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"ABSTRAK Latar Belakang dan tujuan: Karsinoma pankreas merupakan keganasan gastrointestinal kedua terbanyak dan merupakan salah satu tumor dengan angka kematian tinggi. Operasi reseksi merupakan satu-satunya terapi kuratif. Kegagalan dalam evaluasi preoperatif dari menyebabkan resiko operasi, terlambatnya pasien mendapat terapi paliatif serta meningkatkan biaya pengobatan. Penelitian ini bertujuan untuk mengevaluasi penilaian resektabilitas karsinoma pankreas pada CT-scan abdomen dibandingkan penemuan operasi serta faktor-faktor yang mempengaruhinya. Metode: Dilakukan pembacaan ulang CT scan pasien karsinoma pankreas pada sistem PACS Departemen Radiologi RSCM dan dibandingkan dengan laporan operasi pada rekam medis. Hasil: Uji statistik McNemar dari hubungan CT-scan dan operasi n=21 menunjukan p > 0,99, dengan nilai R = 0,52 p = 0,017 . Uji McNemar dari hubungan kesesuaian gambaran CT-scan abdomen dan penemuan operasi dengan teknik pemeriksaan CT-scan p > 0,05.Uji McNemar hubungan kesesuaian gambaran CT-scan abdomen dan penemuan operasi dengan interval CT-scan dan operasi p > 0,99. Uji McNemar hubungan kesesuaian gambaran CT-scan abdomen dan penemuan operasi dengan lama sakit p > 0,05. Kesimpulan: Terdapat kesesuaian antara gambaran CT-scan abdomen dengan penemuan saat operasi terhadap keterlibatan vaskuler pada karsinoma pankreas. Lama sakit, interval CT-scan dan operasi serta teknik pemeriksaan CT-scan memperlihatkan kecenderungan tidak berhubungan.Kata Kunci: CT-scan abdomen; karsinoma pankreas; laparatomi; resektabilitas ABSTRACT Background and Objective : Pancreatic carcinoma is malignancy in gastrointestinal with high mortality. Surgery is the only curative therapy. Failure evaluation prior to surgery leads to the risk of non-curative surgery, delayed palliative and increased treatment costs. This study aims to evaluate the resectability assessment of pancreatic carcinoma in preoperatif CT-scan compared to surgical findings and the factors that influence it. Methods : Patients with pancreatic carcinoma whose CT scans were in the PACS system of the Radiology Department RSCM reevaluated and compared with surgical reports. Results : McNemar 39;s analysis of the preoperative CT-scan and surgical findings n=21 p>0.99, with R=0.52 p=0.017 . The McNemar analysis conformity relationship between preoperative abdominal CT scan and surgical findings with CT-scan technique p>0.05. McNemar analysis conformity relationship between preoperative abdominal CT-scan and surgical findings with CT-scan interval and surgery p> ?? ??0.99. McNemar analysis conformity relationship between preoperative abdominal CT-scan and surgical findings with prolonged illness p> ?? ??0.05. Conclusion : There is a suitability between preoperative abdominal CT-scan and the surgical findings of vascular involvement in pancreatic carcinoma. Length of prolonged illness, interval between CT-scan and surgery as well as CT-scan technique showed a tendency not to correlate. "

"ABSTRACTPurpose Adenosquamous carcinoma (ASC) of the pancreas is a rare malignancy, associated with a poor prognosis after surgical resection, with reported median survival times (MSTs) ranging from 4.4 to 13.1 months. We conducted this study to investigate the long-term outcomes of patients after the resection for ASC.MethodsBetween 2002 and 2016, a total of 456 patients underwent resection for ASC or adenocarcinoma (AC) of the pancreas. ASC was confirmed in 17 (3.7%) of these patients. We analyzed the clinicopathological characteristics and survival of these 17 patients in comparison with those of patients with AC of the pancreas.ResultsThe operative procedures performed were pancreaticoduodenectomy (n = 6) and distal pancreatectomy (n = 11). Seven (41.2%) of the 17 patients underwent combined organ resection. R0 resection was achieved in 16 (94.1%) patients. The 5-year overall survival (OS) rate and MST were 40.3% and 20.9 months, respectively. A squamous component of ≥ 60% (P = 0.001) and R1 resection (P < 0.001) were significantly associated with poor OS for patients with ASCConclusionThis study revealed longer survival and a higher R0 resection rate after aggressive combined resection in our ASC patients than those in previous studies. Although this was only a small series, our findings suggest that local control with aggressive resection may be an effective treatment protocol for ASC patients."

"Latar Belakang: Kanker pankreas adalah penyebab kematian keempat yang berhubungan dengan keganasan di Amerika Serikat, dan diperkirakan akan menjadi penyebab kematian kedua di tahun 2030 di United Kingdom. Indonesia belum memiliki data kesintasan kanker pankreas dan faktor-faktor yang memengaruhinya.Tujuan: Mengetahui kesintasan 1 tahun kanker pankreas dan faktor- faktor yang memengaruhinya di RS dr. Cipto Mangunkusumo, Jakarta.Metode: Dilakukan penelitian kohort retrospektif menggunakan data dari rekam medis pasien kanker pankreas RS dr. Cipto Mangunkusumo antara Januari 2012 - Desember 2016. Faktor umur, jenis kelamin, metastasis, stadium, komorbid dan pengobatan dianalisis secara bivariat dan multivariat menggunakan Cox Proportional Hazards Regression untuk mendapatkan Hazard Ratio HR setiap faktor prognosis. Kesintasan kumulatif 1 tahun setelah diagnosis dinyatakan dengan kurva Kaplan- Meier.Hasil: Dari 83 subyek penelitian proporsi laki-laki adalah 62.7, usia ge; 50 tahun 68,7, dengan rentang usia 33-79 tahun, dan rata-rata 55 tahun. Pada analisis bivariat didapati hubungan bermakna secara statistik kesintasan dengan variabel komorbid HR 2,116 IK 95 1,335-3,513 p< 0,002, metastasis HR 3,802 IK 95 1,995-7,249 p

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Background Pancreatic cancer is the fourth leading cause of death associated with malignancy in the United States, and is thought to be the second leading cause of death in 2030 in the United Kingdom. Currently, Indonesia has no data on the survival of pancreatic cancer and the factors that affect it. Aim This study aims to know the 1 year survival of pancreatic cancer and its influencing factors. Methods A retrospective cohort study was performed using data from the medical record of pancreatic cancer patients in dr Cipto Mangunkusumo General Hospital, Jakarta, from January 2012 to December 2016. Age, sex, metastasis, stage, comorbidities, and treatment were analyzed bivariate and multivariate using Cox Proportional Hazards Regression to obtain Hazard Ratio HR for each prognostic factor. The 1 year cumulative survival rate after diagnosis is expressed by the Kaplan Meier Curve.Results Of 83 subjects, the proportion of male was 62,7, age ge 50 years 68,7, with age range 33 79 years, and 55 years on average. In bivariate analysis, there was a statistically significant relationship of survival with comorbidities HR 2.116 95 CI 1.335 3.513 p 0.002, metastasis HR 3.802 95 CI 1.995 7.249 p 0.001, palliative treatment HR 2.108 95 CI 1.077 4.125 p 0.029 and group without treatment HR 2.924 95 CI 1.496 5.716 p 0.002. Multivariate analysis showed that metastasis provided the greatest risk of death with HR 4.306 95 CI 2.125 8.724 p 0.001. Palliative group HR was 2.510 95 CI 1.245 5.061 p 0.010 while the group without treatment gave HR 2.535 95 CI 1.277 5.032 p 0.008. Conclusion The overall survival of 1 year of pancreatic cancer patients was 14, with median survival of 6 months. The presence of metastasis and the decision not to do curative therapy Whipple surgery in patients with pancreatic cancer in dr Cipto Mangunkusumo General Hospital are the primary factors that negatively affect the 1 year survival rate. "

"Pendahuluan: Pembedahan merupakan pilihan tatalaksana kuratif terbaik kanker pancreas, oleh karena itu sangat penting untuk dapat menegakkan diagnosis secara akurat sejak awal. Skor BACAP dan CA 19-9 telah diterima sebagai prediktor resektabilitas kanker pancreas yang cukup baik, dan akurasinya diharapkan akan meningkat apabila keduanya dikombinasikan. Studi ini bertujuan untuk mengetahui keluaran yang dihasilkan oleh kombinasi skor BACAP dan penanda tumor CA 19-9.Metode: Penelitian potong lintang retrospektif ini melibatkan pasien kanker pankreas yang telah menjalani operasi di RSUPN Dr. Cipto Mangunkusumo Indonesia pada periode Januari 2017 hingga April 2023. Data diperoleh dari medical record. Pasien dengan penyakit penyerta seperti jaundice karena obstruksi batu bilier, pankreatitis, sirosis hati, kelainan paru dan pasien dengan neoadjuvant akan diekslusi. Nilai  CA 19-9 diperoleh melalui pemeriksaan Chemiluminescent Immunoassay, titik potong 140,6 dipilih berdasarkan penelitian sebelumnya di RSCM. Nilai skor BACAP melibatkan enam variabel klinis dan radiologis dan dapat diperoleh dengan mengaplikasikan kalkulator yang terdapat pada http://jdlp.fr/resectability/.Hasil: Total 87 pasien yang dilibatkan pada penelitian ini didapatkan keluaran skor BACAP yaitu sensitivitas sebesar 50,0%, spesifisitas 100%; PPV 100%; NPV 73,8%, dan akurasi 75,9% (AUC 94,6%). Sementara modifikasi skor BACAP menghasilkan sensitivitas 83,1%, spesifisitas 85,7%, PPV 70,5%, NPV 92,5%, dan akurasi 83,9% (AUC 89,4%).Kesimpulan: Kombinasi CA 19-9 dan skor BACAP menghasilkan skor modifikasi dengan keluaran yang lebih baik dibandingkan skor BACAP dalam memprediksi resektabilitas karsinoma pankreas.

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Background: Surgery remains the best choice curative treatment for pancreatic cancer. Therefore, it is crucial to establish accurate diagnosis from the beginning. BACAP score and CA 19-9 have been identified as good predictors of pancreatic cancer resectability, and their accuracy is expected to increase when combined. This study aimed to determine the outcomes produced by the combination of the BACAP score and CA 19-9 tumor marker

Methods: This was a retrospective cross-sectional study involved 87 pancreatic cancer patients who underwent surgery between January 2017 and April 2023. The research data was obtained from medical records. The presence of other diseases such as biliary stones, strictures, pancreatitis, liver cirrhosis, or other pulmonary abnormalities, and prior neoadjuvant chemotherapy were excluded. The CA 19-9 value was obtained through a blood examination using the Chemiluminescent Immunoassay method. The cut-off point of 140.6 has been selected and determined based on previous studies at RSCM. The BACAP score, comprising 6 variables (Abdominal pain, weight loss, tumor size, thrombosis, tumor location, and performance status), was applied to the entire research sample using the BACAP score calculator available at http://jdlp.fr/resectability/.

Results: A total 87 patients were included. BACAP score yields a sensitivity of 50.0%, specificity of 100%, positive predictive value (PPV) of 100%, negative predictive value (NPV) of 73.8%, and accuracy of 75.9% (AUC 94.6%). While modified BACAP score yielded a sensitivity of 83.1%, specificity of 85.7%, PPV of 70.5%, NPV of 92.5%, and accuracy of 83.9% (AUC 89.4%).

Conclusion: The combination of CA 19-9 and the BACAP score yields a modified score with better outcomes compared to the BACAP score alone in predicting the resectability of pancreatic carcinoma."

"Latar Belakang: Pulau Langerhans adalah kumpulan sel pernghasil insulin yang tersebar di seluruh pankreas. Resistensi insulin adalah salah satu tanda dari diabetes tipe 2, pada pasien diabetes tipe 2 terjadi penurunan pada ukuran dan jumlah dari pulau Langerhans yang berdampak pada produksi insulin dan menyebabkan pasien dengan kondisi ini memiliki kadar gula darah yang tinggi. Alpha-mangostin diduga berperan dalam proses regenerasi pancreas pada kondisi resistensi insulin. Tujuan dari penelitian ini adalah untuk mengetahui efek dari alpha-mangostin terhadap regenerasi pankreas, baik pada kelenjar endokrin (pulau Langerhans) maupun kelenjar eksokrin. Metode: Tikus jantan galur wistar diacak dan dibagi menjadi 6 kelompok berdasarkan perlakuan yang diterima; Kelompok Normal/Kontrol, Kelompok Normal + Alpha Mangostin 200mg/kgBB, Kelompok Resistensi Insulin (Induksi STZ + HF + HG), Kelompok Resistensi Insulin + Alpha Mangostin 100mg/kgBB, Kelompok Resistensi Insulin + Metformin 200mg/kgBB, Kelompok Resistensi Insulin + Alpha Mangostin 200mg/kgBB. Diameter pulau Langerhans dihitung menggunakan aplikasi ImageJ computer software, sedangkan struktur histologi bagian eksokrin diobservasi dibawah mikroskop cahaya. Hasil: Pemberian alpha mangostin menyebabkan peningkatan pada luas area Langerhans islet secara signifikan. Tidak ditemukan pengaruh signifikan pada pemberian alpha mangostin pada kelenjar eksokrin pulau Langerhans. Kesimpulan: Terdapat hubungan bermakna antara pemberian alpha-mangostin dengan regenerasi pulau Langerhans pankreas pada tikus model insulin resisten. Alphamangostin tidak menyebabkan terjadinya perubahan struktur histologi pada bagian eksokrin pancreas.

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Background: The islets of Langerhans are clusters of insulin-producing cells scattered throughout the pancreas. Insulin resistance is one of the signs of type 2 diabetes, in patients with type 2 diabetes there is a decrease in the size and number of the islets of Langerhans which affects insulin production and causes patients with this condition to have high blood sugar levels. Alpha-mangostin is thought to play a role in the process of pancreatic regeneration in conditions of insulin resistance. The purpose of this study was to determine the effect of alpha-mangostin on pancreatic regeneration, both in endocrine glands (island of Langerhans) and exocrine glands.

Method: Wistar male rats were randomized and divided into 6 groups based on the treatment received; Normal/Control Group, Normal Group + Alpha Mangostin 200mg/kgBB, Insulin Resistance Group (STZ Induction + HF + HG), Insulin Resistance Group + Alpha Mangostin 100mg/kgBB, Insulin Resistance Group + Metformin 200mg/kgBB, Insulin Resistance Group + Alpha Mangostin 200mg /kgBB. The diameter of the islets of Langerhans was calculated using the ImageJ computer software application, while the histological structures of the exocrine sections were observed under a light microscope.

Results: Administration of alpha mangostin caused a significant increase in the Langerhans islet area. No significant effect was found on the administration of alpha mangostin on the exocrine glands of the islets of Langerhans.

Conclusion: There is a significant relationship between the administration of alphamangostin and the regeneration of the pancreatic islets of Langerhans in insulin-resistant rats. Alpha-mangostin does not cause changes in the histological structure of the exocrine pancreas."

"ABSTRAKTujuan: Menilai ekspresi protein Epidermal Growth Factor Receptor (EGFR) pada Karsinoma Sel Ginjal (KSG) serta kaitannya dengan faktor-faktor prediktor prognosis yang dinilai secara histopatologik (subtipe, staging histopatologik, derajat anaplasia inti Fuhrman)Metode: Studi potong lintang terhadap jaringan yang difiksasi formalin dan diletakkan di dalam parafin dari pasien-pasien dengan KSG, yang diwarnai menggunakan metode imunohistokimia terhadap protein EGFR. Hasil: Ekspresi EGFR pada membran ditemukan pada 46% dari keseluruhan kasus (N=41) dan ekspresi EGFR di sitoplasma ditemukan pada 49% dari keseluruhan kasus (N=41). Terdapat hubungan antara subtipe histopatologik dan derajat anaplasia inti Fuhrman dengan ekspresi EGFR di sitoplasma (nilai p 0,017 dan 0,014 dengan uji Fisher’s exact). Tidak ditemukan asosiasi antara staging histopatologik dengan ekspresi EGFR.Diskusi: Perlu dibuat penelitian lanjutan dengan membandingkan ekspresi EGFR terhadap angka kesintasan pasien serta dibandingkan dengan faktor prediktor prognosis yang lain. Kemaknaan lokasi ekspresi EGFR di sitoplasma juga memerlukan perhatian khusus dan pembuktian secara ilmiah.

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ABSTRACTObjective: To study the expression of Epidermal Growth Factor Receptor protein in Renal Cell Carcinoma (RCC) and its relationship with prognostic predictor factors evaluated histopathologically (subtype, histopathological staging, Fuhrman nuclear grading). Methods: This was a cross-sectional study on 41 formalin-fixated paraffin-embedded tissue of patients with RCC, stained using immunohistochemical method against EGFR protein. Result: Membranous EGFR expression was found in 46% of cases (N=41), while cytoplasmic EGFR expression was found in 49% of cases. There was a significant association between histopathological subtype or Fuhrman nuclear anaplasia grading and cytoplasmic expression of EGFR (p value 0,017 and 0,014, respectively, using Fisher’s exact test). No significant association was found between histopathological staging and EGFR expressionDiscussion: A further study on the association EGFR expression and survival, and its comparison to other prognostic factors is necessary. The significance of EGFR expresion in the cytoplasm requires special attention and further scientific evidence."

"ABSTRAKLatar belakang: Penilaian pre-operatif penting dilakukan sebelum reseksi papiloma inverted untuk menjamin reseksi tumor yang bersih dan mencegah kekambuhan, namun belum ada tata cara penilaian pre-operatif papiloma inverted di Indonesia.Tujuan: Penelitian ini membandingkan penilaian pre-operatif CTscan dan MRI dengan penemuan saat operasi sehingga diketahui modalitas terbaik yang dapat menjadi dasar dalam penatalaksanaan papiloma inverted.Metode: Dilakukan prediksi lokasi asal tumor, keterlibatan sinus paranasal dan penentuan stadium tumor pada 10 pasien papiloma inverted dengan CT-scan dan MRI kemudian dibandingkan dengan penemuan saat operasi dengan panduan sistem navigasi pencitraan. Navigation panel unit menjadi alat yang penting dalam memandu operasi dan memastikan kesesuaian pencitraan dengan penemuan saat operasi.Hasil: Prediksi lokasi asal tumor dengan CT-scan dilakukan dengan menilai hiperostosis (9/10 subjek), sedangkan pada MRI dicari gambaran serpentine cerebriform filamentous structure (5/10 subjek). CT-scan lebih baik dalam prediksi lokasi asal tumor dibandingkan MRI (p=0,046). Tidak didapatkan perbedaan yang bermakna dalam prediksi keterlibatan sinus paranasal (p=0,083) dan stadium tumor (p=0,317) dengan menggunakan kedua modalitas tersebut.Kesimpulan: CT-scan merupakan pemeriksaan pencitraan yang paling baik dalam penilaian pre-operatif pada papiloma inverted sinonasal.

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ABSTRACTBackground: Preoperative assessment is essential before inverted papilloma surgery to ensure complete resection and prevent recurrence. There are no standard preoperative assessment for inverted papilloma in Indonesia.Purpose: This study was aim to compare CT-scan and MRI in preoperative assessment with the intra operative findings to determine which is the best preoperative imaging for inverted papilloma. Methods: Preoperative assessment predicted the site of origin, involvement of the paranasal sinus and tumor staging of inverted papilloma in 10 patients with CT-scan and MRI, then subsequently compared with the operation findings by surgical navigation imaging guidance. Navigation panel units was an important tool in guiding operations and ensure the intraoperative findingsconsistent with the imaging.Result: Site of origin was predicted by finding focal hyperostosis on CT-scan (9/10 subjects), whereas the serpentine cerebriform filamentous structure evaluated on MRI (5/10 subjects). The results of this study showed that CT-scan predicted site of origin better than MRI (p=0.046). There were no significant differences in prediction of paranasal sinus involvement (p = 0.083) and tumor staging (p = 0.317) using both modalities.Conclusion: Therefore, concluded that CT-scan is the best imaging preoperative assessment for sinonasal inverted papilloma."

"Latar Belakang: Kanker pankreas merupakan penyakit dengan kesintasan rendah dan kesulitan untuk melakukan diagnosis. Pemeriksaan Computed Tomography (CT)-Scan abdomen dan Ca 19-9 merupakan modalitas yang murah, mudah, dan terjangkau dalam diagnosis kanker pankreas. Endoscopic Ultrasound Fine Needle Aspiration (EUS-FNA) merupakan pemeriksaan baku emas untuk diagnosis kanker pankreas tetapi belum banyak tersedia di fasilitas kesehatan di IndonesiaTujuan: Penelitian ini bertujuan untuk mengetahui kemampuan diagnostik CT-Scan abdomen dan Ca 19-9 dibandingkan dengan EUS-FNA dalam diagnosis kanker pankreas.Metode: Desain studi ini adalah potong lintang dengan melihat rekam medis 62 pasien dengan kecurigaan kanker pankreas di RSCM pada tahun 2015-2019. Diambil pasien-pasien yang memiliki data Ca 19-9 dan CT-Scan abdomen yang kemudian dilakukan EUS-FNA untuk penegakan diagnosis kanker pankreas.Hasil: Sensitivitas dan spesifisitas CT-Scan abdomen masing-masing 76,27% dan 100%, sedangkan Ca 19-9 masing-masing 67,8% dan 33,33%. Nilai duga positif (NDP), nilai duga negatif (NDN), rasio kemungkinan positif (RKP), rasio kemungkinan negatif (RKN), dan akurasi CT-Scan abdomen masing-masing adalah 100%, 17.65%, tidak dapat dinilai, 0,24 , dan 77,42%. Nilai duga positif, NDN, RKP, RKN, dan akurasi untuk Ca 19-9 masing-masing adalah 95.24%, 5%, 1,02, 0,97, dan 66,13%.Kesimpulan: Kombinasi pemeriksaan CT-Scan Abdomen dan Ca 19-9 memiliki sensitivitas yang tinggi untuk kanker pankreas. Computed Tomography abdomen dapat digunakan untuk diagnosis kanker pankreas dengan sensitivitas dan spesifisitas yang baik.

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Introduction: Pancreatic cancer is a disease with low survival rate and difficult to diagnose. Abdominal computed tomography (CT) and Ca 19-9 are diagnostic modalities which are easy, simple, and non-invasive in diagnosis of pancreatic cancer. Endoscopic Ultrasound Fine Needle Aspiration (EUS-FNA) is the gold standard for diagnosis of pancreatic cancer but it is not available in many health care facilities in Indonesia.Purpose: This study aims to know the diagnostic accuracy of abdominal CT and Ca 19-9 compared to EUS-FNA for diagnosis of pancreatic cancer.Methods: The design of this study is cross-sectional by searching medical record of 62 patients with clinical suspicion of pancreatic cancer in Cipto Mangunkusumo hospital from year 2015-2019. Patients who undergo EUS-FNA with clinical suspicion of pancreatic cancer and have abdominal CT and Ca 19-9 data is included.Results: The sensitivity and specificity of abdominal CT are 76.27% and 100%, respectively, and Ca 19-9 are 67.8% and 33.33%, respectively. Positive predictive value, NPV, positive likelihood ratio, negative likelihood ratio, and accuracy of abdominal CT are 100%, 17.65%, unmeasurable, 0.24 , and 77.42%, respectively. Positive predictive value, NPV, positive likelihood ratio, negative likelihood ratio, and accuracy of Ca 19-9 are 95.24%, 5%, 1.02, 0.97, and 66.13%, respectively.Conclusion: The combined sensitivity of abdominal CT and Ca 19-9 has high sensitivity to diagnose pancreatic cancer. Abdominal CT can be used to diagnose pancreatic cancer with good sensitivity and specificity."

"Latar belakang dan tujuan : CT scan merupakan modalitas pencitraan utama pada berbagai tumor primer kepala dan leher serta ketersedian modalitas CT yang lebih luas di Indonesia. Penelitian ini bertujuan untuk mendiskusikan peranan CT sebagai modalitas yang berpotensi membantu menegakkan diagnosis keterlibatan lokoregional kelenjar getah bening KGB leher sehingga didapatkan perencanaan tatalaksana karsinoma sel skuamosa KSS dengan nilai terapi dan prognosis terbaik. Penelitian ini modifikasi Choi dan meneliti kesesuaian antara kriteria diagnostik KGB metastasis pada CT scan dibandingkan dengan hasil histopatologik pada pasien KSS. Metode : Penelitian ini merupakan studi asosiatif secara potong lintang pada data primer kasus baru KSS-KL. Pengambilan data berlangsung dari bulan Februari 2018 hingga April 2018 di Poli Onkologi Departemen THT, Departemen Radiologi dan Departemen Patologi Anatomi RSUPN Cipto Mangunkusumo. Sebanyak 90 unit sampel dievaluasi lokasi, morfologi dan kemungkinan metastasis pada CT scan preoperatif menggunakan kriteria diagnostik, kemudian tiap unit sampel diberi label untuk menunjang kesesuaian node-per-node yang kemudian disesuaikan dengan KGB temuan intraoperasi. Operasi diseksi leher dilakukan dengan jarak kurang dari 1 minggu pasca CT scan preoperatif. Pasca diseksi, setiap KGB yang telah diberi label dilakukan pemeriksaan histopatologik. Kemudian asumsi kesesuaian temuan pada CT scan preoperatif dan histopatologik diuji hipotesis komparatif menggunakan uji McNemar. Hasil : Penelitian ini menunjukkan nilai p = 0,000 yaitu terdapat perbedaan bermakna antara kriteria diagnostik KGB maligna pada CT scan dengan histopatologik. Penilaian kesesuaian kriteria diagnostik KGB maligna pada CT scan dengan histopatologik menggunakan Kappa didapatkan R = 0,12 p=0,100 . Kriteria diagnostik KGB maligna pada CT scan pada penelitian ini memiliki nilai sensitivitas 33,3 dan nilai spesifisitas 61,7 dengan nilai spesifisitas ukuran aksis pendek, hipodensitas dan penyangatan heterogen masing-masing 100 dan nilai sensitivitas lokasi drainase primer 100 . Kesimpulan : Tidak terdapat kesesuaian antara kriteria diagnostik KGB maligna pada CT scan dengan hasil histopatologik. Adanya komponen kriteria diagnostik yang sangat sensitif tapi tidak spesifik dan yang sangat spesifik tapi tidak sensitif menyebabkan nilai sensitivitas dan spesifisitas kriteria diagnostik ini rendah.

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Background and Objective CT scan is the main imaging modality in various head and neck primary tumors and broader availability in Indonesia. This study aims to discuss CT as a modality that helps establish the diagnosis of lymph node metastases so the management of head and neck squamous cell carcinoma HNSCC can be done with the best therapeutic value and prognosis. This study of Choi modification is trying to research about association between diagnostic criteria of metastases lymph node in CT Scan and histopathologic in SCC Patients Methods This research is a cross sectional associative study on the primary data of the new case of HNSCC. Data collection took place from February 2018 to April 2018 at the Polyclinic Oncology Department of ENT, Department of Radiology and Department of Pathology Anatomy Cipto Mangunkusumo Hospital. A total of 90 sample units were evaluated for location, morphology and possible metastasis on preoperative CT scans using diagnostic criteria, then each sample unit was labeled to support node per node association which was then adjusted to intraoperative lymph node findings. Neck dissection surgery is performed less than 1 week after a preoperative CT scan. After the operation, every lymph node that has been labeled is carried out to histopathologic examination. Then the hypothesis of association of the findings on preoperative CT scans and histopathologic is tested using McNemar test. Results This study shows p value 0,000 so that there is a significant difference between the diagnostic criteria on CT scan and histopathologic examination. Assessment of the diagnostic criteria for malignant KGB on CT scans and histopathologic examination using Kappa obtained R 0.12 p 0.100 , which shows no suitability between them. The diagnostic criteria for malignant lymph node on CT scan in this study have a sensitivity value of 33.3 and a specificity value of 61.7 with a specificity value of the size of the short axis, hypodensity and heterogeneous enhancement respectively 100 and the sensitivity value of the primary drainage site 100 . Conclusion There is no agreement between the diagnostic criteria for malignant lymph nodes on CT scan with histopathologic examination. The existence of a highly sensitive but non specific and a highly specific but insensitive component of the diagnostic criteria might causes the sensitivity and specificity of these diagnostic criteria to be low."

"Menilai tingkat akurasi Node-RADS dalam mendiagnosis metastasis kelenjar getah bening regio leher pada pasien dengan karsinoma sel skuamosa di kepala dan leher.

Metode: Sebanyak 221 sampel kelenjar getah bening dari 40 pasien yang memenuhi kriteria penelitian studi potong lintang yang menjalankan pemeriksaan CT scan leher dengan kontras, dilakukan operasi diseksi leher, dan memiliki hasil pemeriksaan histopatologi dari tahun 2020 hingga 2023. Dilakukan analisis bivariat antara Node-RADS dan histopatologi menggunakan Mc Nemar test dan Kappa Cohen R.

Hasil: Sistem skoring Node-RADS memiliki nilai diagnostik yang tidak terlalu berbeda dengan histopatologi dengan p = 0,76. Sistem skoring Node-RADS memiliki nilai Kappa Cohen 0,725, masuk kedalam substansial agreement. Hasil rasio konkordans pada skoring Node-RADS yang tinggi sebesar 88,2%, Sensitivitas 87,3%, Spesifisitas 88,6%, Nilai Duga Positif 75,3%, Nilai Duga Negatif 94,5%, LR+ 7,2, LR- 14%.

Kesimpulan: Node-RADS memiliki nilai akurasi yang cukup tinggi dan dapat dipertimbangkan sebagai metode diagnostik metastasis kelenjar getah bening regio leher pada pasien dengan karsinoma sel skuamosa di kepala dan leher.

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Squamous cell carcinoma is generally associated with metastases to the lymph nodes of the cervical region. Ricently,there have been attemts to standardize radiology reporting in oncology cases with the adoption of the Reporting and Data Systems (RADS). Node-RADS 1.0 aims to improve reporting of regional and distant lymph nodes in cancer patients by providing imaging criteria for size and configuration, facilitating a standardization system in reporting lymph nodes. However, there have been no reports regarding the suitability of Node-RADS in head and neck squamous cell carcinoma patients.

Objective: Assessing the accuracy of Node-RADS in diagnosing lymph node metastases in the neck region in patients with squamous cell carcinoma of the head and neck.

Method: A total of 221 lymph node from 40 patients who met the criteria for a cross-sectional research study, underwent a CT scan of the neck with contrast, neck dissection surgery, and had histopathological examination results from 2020 to 2023. Bivariate analysis was carried out between Node-RADS and histopathology using the McNemar test and Cohen's Kappa (κ).

Results: Node-RADS scoring system had a diagnostic value that was not significantly different from histopathology, with p = 0.76. The Node-RADS scoring system has a Cohen's Kappa value of 0.725, indicating substantial agreement. The concordance ratio results for Node-RADS scoring were high, with 88.2% concordance, a sensitivity of 87.3%, specificity of 88.6%, positive predictive value of 75.3%, negative predictive value of 94.5%, LR+ of 7.2, and LR- of 14%.

Conclusion: Node-RADS has a high accuracy value and can be considered as a diagnostic method for lymph node metastases in the neck region in patients with squamous cell carcinoma of the head and neck."