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"ABSTRAKLatar Belakang :Karsinoma kolorektal (KKR) merupakan salah satu kanker tersering di duniadan menjadi beban kesehatan global. KKR dapat muncul melalui 4 jalur patogenenis yangberbeda, salah satu di antaranya adalah serrated pathway. Pengaktifan jalur ini mengakibatkanperubahan progresif lesi-lesi prekursor seperti polip serrated, termasuk di dalamnya sessileserrated adenoma (SSA) dan tradisional serrated adenoma (TSA), menjadi karsinoma,diantaranya adenokarsinoma serrated (AS). AS diduga memberikan prognosis yang burukterhadap pengobatan. Gambaran histomorfologi adenokarsinoma serrated lebih banyakdidasarkan pada kemiripan dengan lesi prekursor SSA atau TSA, sehingga sulit dikenali.Penelitian ini bertujuan mengetahui persentasi AS diantara kasus KKR di Departemen PatologiAnatomik FKUI/RSCM, dan mengetahui gambaran histomorfologi yang bermakna dalammenandakan AS.Bahan dan Metode :Dilakukan review slide dari kasus-kasus KKR yang tercatat di arsipDepartemen Patologi Anatomik FKUI/RSCM. Penilaian histomorfologi dilakukan berdasarkankriteria yang diajukan oleh Tuppurainen et al, meliputi epithelial serration, sitoplasmaeosinofilik, inti vesikuler, anak inti nyata, nekrosis, produksi musin, dan adanya cell balls. Kasusdikategotikan ke dalam ?Pasti? dan ?Samar? AS, serta ?Klasik?. Dilakukan juga penilaian faktorprognostik, berupa invasi limfovaskular, invasi perineural, infiltrasi limfosit, dan tumor budding.Hasil :Didapatkan 41 kasus (35%) tergolong kategori ?Pasti? AS, 11 kasus (9.4%) tergolong?Samar? AS, dan sisanya sebanyak 65 kasus (55.6%) tergolong kategori adenokarsinoma?Klasik?. Didapatkan pula bahwa kriteria histomorfologi yang dapat dijadikan penanda serratedadalah epithelial serration (p=0.029), anak inti nyata (p=0.041), dan nekrosis <10% (p=0.014).Selain itu, didapatkan pula bahwa faktor-faktor yang berhubungan dengan morfologi serratedadalah yaitu lokasi tumor (p=0.010), infiltrasi limfosit (p=0.000), dan tumor budding (p=0.012).Kesimpulan :Adenokarsinoma serrated ditemukan 35% dari kasus-kasus adenokarsinoma kolondi Departemen Patologi Anatomik FKUI/RSCM. Gambaran histomorfologi yang menandakanadenokarsinoma serrated adalah adanya epithelial serration, anak inti nyata, dan nekrosis yangsedikit.Kata Kunci :Adenokarsinoma serrated, serrated pathway, histomorfologi, karsinomakolorektal.

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ABSTRACTBackground: Colorectal carcinoma (CRC) is one of the most common cancers in the world andbecome a global health burden nowadays. CRC may arise through 4 different pathways, one ofwhich is serrated pathway. Activation of this pathway results in progressive changes of precursorlesions such as sessile serrated adenomas (SSA) and traditional serrated adenomas (TSA), intocarcinoma. One type of carcinomais serrated adenocarcinoma (SA), in which known to give apoor prognosis to patient. Histomorphology overview shows that SA has similarity with SSA orTSA, making it difficult to recognize. This study aims to determine the percentage of the SAamong cases of CRC in Department of Anatomical Pathology Faculty of Medicine UniversitasIndonesia/Cipto Mangunkusumo Hospital, and to know histomorphological features that aremeaningful in indicating SA.Materials and Methods: CRC cases were collected from archive, and review slide wasconducted using morphological criteria proposed by Tuppurainen et al. This criteria includesepithelial serration, eosinophilic cytoplasm, vesicular nuclei, prominent nucleolei, necrosis,mucin production, and cell balls. Case were categorized into the "Definite" and "Pausy" SA, aswell as the "Classic". Assessment of prognostic factors, such as limfovascular invasion,perineural invasion, infiltration of lymphocytes and tumor budding, were also conducted.Results: There were 41 cases (35%) belong to the category of "Definite" SA, 11 cases (9.4%)classified as "Pausy? SA, and 65 cases (55.6%) belong to the category of "Classic"adenocarcinoma. Histomorphological analysis found that criteria showing significancy to SAwere epithelial serration (p = 0.029), prominent nucleolei (p = 0.041), and necrosis <10% (p =0.014). Several factors showed relation to serrated morphology were location of the tumor (p =0.010), infiltration of lymphocytes (p = 0.000), and tumor budding (p = 0.012).Conclusion: Serrated adenocarcinoma were found approximately 35% among cases of colorectaladenocarcinoma in the Department of Anatomical Pathology, Faculty of Medicine/CiptoMangunkusumo Hospital. Histomorpoholigical features that indicates SA includesepithelial serration, prominent nucleolei, and scanty necrosis.Keywords: Serrated adenocarcinoma, serrated pathway, histomorphological features, colorectalcarcinoma"

"Laboratorium memiliki potensi bahaya dan risiko yang cukup tinggi karena dalam aktivitas pekerjaannya terkait dengan penggunaan bahan-bahan dan peralatan yang berbahaya. Tidak terkecuali di Laboratorium FKUI yang dalam proses kerjanya sering menggunakan bahan-bahan kimia dan biologi. Terdapat berbagai macam upaya yang dapat dilakukan untuk meminimalisasi risiko K3 di tempat kerja, salah satunya adalah dengan cara memberikan pelatihan K3 guna meningkatkan skill dan pengetahuan para pekerja tentang K3. Sebelum melaksanakan suatu pelatihan maka terlebih dahulu perlu dilakukan analisis kebutuhan pelatihan. Analisis kebutuhan pelatihan terdiri dari tiga tahap analisis, yaitu analisis organisasi, analisis personal dan analisis tugas. Tujuan dari penelitian ini adalah untuk menganalisis kebutuhan pelatihan K3 yang diperlukan oleh para Laboran sehingga pelatihan K3 yang akan diberikan dapat berjalan efektif dan efisien serta dapat menjawab permasalahan terkait K3 di Laboratorium. Desain yang digunakan dalam penelitian ini adalah desain penelitian deskriptif kualitatif. Terdapat 8 informan yang diambil dari 6 Departemen-departemen preklinik FKUI. Metode pengambilan data dilakukan dengan mewawancarai 8 informan, observasi di Laboratorium dan telaah dokumen dari Laboratorium atau Departemen. Hasil dari penelitian ini menunjukkan bahwa organisasi telah mendukung pelaksanaan K3 di Laboratorium meskipun belum secara maksimal dan merata di semua Laboratorium. Terdapat 4 jenis tugas utama Laboran yaitu membantu praktikum mahasiswa, maintenance rutin alat, administrasi dan membantu penelitian Dosen atau Departemen serta sudah dapat menggambarkan jenis pelatihan yang dibutuhkan. Terkait aspek personal didapatkan bahwa pengetahuan dan keterampilan Laboran akan bahaya dan risiko yang ada di Laboratorium sudah cukup baik. Berdasarkan ketiga hal tersebut, pelatihan yang harus segera dilaksanakan adalah Chemical Hazards, Chemical Hygiene Plan, Develop Controls, General Laboratory Safety, Hazardous Materials, Job Safety Analysis, Laboratory Hygiene, Material Safety Data Sheet (MSDS), dan Safe Storage.

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Laboratory has a potential of occupational health and safety (OHS) hazards and risks because of the usage of hazardous materials and dangerous equipments. Laboratories of Faculty of Medicine University of Indonesia (FKUI) for instance use number of chemicals and biological materials and thus reduction of OHS risks is necessary. Training is one method of risk control by improving the OHS skills and the OHS knowledge of the workers. Prior to the training implementation, assessing the need of training is necessary.

Training needs analysis consists of three stages which are organizational, personal and task analysis. The purpose of this study was to analyze the need of OHS training for the Laboratory Assistants in order to have an effective and efficient training programs that can address the OHS related issues in the Laboratory. The research design was descriptive qualitative. There were 8 informants sampled from 6 FKUI preclinical Departments were interviewed . Observation and document analysis were also done to collect data.

The results of this study was shown that the organization has supported the OHS implementation in the Laboratories although not optimally and evenly distributed in all Laboratories. There were 4 Laboratory Assistant main types of tasks that consists of help students practice, routine maintenance tools, administration and assist Departments and Lecturer’s research and was able to describe the type of training required. Related to personal aspects obtained that Laboratory Assistant’s knowledge and skills about hazards and risks in the Laboratories were good enough. Based on those three, the training must be implemented was Chemical Hazards, Chemical Hygiene Plan, Develop Controls, General Laboratory Safety, Hazardous Materials, Job Safety Analysis, Laboratory Hygiene, Material Safety Data Sheet (MSDS) and Safe Storage."