Hasil Pencarian  ::  Simpan CSV :: Kembali

"[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.

---

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]"

"Latar belakang: Interpretasi cairan peritoneum yang tepat secara sitopatologi sangat mempengaruhi tatalaksana dan prognosis pasien, padahal pemeriksaan sitopatologi cairan peritoneum masih memiliki nilai negatif palsu dan positif palsu yang cukup tinggi, dan hingga saat ini penelitian tentang arsitektur sitopatologi maupun penanda sitomorfologi yang mengarahkan pada adanya sel neoplasma di cairan peritoneum masih menunjukkan hasil yang beragam. Bahan dan cara kerja: Penelitian potong lintang dengan data sekunder berupa slaid dan formulir sediaan sitopatologi cairan peritoneum yang memiliki data berpasangan dengan diagnosis histopatologi. Diagnosis klinis berupa neoplasma epitelial ovarium. Slaid dan formulir diambil dari arsip Departemen Patologi Anatomik FKUI/RSCM tahun 2011 - 2012, dilakukan pembacaan ulang semua slaid sitopatologi dengan diagnosis akhir dikategorikan sebagai positif atau negatif, peneliti membaca pula sediaan histopatologi untuk mengetahui morfologi sel pada lesi, kemudiaan dilakukan penilaian terhadap arsitektur sitopatologi berupa: selularitas, sel berkelompok, struktur papiler, intercelular windows, group contours, jisim psamoma, dan penanda sitomorfologi berupa: atipia inti, inti bertumpuk, anak inti, rasio inti:sitoplasma, ukuran inti, dan ukuran sel.Hasil penelitian: Sampel penelitian sejumlah 47 sediaan sitopatologi dengan diagnosis sitopatologi akhir 34 kasus (72.3%) negatif, 13 kasus (27.7%) positif. Terdapat perbedaan bermakna arsitektur sitopatologi berupa: selularitas (p = 0.017), sel berkelompok (p = 0.001), intercellular windows (p = 0.00), group contours (p = 0.00), dan gambaran sitomorfologi berupa: atipia inti (p = 0.00), inti bertumpuk (p = 0.001), anak inti (p = 0.001), rasio inti:sitoplasma (p = 0.00), ukuran inti (p = 0.00), ukuran sel (p = 0.00) antara cairan peritoneum positif dan negatif. Melalui uji multivariat didapatkan penanda yang paling berpengaruh terhadap diagnosis sitopatologi positif atau negatif yaitu: intercellular windows, atipia inti, dan selularitas.Kesimpulan: Terdapat tiga penanda yang paling berpengaruh terhadap diagnosis positif ditemukannya sel neoplasma ganas dalam cairan peritoneum pada kasus dengan lesi ovarium, secara berturut - turut yaitu: tidak ditemukannya intercellular windows pada kelompokan sel, sel memiliki atipia inti sedang hingga berat, dan selularitas lebih dari 20 kelompok dari keseluruhan sediaan apus.

---

Background : Peritoneal fluid cytopathology interpretation profoundly influences patients management and prognosis, however this practice still has high false positive and false negative value, and until now research concerning the architectural and cytomorphology features for detecting malignant cells in peritoneal fluid still has various result.Materials and Methods : Cross sectional study using secondary data of peritoneal fluid cytopathology and histopathology slides and form, from patients with clinical diagnosis of ovarian epithelial neoplasm. The data was taken from the archive of Anatomical Pathology Department Cipto Mangunkusumo Hospital 2011 - 2012. The researchers examined the cytopathology slides and also examined the histopatology slide for morphology comparison, and then make a final cytopathological diagnosis of positive peritoneal fluid containing neoplastic cells or negative. Architectural features including: cellularity, cells grouping, papillary structure, intercellular windows, group contours, psamoma bodies, and cytomorphology features including: nuclear atypia, overlapping nuclei, nucleoli, nuclei : cytoplasm ratio, the dimension of the nuclei and cells were also examined.Result : There were 47 samples with final cytopathology diagnosis: 34 cases (72.3%) negative for neoplastic cells in the peritoneal fluid and 13 cases (27.7%) positive. There were significant differences in cytopathology architectural including cellularity (p = 0.017), cells grouping (p = 0.001), intercellular windows (p = 0.00), group contours (p = 0.00) and cytomorphology features including nuclear atypia (p = 0.00), overlapping nuclei (p = 0.001), nucleoli (p =0.001), nuclei : cytoplasm ratio (p = 0.00), the dimension of nuclei (p = 0.00), the dimension of cell (p = 0.00) between the positive and negative peritoneal fluid cytopathology. Using multivariate analysis there were 3 cytological features that have the strongest association with positive or negative peritoneal cytopathology diagnosis, they were: intercellular windows, nuclear atypia, and cellularity.Conclusion: In peritoneal fluid cytopathology for examining ovarian lesion there were 3 cytological features that have the strongest association with finding neoplastic cells in peritoneal fluid, they were: the absent of intercellular windows, moderate to severe cytological atypia, and cellularity more than 20 groups in all smear preparation."

"Tujuan: Mengetahui bahwa indeks morfometrik USG merupakan metode yang baik dalam mendiagnosis keganasan ovarium tipe epitelial. Metode: Penelitian ini merupakan penelitian uji diagnostik yang dilakukan di Rumah Sakit Cipto Mangunkusumo dengan mengambil data retrospektif dari Januari 2016 hingga Desember 2017. Pasien poliklinik rawat jalan ginekologi dengan kecurigaan memiliki neoplasma ovarium kistik direkrut. Standar baku emas adalah temuan histologi dari massa adneksa yang dioperasi. Karakteristik gambaran pola morfometrik ultrasonografi meliputi bilateralitas, jumlah lokus, regularitas dinding dalam (inner wall), tonjolan papiler (papillary projection), bagian padat (solid part), asites, dan doppler blood flow.  Analisis ROC dilakukan untuk menentukan seberapa baik model ini digunakan sebagai metode diagnostik keganasan ovarium tipe epitelial. Analisis statistik dihitung, untuk mendapatkan nilai akurasi, sensitivitas, spesifisitas, nilai prediksi positif dan nilai prediksi negatif. Hasil: Penelitian ini melibatkan 178 pasien, sebanyak 101 kasus (56.74%) adalah k asusjinak dan 77 kasus (43.25%) adalah kasus ganas. Pola karakteristik USG, papillary projection (p-value = 0.000), solid part (p-value = 0.000), inner wall (p-value = 0.000), asites (p-value = 0.000) dan Doppler blood flow (p-value = 0.000) subjek penelitian memiliki hubungan yang bermakna dengan kejadian keganasan ovarium. Pola morfologi papillary projection memiliki nilai sensitifitas yang paling tinggi (83%), kemudian adanya asites (82%), dan iregularitas dinding (81%). Untuk kategori spesifisitas, didapatkan adanya bagian padat (solid part) memiliki nilai spesifisitas yang paling tinggi (93%).Analisis regresi multinomial digunakan untuk menilai gabungan pola karateristik yang bermakna untuk diagnostik keganasan ovarium tipe epitelial dengan AUC 89.40% (95%CI 84.70%-94.00%), Model ini akurat  secara statistik (p <0,05). Kesimpulan: Indeks morfometrik USG merupakan salah satu metode yang baik dalam memprediksi keganasan ovarium.

---

Objective: To know whether the ultrasound morphometric index is a good method to diagnose epithelial ovarian malignancy.

Materials and methods: This study is a diagnostic test conducted at Cipto Mangunkusumo Hospital, Jakarta, Indonesia. All data were taken retrospectively from January 2016 to December 2017. Gynecological outpatient polyclinic patients with suspicion of having cystic ovarian neoplasms were recruited. Characteristics of ultrasound morphometric patterns include bilaterality, number of loci, inner wall regularity, papillary projection, solid part, ascites, and doppler blood flow.

Results: The study involved 178 patients, 101 cases (56.74%) were malignant and 77 cases (43.25%) were malignant cases. The characteristics of ultrasound, papillary projection, solid part, inner wall, ascites and Doppler blood flow patterns of the study subjects had a significant relationship with the incidence of ovarian malignancy. Multinomial regression analysis was used to assess the combined characteristic patterns for the diagnostic epithelial type ovarian malignancy with AUC 89.40% (95% CI 84.70% -94.00%), this model was statistically accurate (p <0.05).

Conclusion: Morphometric index of ultrasound is a good methods in predicting epithelial ovarian malignancy "

"Metode : Penelitian ini merupakan penelitian uji diagnostik dengan menggunakan metode potong lintang. Pengambilan sampel dilakukan secara konsekutif. Penelitian dilakukan di Poliklinik Obstetri dan Ginekologi RSCM Jakarta pada 31 Januari 2015 hingga 31 Januari 2020. Sebanyak 183 pasien wanita dengan kecurigaan neoplasma ovarium padat diikutsertakan dalam penelitian. Pasien dengan penyakit sistemik lainnya atau mengalami kehamilan dieksklusi dari penetlitian. Dilakukan uji kesesuaian dengan menggunakan uji Kappa. Didapatkan sensitivitas dan spesifisitas dari masing-masing penanda tumorHasil : AFP memiliki sensitivitas 1,92% dan spesifisitas 77,1% sebagai penanda disgerminoma. LDH memiliki sensitivitas 55,67% dan spesifisitas 65,65% sebagai penanda disgerminoma.. AFP memiliki sensitivitas 30,43% dan spesifisitas 85% sebagai penanda teratoma. LDH memiliki sensitivitas 30,43% dan spesifisitas 58,13% sebagai penanda teratoma . AFP memiliki sensitivitas 100% dan spesifisitas 88,89% sebagai penanda Yolk sac tumor. LDH memiliki sensitivitas 41,67% dan spesifisitas 59,65% sebagai penanda Yolk sac tumor. Kombinasi AFP dan LDH memiliki sensitivitas 100% dan spesifisitas 50,29% sebagai penanda Yolk sac tumor. Kombinasi tumor marker AFP dan LDH memiliki nilai sensitivitas yang lebih tinggi namun tidak memiliki akurasi yang lebih baik dibandingkan pemeriksaan menggunakan AFP atau LDH saja.Kesimpulan : AFP dan LDH merupakan penanda tumor yang dapat digunakan untuk deteksi dini maupun skrining pada kasus neoplasma padat ovarium.

---

Background: Ovarian neoplasms are the most common malignancy experienced by women in Indonesia. Solid ovarian neoplasm is a form of ovarian neopalsma that has a low survival rate due to late diagnosis. Early detection using tumor markers is one of the focuses of researches on ovarian neoplasms, one of which includes AFP and LDH.

Objective : To determine the sensitivity and specificity of AFP, LDH, and the combination of the two tumor markers.

Method : This research is a diagnostic test using cross sectional method. Sampling is done consecutively. The study was conducted at the Obstetrics and Gynecology Clinic of RSCM Jakarta from 31 January 2015 to 31 January 2020. A total of 182 female patients with suspicion of solid ovarian neoplasms were included in the study. Patients with other systemic diseases or pregnant were excluded from research. Conformity test was performed using the Kappa test. Sensitivity and specificity of each tumor marker was obtained

Result : AFP has a sensitivity of 1.92% and specificity of 77.1% as a marker of dysgerminoma. LDH has a sensitivity of 55.67% and a specificity of 65.65% as a marker of dysgerminoma. AFP has a sensitivity of 30.43% and a specificity of 85% as a marker of teratoma. LDH has a sensitivity of 30.43% and specificity 58.13% as a marker of teratomas. AFP has 100% sensitivity and 88.89% specificity as a marker of Yolk sac tumor. LDH has a sensitivity of 41.67% and specificity 59.65% as a marker of Yolk sac tumor. The combination of AFP and LDH has a sensitivity of 100% and a specificity of 50.29% as a marker of Yolk sac tumor. The combination of AFP and LDH marker tumors has a higher sensitivity value but does not have better accuracy than examinations using AFP or LDH alone"

"Latar Belakang : Sampai saat ini kanker ovarium masih menjadi salah satu kanker dengan angka mortalitas yang tinggi pada wanita dikarenakan tidak dijumpainya gejala yang khas sehingga lebih banyak kasus terdiagnosis pada stadium lanjut. Belum adanya metode skrining menjadikan pentingnya metode diagnostik yang mempunyai sensitivitas dan spesifisitas yang tinggi. Evaluasi biomarker yang baru diperlukan untuk dapat mendeteksi tumor ovarium ganas pada stadium awal.Objektif : Penelitian ini dilakukan untuk menilai ekspresi Immediate Early Response Gene X-1 (IEX-1) saliva sebagai prediktor keganasan pada tumor ovarium epitelial.Metode : Merupakan penelitian uji diagnostik pada pasien tumor ovarium yang direncanakan operasi elektif dengan mengambil 3-5 ml saliva pasien sebelum tindakan operasi. Subjek penelitian yang memenuhi kriteria inklusi dan eksklusi dibagi menjadi dua kelompok berdasarkan hasil histopatologi yaitu tumor ovarium epitelial jinak dan ganas. Dilakukan pemeriksaan ekspresi IEX-1 saliva dengan metode Real Time qPCR.Hasil : Hasil penelitian ini didapat dari 47 subjek, 22 subjek tumor ovarium epitelial ganas dan 25 subjek merupakan tumor ovarium epitelial jinak. Rerata ekspresi IEX-1 saliva lebih tinggi pada tumor ovarium epitelial jinak (1,976) dibandingkan ganas (0,554) (p<0,001). Didapatkan nilai AUC ekspresi IEX-1 0,949 (IK95% 0,894-1,000), nilai cut off point IEX-1 saliva ≥ 0.9115 dengan sensitivitas 84%, spesifisitas 86,4%, nilai duga positif 82,6% dan nilai duga negatif 87,5%. Terdapat hubungan yang signifikan antara ekspresi IEX-1 saliva dengan kejadian tumor ovarium epitelial ganas (OR 5,031, IK95% 2,039-12,41; p<0,001).Kesimpulan : Terdapat hubungan yang bermakna antara penurunan ekspresi IEX-1 saliva dengan kejadian tumor ovarium epitelial ganas dengan sensitivitas dan spesifisitas yang cukup baik.

---

Backgound: Ovarian cancer is still one of the cancers with a high mortality rate in women because there are no typical symptoms so that more cases are diagnosed at an advanced stage. The absence of a screening method makes the importance of a diagnostic method that has high sensitivity and specificity. Evaluation of new biomarkers is needed to detect malignant ovarian tumors at an early stage.

Objectives: This study was conducted to assess the expression of salivary Immediate Early Response Gene X-1 (IEX-1) as a predictor of malignancy in epithelial ovarian tumors.

Methods: This is a diagnostic test study in ovarian tumor patients who are planned for elective surgery by taking 3-5 ml of patient's saliva before surgery. Research subjects who met the inclusion and exclusion criteria were divided into two groups based on the histopathological results, benign and malignant epithelial ovarian tumors. The salivary IEX-1 expression was examined using the Real Time qPCR method.

Results: The results of this study were obtained from 47 epithelial ovarian tumors subjects, 22 malignant tumors and 27 benign tumors. The mean salivary IEX-1 expression was higher in benign epithelial ovarian tumors (1.976) than in malignant (0.554) (p<0.001). The AUC expression value of IEX-1 was 0.949 (95% CI 0.894-1,000), salivary IEX-1 cut off point value was 0.9115 with sensitivity 84%, specificity 86.4%, positive predictive value 82.6% and negative predictive value 87, 5%. There was a significant relationship between salivary IEX-1 expression and the event of malignant epithelial ovarian tumors (OR 5.031, 95% CI 2.039-12.41; p<0.001).

Conclusions: There is a significant correlation between decreased salivary IEX-1 expression and the event of malignant epithelial ovarian tumors with a good sensitivity and specificity."

"Latar belakang: Kanker ovarium merupakan jenis kanker ke-3 yang paling sering dialami oleh wanita di Indonesia. Diagnosis yang terlambat berperan besar dalam tingginya angka mortalitas. Metode skrining cepat kanker ovarium semakin penting untuk diteliti, dengan beragam biomarker penanda kanker seperti CA-125, HE4, dan FOLR1 yang menawarkan indeks diagnostik dan kemudahan prosedur yang menjanjikan.Metode: Studi deskriptif desain potong lintang ini dilakukan di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, Jakarta pada Januari 2022 hingga Januari 2023. Kadar serum CA-125, HE4, dan FOLR1 dianalisis dari 48 subjek yang terbagi dalam kelompok tumor ovarium ganas dan jinak. Diagnosis pasti tumor merujuk hasil pemeriksaan histopatologis dan pencitraan. Data demografis pasien seperti usia, status menopause, ukuran tumor, hingga hasil analisis sitologi cairan asites dikumpulkan.Hasil: Hasil analisis demografis menunjukkan kecenderungan subjek menopause untuk memiliki tumor ovarium non-maligna (57,6% vs. 26,7%; p < 0,05), dan subjek dengan cairan asites ganas cenderung memiliki tumor ovaium maligna (3,0% vs. 40,0%; p < 0,05). Kadar ketiga biomarker serum meningkat pada kelompok tumor maligna, namun hanya HE4 (median 12,43 vs. 42,03; p < 0,05) yang memiliki perbedaan bermakna (CA-125 median 102,50 vs. 461,85; p = 0,062; FOLR1 median 0,070 vs. 0,172; p=0,213). Area under the curve (AUC) pada hasil analisis kurva receiver operating characteristic (ROC) menunjukkan hasil 0,630, 0,747, dan 0,794 secara berturut-turut untuk biomarker FOLR1, Ca125, dan HE4, dengan analisis beda proporsi signifikan pada titik potong 0,1165 ng/mL (Se 66,7%, Sp 60,6%), 208,00 U/mL (Se 73,3%, Sp 84,8%), dan 19,66 pg/mL (Se 86,7%, Sp 60,6%). Analisis kombinasi biomarker menunjukkan peningkatan sensitifitas namun penurunan spesifisitas.Kesimpulan: Kadar serum ketiga biomarker memiliki kemampuan yang baik sebagai prediktor keganasan tumor ovarium maligna. Pada populasi penelitian, HE4 secara tunggal memiliki indeks diagnostik terbaik, dan kombinasi biomarker tidak memberikan peningkatan kemampuan diagnostik.

---

Background : Ovarian cancer is the third most common cancer in women in Indonesia. Late diagnosis significantly contributes to high mortality rates. Rapid screening methods for ovarian cancer are increasingly important, with biomarkers such as CA-125, HE4, and FOLR1 offering promising diagnostic indices and procedural ease.

Methods: This cross-sectional descriptive study was conducted at Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta from January 2022 to January 2023. Serum levels of CA-125, HE4, and FOLR1 were analyzed in 48 subjects divided into malignant and benign ovarian tumor groups. Tumor type diagnosis was based on histopathological examination and imaging. Patient demographic data including age, menopausal status, tumor size, and cytology analysis of ascitic fluid were collected.

Results: Demographic analysis showed tendencies of menopausal subjects to have non-malignant ovarian tumors (57.6% vs. 26.7%; p < 0.05), and subjects with malignant ascitic fluid were more likely to have malignant ovarian tumors (3.0% vs. 40.0%; p < 0.05). Serum levels of all three biomarkers were higher in the malignant group, but only HE4 (median 12.43 vs. 42.03; p < 0.05) showed significant differences (CA-125 median 102.50 vs. 461.85; p = 0.062; FOLR1 median 0.070 vs. 0.172; p = 0.213). The area under the curve (AUC) for the receiver operating characteristic (ROC) curve analysis showed 0.630, 0.747, and 0.794 for FOLR1, CA-125, and HE4, respectively. Significant cut-off points were 0.1165 ng/mL (Se 66.7%, Sp 60.6%), 208.00 U/mL (Se 73.3%, Sp 84.8%), and 19.66 pg/mL (Se 86.7%, Sp 60.6%). Biomarker combination analysis increased sensitivity but decreased specificity.

Conclusion: Serum levels of the three biomarkers are good predictors of malignancy in ovarian tumors. In this study population, HE4 alone had the best diagnostic index, and combining biomarkers did not enhance diagnostic capability."

"ABSTRAKNama :Nugraha Utama PelupessyProgram Studi :S3 Ilmu KedokteranJudul :Marker Cancer Stem Cells CD133, CD44, dan ALDH1A1 Sebagai Faktor Prognostik pada Kanker Ovarium Tipe Epitelial Kanker ovarium merupakan penyakit yang bersifat heterogen dan kebanyakan pasien datang dengan stadium lanjut. Kanker ovarium epitelial tipe II mempunyai sifat pertumbuhan tumor yang cepat dan secara genetik labil dibandingkan tipe I. Keberadaan cancer stem cells CSC dianggap sebagai salah satu faktor prognostik terjadinya kemoresisten dan kesintasan hidup yang rendah.Penelitian ini bertujuan untuk membuktikan CSC sebagai faktor prognostik dengan menggunakan marker CD133, CD44, dan ALDH1A1 pada kanker ovarium tipe epitelial.Marker CD133, CD44, dan ALDH1A1 diperiksa dengan imunohistokimia dan flowcytometry. Hasil ekspresi marker CSC pasien kanker ovarium tipe I dan tipe II dimasukkan kedalam suatu tabel yang dihubungkan dengan respons kemoterapi dan kesintasan hidup. Analisis data dilakukan dengan program computer STATA 14. Analisis kesintasan dilakukan dengan analisis Kaplan-Meier dan uji asumsi cox proportional hazard. Analisis multivariat dipakai untuk model prognosis selama 10 bulan. Sistem skoring dibuat dengan menggunakan receiver operating characteristic ROC curve analyses.Data demografi kelompok terbanyak adalah usia ge; 45 tahun; 40 sampel 72,7 , stadium I, 23 sampel 41,8 , diferensiasi buruk 30 sampel 54,5 , dan tipe II 16 sampel 29,1 . Perbedaan yang bermakna antara tipe histopatologi dengan marker CSC hanya terlihat pada marker CD44. Skor Prediksi Kemoresisten SPKr 10 bulan yang dihubungkan dengan 4 variabel yaitu usia ge; 45 tahun, tipe II, stadium III minus;IV, dan CD44 tinggi dengan ROC 72,47 dan probabilitas post test 82,5 . Kurva ROC berdasarkan kombinasi marker CSC dan faktor klinikopatologi yaitu stadium III minus;IV, usia ge; 45 tahun, diferensiasi buruk, tipe II, CD133 negatif, CD44 tinggi, dan ALDH1A1 tinggi adalah 0,841. Skor Prediksi Kematian SPKm 10 bulan yang dihubungkan dengan 3 variabel yaitu stadium III minus;IV, tipe II, dan CD44 tinggi dengan AUC 80,44 dan probabilitas post test 78,7 . Kurva ROC berdasarkan kombinasi marker CSC dan faktor klinikopatologi yaitu stadium III minus;IV, usia ge; 45 tahun, diferensiasi buruk, tipe II, CD133 positif, CD44 tinggi, dan ALDH1A1 tinggi adalah 0,841.Simpulan: Marker CD44 terbukti berperan pada kanker ovarium tipe II. Skor Prediksi Kemoresisten dan Skor Prediksi Kematian dapat ditentukan selain dengan faktor klinikopatologi, juga dengan memakai marker CSC. Kata kunci: ALDH1A1, CD44, CD133, CSC, kanker ovarium epitelial, kesintasan hidup, respons kemoterapi.

---

ABSTRACTName : Nugraha Utama PelupessyStudy Program : Doctoral Program Medical SciencesTitle :Cancer Stem Cell CD133, CD44 andALDH1A1 Markers As Prognostic Factors on Epithelial Ovarian Cancer. Ovarian cancer is a heterogeneous disease and most of the patients came with an advanced stage. Epithelial ovarian cancer type II has the characteristic of rapid tumor growth and genetically more labile than that of type I. The presence of cancer stem cells CSC is considered as one of the prognostic factors of low mortality and survival.The aims of this study was to prove CSC as prognostic factors using CD133, CD44, and ALDH1A1 markers on epithelial ovarian cancer.Clinicopathology and demographic data were collected from medical records. CD133, CD44, and ALDH1A1 markers were examined with flowcytometry and immunohistochemistry. CSC marker expression of the patients with ovarian cancer type I and II was connected with chemotherapy and survival response. Data analysis was done by using STATA 14 software. Survival analysis was done by using Kaplan-Meier analysis and Cox proportional hazard test. Multivariate analysis is used for prognosis model for ten months. Receiver Operating Characteristic ROC curve analyses was used as the system scoring. The highest group demographic data were age ge; 45 years; 40 samples 72.7 , stage I, 23 samples 41.8 , poor differentiation 30 samples 54.5 , and type II 16 samples 29.1 . A significant difference between the histopathologic type and the CSC marker was seen only in CD44 marker. Chemoresistance Prediction Score in 10 months was associated with 4 variables ie age ge; 45 years, type II, stage III minus;IV, and CD44 high with ROC 72.47 and posttest probability 82.5 . The highest chemoresitency scoring ROC curve based on the combination of CSC marker and clinicopathology factors; stage III minus;IV, age ge; 45 years, poor differentiation, type II, negative CD133, high CD44, and high ALDH1A1, was 0.841. Mortality Prediction Score in 10 months was associated with 3 variables is stage III minus;IV, type II, and CD44 high with AUC 80.44 and posttest probability 78.7 . The highest mortality scoring ROC curve based on the combination of CSC marker and clinicopathology factors; stage III minus;IV, age ge; 45 years, poor differentiation, type II, positive CD133, high CD44, and high ALDH1A1, was 0.841. Conclusion: The CD44 marker has a role in type II ovarian epithelial cancer. Chemoresistance Prediction Score and Mortality Prediction Score can be determined from clinicopathological factors and using CSC marker. Keywords: ALDH1A1, CD44, CD133, chemotherapy response, CSC, Epithelial Ovarian Cancer, survival"

"Latar belakang: Kanker ovarium khususnya jenis epitelial merupakan salah satu kanker tersering yang diderita oleh perempuan dengan angka mortalitas dan morbiditas yang tinggi. Hingga saat ini, beberapa penelitian telah meneliti berbagai faktor prognostik pada kanker ovarium, khususnya trombosit yang secara patofisiologi memiliki hubungan dengan berbagai marker inflamasi pada kanker. Tujuan: (1) Membuktikan bahwa trombositosis sebagai faktor prognosis pada pasien kanker ovarium jenis epitelial (2) Membuktikan angka OS selama 3 tahun pada pasien kanker ovarium jenis epitelial dengan trombositosis lebih buruk dibandingkan tanpa trombositosis. Metode: Penelitian ini menggunakan studi kohort retrospektif menggunakan data rekam medis pasien kanker ovarium epitelial yang terdaftar pada cancer registry Departemen Obstetri dan Ginekologi Divisi Onkologi Rumah Sakit Cipto Mangunkusumo pada tahun Januari 2014- Juli 2016. Pengamatan dilakukan saat subjek pertama kali didiagnosis kanker ovarium hingga terjadi peristiwa hidup, meninggal, atau hilang dari pengamatan dalam waktu 3 tahun. Hasil: Didapatkan 220 subjek penelitian yang merupakan populasi terjangkau dan memenuhi kriteria inklusi dan eksklusi. Dari 220 subjek penelitian, 132 (60%) dari 220 subjek penelitian merupakan pasien dengan kanker ovarium stadium lanjut (Stadium II/III/IV). Trombositosis didapatkan pada 94 orang subjek penelitian (42,7%). Pasien dengan kanker stadium lanjut memiliki risiko trombositosis yang lebih tinggi dibandingkan subjek pada stadium awal (p=0,005;OR=2,329). Meski begitu, ada atau tidaknya trombositosis secara statistik tidak bermakna pada OS selama 3 tahun (p=0,555). Terdapat mean time survival yang lebih rendah pada pasien dengan trombositosis tetapi tidak ada perbedaan hazard ratio yang bermakna antara subjek dengan atau tanpa trombositosis (p=0,399). Pada penelitian ini, didapatkan faktor prognostik yang bermakna pada OS selama 3 tahun antara lain adalah ada tidaknya asites (HR=3,425; p=0,025), stadium (HR=9,523; p=0,029) dan residu tumor ≥ 1 cm (HR=4,137; p=0,015) dengan stadium kanker ovarium merupakan faktor independen (HR=9,162; p=0,033). Sensitivitas dan spesifisitas trombositosis terhadap kanker ovarium stadium lanjut didapatkan sebesar 50,75% dan 69,32%. Kesimpulan: Trombositosis sebagai faktor prognostik pada pasien kanker ovarium jenis epitelial tidak dapat dibuktikan dan angka OS selama 3 tahun pada pasien dengan trombositosis dibandingkan dengan pasien tanpa trombositosis tidak bermakna secara statistik.

---

Background: Ovarian cancer, especially, epithelial ovarian cancer is one of the most common cancer in women with high rate of mortality and morbidity. Some studies have found that some biological factors that can be used as a prognostic factor for epithelial ovarian cancer, particularly, thrombocytes which pathophysiologically correlates with inflammation markers in cancer. Aim: (1) To determine thrombocytosis as a prognostic factor for epithelial ovarian cancer. (2) To determine that 3-year overall survival in epithelial ovarian cancer with thrombocytosis is significantly shorter than patients without thrombocytosis. Method: This study is a retrospective cohort study using medical record of patients with epithelial ovarian cancer which are registed in the cancer registry of Oncology Division in Obstetric and Gynecology Department, Cipto Mangunkusumo Hospital from January 2014 until July 2016. Datas were collected when subjects were first diagnosed with epithelial ovarian cancer until diseases outcomes (survive, death, or loss to follow up) were identified in 3 years. Result: Out of 220 subjects, 132 (60%) were patients with advanced stage epithelial ovarian cancer (stage II/III/IV). 94 (42,7%) subjects had thrombocytosis. Patients with advanced stage of disease had higher risk of having thrombocytosis than the ones with earlier stage (p=0,005;OR=2,329). Correlation between thrombocytosis and 3-year overall survival was known to be insignificant (p=0,555). There was shorter mean time survival between patients with thrombocytosis and the ones without but the there was no significant difference in hazard ratio between the two groups. In this study, several prognostic factors of epithelial ovarian cancer were identifed such as ascites (HR=3,425; p=0,025), stage of disease (HR=9,523; p=0,029), and post-operative residual tumor ≥ 1 cm (HR=4,137; p=0,015) with stage of disease being the independent prognostic factor (HR=9,162; p=0,033). Sensitivity and specificity of thrombocytosis to advance stage of epithelial ovarian cancer were found to be 50,75% and 69,32%, respectively. Conclusion: Thrombocytosis as a prognostic factor in patients with epithelial ovarian cancer cannot be proven statistically. There is also no significant difference of 3-year overall survival between patients with or without thrombocytosis."

"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.

---

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"

"Endometriosis adalah pertumbuhan jaringan mirip endometrium di luar uterus. Jaringan ini memiliki kemampuan tertanam di berbagai tempat ektopik karena dipengaruhi sistem aktivator plasminogen yang berperan dalam proses fibrinolisis. Pada endometriosis terdapat ekspresi plasminogen activator inhibitor-1 (PAI-1) berlebih yang menyebabkan kurangnya fibrinolisis sehingga menyebabkan terbentuknya produk fibrin terdegradasi yang dapat mempengaruhi penempelan dan perkembangannya. Faktor epigenetik perubahan tingkat metilasi DNA berperan pada patogenesis endometriosis. Penelitian ini bertujuan untuk menilai tingkat metilasi gen PAI-1 dan hubungannya dengan perkembangan jaringan endometriosis ovarium dan peritoneum. Studi potong lintang ini menggunakan 13 sampel wanita endometriosis ovarium, 5 wanita endometriosis peritoneum, dan 8 wanita tanpa endometriosis. DNA dari sampel diisolasi, dilakukan konversi bisulfit, kemudian diamati tingkat metilasi DNAnya dengan metode methylation specific polymerase chain reaction (MSP). Hasilnya dianalisis dengan uji Kruskal-Wallis dan uji Mann-Whitney. Terdapat perbedaan yang signifikan tingkat metilasi DNA gen PAI-1 pada ketiga kelompok sampel (p<0,05). Penelitian ini menemukan perbedaan signifikan antara endometriosis ovarium dan peritoneum dibandingkan dengan kontrol (p=0,006 dan p = 0,003); namun tidak ada perbedaan yang signifikan pada endometriosis peritoneum dibandingkan dengan ovarium (p>0,05). Penelitian kami menunjukkan rendahnya tingkat metilasi gen PAI-1 yang dapat meningkatkan ekspresi gen PAI-1 dan hal ini disugestikan dapat berkontribusi sebagai faktor risiko endometriosis pada ovarium dan peritoneum."