigate the effects of creat extract and spirulina administration on Ki-67 protein expression in medial colon epithelial cells of Plasmodium berghei-infected mice.

Methods: Thirty P. berghei-infected male Swiss-Webster mice were distributed into five experimental groups. The five groups were negative controls (CMC), positive controls (DHP), creat extract alone (AP), creat extract in combination with spirulina extract (AP+ES), and with spirulina powder (AP+PS). Medial colon tissues were processed with immunohistochemistry to detect Ki-67. Expression level was measured by H-score using ImageJ®.

Results: Difference of Ki-67 expression was observed among the 5 groups (p<0,01). The mean H-score for the CMC control group is 135,503 ± 6,723. Lowest level of Ki-67 expression was observed in the AP+PS group (H-score = 110,941 ± 7,079). Administration of creat extract alone didn’t show a significant difference from the CMC group (p=0,514) and neither is the AP+ES group (p=0,234).

Conclusion: Administration of creat extract and spirulina powder lowers Ki-67 expression in medial colon epithelial cells of Plasmodium berghei-infected mice."

"Kanker payudara masih menjadi jenis kanker yang paling umum terjadi di dunia. Kanker payudara merupakan penyakit kompleks yang disebabkan oleh berbagai faktor. Pemeriksaan histopatologi dapat memberikan informasi penting mengenai fenotipe, yaitu karakteristik fisik atau morfologi dari jaringan yang diperiksa. Pemeriksaan genotipe juga dapat dilakukan untuk mengidentifikasi varian gen pada mutasi gen tertentu, yang dapat memberikan informasi tentang faktor risiko genetik seseorang terhadap penyakit tertentu dan respons terhadap terapi target yang ditujukan pada mutasi gen tertentu. Penelitian ini bertujuan untuk mengidentifikasi mutasi gen penetrasi non-BRCA dan hubungan antara genotipe-fenotipe pada pasien kanker payudara. Pada penelitian ini, pemeriksaan genotipe dilakukan menggunakan metode targeted sequencing. Pada penelitian ini ditemukan sebanyak 18 gen kerentanan dengan varian pathogenic dan likely-pathogenic (P/LP). Kelompok varian gen dibandingkan dengan fenotipe pasien yaitu diantaranya adalah usia, riwayat kanker payudara pada keluarga, status metastasis, subtipe molekuler, dan grade. Kesimpulannya, ditemukan mutasi gen penetrasi non-BRCA diantaranya SMAD4 H427Lfs*9, ATM H1951Pfs*39, PTEN Q219Rfs*2, dan MET K842Sfs*7, mutasi gen penetrasi SMAD4 H427Lfs*9 berhubungan dengan subtipe molekuler luminal B, mutasi gen penetrasi ATM H1951Pfs*39, PTEN Q219Rfs*2, dan MET K842Sfs*7 berhubungan dengan subtipe molekuler TNBC. Pada penelitian ini juga dilakukan homology modelling protein PTEN mutan terhadap protein PTEN wild type dan kaitannya dengan respons terapi target GSK2636771 dan AZD8186.

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Breast cancer is still the most common type of cancer in the world. Breast cancer is a complex disease caused by various factors. Histopathological examination can provide important information regarding the phenotype, namely the physical or morphological characteristics of the tissue being examined. Genotyping tests can also be performed to identify gene variants in certain gene mutations, which can provide information about a person's risk of genetic factors for certain diseases and response to targeted therapy aimed at certain gene mutations. This study aims to identify non-BRCA penetrance gene mutations and the relationship between genotypes in breast cancer patients. In this study, genotype examination was carried out using the targeted sequencing method. In this study, 18 susceptibility genes with pathogenic and likely-pathogenic (P/LP) variants were found. Gene variant groups were compared with the patient's phenotype, including age, family history of breast cancer, metastatic status, molecular subtype, and grade. In conclusion, non-BRCA penetrance gene mutations were found, including SMAD4 H427Lfs*9, ATM H1951Pfs*39, PTEN Q219Rfs*2, and MET K842Sfs*7. SMAD4 H427Lfs*9 penetrance gene mutation is associated with luminal molecular subtype B, ATM H1951Pfs penetrance gene mutation *39, PTEN Q219Rfs*2, and MET K842Sfs*7 are associated with TNBC molecular subtypes. In this study, homology modeling was also performed on wild type PTEN protein with mutant PTEN protein and its relation to the response to targeted therapy of GSK2636771 and AZD8186."