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"ABSTRACTKanker serviks adalah salah satu penyakit malignansi yang cukup berbahaya, dengan 500.000 kejadian baru dan 240.000 kematian setiap tahunnya. Walau etiologi intinya, human papillomavirus (HPV), telah diketahui sejak tahun 1990-an, sepertinya terdapat kofaktor-kofaktor yang mendorong kejadian penyakit ini. Salah satu yang menarik untuk diteliti adalah Epstein-Barr virus (EBV). Pada penelitian ini, 20 sampel swab serviks dari pasien dengan kanker serviks (positif HPV risiko tinggi), sementara 48 sampel swab serviks dari pasien dengan penyakit non-kanker serviks (negatif HPV). EBV dideteksi menggunakan uji real time PCR, sementara level DNA EBV dihitung berdasarkan persamaan Livak. Hubungan infeksi EBV sebagai kofaktor terhadap infeksi HPV dianalisis menggunakan statistik. Secara kualitatif, ditemukan bahwa populasi subyek positif EBV memiliki risiko sekitar 2,388 kali lebih mungkin menderita infeksi HPV dibandingkan populasi negatif EBV. Secara kuantitatif, jumlah DNA EBV pada populasi subyek dengan kanker serviks dan positif EBV sekitar 71 kali lebih tinggi dibandingkan dengan populasi subyek dengan kanker serviks dan negatif EBV. Secara statistik, hubungan infeksi EBV sebagai kofaktor terhadap infeksi HPV secara kualitatif maupun kuantitatif tidak bermakna (p > 0,05). Penelitian dengan populasi yang lebih besar dan multicenter dibutuhkan untuk menyokong hasil penelitian ini.

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ABSTRACTCervical cancer is one of the most dangerous malignant diseases, with around 500,000 new cases and 240,000 deaths each year. Although its main etiology, HPV, has been associated clearly with it since the 1990s, there appears to be various cofactors driving the pathophysiology of this disease, with one of the most interesting ones being EBV. In this study, 68 cervical swab samples with known HPV DNA content is analysed for the presence of EBV DNA. 2-by-2 table analytic statistics with various methods are then conducted to understand the connections between these two pathogens and the patients disease. It is found that in this sample population, patients with HPV are around 2.388 times more likely to be infected by EBV. The amount of EBV DNA in the case population is also found to be around 71 times more than in the control population. However, both results are statistically insignificant (p > 0.05). In conclusion, the results found shows interesting proof for the complicicity of EBV in the pathophysiology of cervical cancer, although statistically insignificant. Studies with a larger population and multicentered approach are needed to support the findings of this study."

"Latar belakang: Kanker nasofaring merupakan keganasan yang unik dimana angka kejadiannya termasuk jarang disebagian besar negara, namun endemis di wilayah tiongkok selatan, dan asia tenggara termasuk Indonesia. Histopatologi kanker nasofaring di daerah endemik biasanya merupakan karsinoma jenis tidak berkeratin tidak berdiferensiasi dan selalu terkait dengan infeksi EBV. Berbagai jenis protein virus diekspresikan pada infeksi laten EBV termasuk EBNA1 dan LMP1 mungkin berkontribusi dalam perkembangan kanker. Oleh karenanya, kami ingin menginvestigasi peran onkoprotein virus tersebut terhadap agresivitas dan respon terapi kanker nasofaring. Metode: Spesimen biopsi jaringan dan darah yang diambil dari pasien kanker nasofaring diukur kadar EBNA1 dan LMP1 dengan menggunakan pemeriksaan ELISA kit masing-masing dari DRG® dan MyBioSource® kemudian dikorelasikan dengan voume tumor dan KGB terlibat yang dinilai berdasarkan delineasi berbasis pencitraan 3D. Pasien kemudian menjalani terapi standar, dan dilakukan penilaian 3 bulan paska terapi. Respon terapi akan dinilai hubungannya dengan kadar EBNA1 dan LMP1. Hasil: 23 subjek dimasukan kedalam studi, 69,5% berada pada stadium IVA keatas, dengan mayoritas laki-laki sebanyak 61%. Median volume tumor primer dan volume KGB masing masing 41,4cc (13,2-128,8) dan 40,1cc (1,2-633,5). Uji korelasi Spearman mendapatkan hubungan bermakna (p=0,032) antara kadar LMP1 jaringan dan volume tumor sebelum terapi (r=0,448). Tren korelasi yang moderat terlihat pada kadar EBNA1 di jaringan dengan di darah, kadar EBNA1 di jaringan dengan volume tumor primer, kadar EBNA1 di darah dengan volume KGB, serta Kadar LMP1 baik di jaringan maupun di darah dengan volume KGB, meskipun secara keseluruhan tidak bermakna secara statistik. Sementara itu, pengaruh kadar LMP1 dan EBNA1 terhadap respon terapi belum dapat disimpulkan. Kesimpulan: Semakin tinggi kadar LMP1 di jaringan tumor akan diikuti oleh semakin besarnya volume tumor primer nasofaring. Korelasi moderat tidak signifikan pada variabel lain mungkin diakibatkan oleh jumlah sampel yang kurang. Penambahan besar sampel diperlukan untuk konfirmasi signifikansi dari korelasi tersebut.

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Background: Nasopharyngeal cancer is an unique malignancy where the incidence is rare in most countries but endemic in Southern China and Southeast Asia, including Indonesia. The histopathology of nasopharyngeal cancer in endemic areas is usually an undifferentiated nonkeratinizing type carcinoma and is always associated with EBV infection. Various viral proteins are expressed in latent EBV infection, including EBNA1 and LMP1. These viral oncoproteins may contribute to cancer development, but they are not always be defined. Therefore, we want to investigate the role of these viral oncoproteins when it comes to the aggressivity and treatment response of nasopharyngeal cancer.

Methods: Tissue biopsy and blood specimens taken from nasopharyngeal cancer patients were measured for EBNA1 and LMP1 using the ELISA kit examination from DRG® and MyBioSource® respectively, then correlated with primary tumor and nodal volume, which was calculated by delineation based on 3D imaging. Patients then underwent standard therapy, and was assessed 3 months post-therapy. Response to therapy will be assessed in relation to levels of EBNA1 and LMP1.

Results: 23 subjects were included in the study, 69.5% was at stage IVA and above with the majority being males (61%). The median primary tumor and lymph node volume were 41.4cc (13.2-128.8) and 40.1cc(1,2-633.5), respectively. Spearman correlation test found a significant relationship (p=0.032) between tissue LMP1 levels and tumor volume before therapy (r=0.448). A moderate correlation trend was seen in EBNA1 levels in tissue with blood, EBNA1 levels in tissue with primary tumor volume, EBNA1 levels in blood with lymph node volume, and LMP1 levels both in tissue and in blood with lymph node volume, although overall it was not statistically significant. Meanwhile, the effect of LMP1 and EBNA1 levels on the response to therapy cannot be concluded.

Conclusion: The higher the level of LMP1 in the tumor tissue, the larger the volume of primary nasopharyngeal tumor will be. Moderately insignificant correlation on the other variables may be caused by a small number of samples. The addition of the sample size is needed to confirm the significance of the correlation."

"Tujuan: Mengetahui konsentrasi dari virus Epstein-Barr pada saliva dengan teknik Real-Time PCR pada RS Kramat 128 Jakarta dan korelasinya dengan terapi antiretroviral, Limfosit T CD4 dan viral load HIV. Metode: Penelitian ini merupakan penelitian analitik deskriptif dengan metode potong lintang. Data didapatkan dari pasien HIV yang berkunjung ke RS Kramat 128 pada periode bulan September-Oktober 2019 dengan kelompok kontrol pegawai RS Kramat pada periode tersebut. Seluruh subjek penelitian (77 subjek, 53 HIV dan 24 non-HIV sebagai kelompok kontrol) yang bersedia berpartisipasi diminta untuk mengisi kuesioner, diperiksa rongga mulutnya, serta dikumpulkan salivanya dalam kondisi terstimulasi dan tidak terstimulasi. Saliva yang terkumpul kemudian diekstraksi DNA nya dan dilakukan pemeriksaan real-time PCR dengan menggunakan diagnostik kit untuk EBV pada Pusat Riset Virologi dan Kanker Patobiologi FKUI RSCM. Hasil: Konsentrasi virus Epstein-Barr pada saliva pasien HIV di RS Kramat 128 Jakarta secara statistik lebih tinggi daripada kelompok kontrol dengan median (min-maks) pada pasien HIV 13.950 (0-38.550.000) dan 680 (0-733.000) pada kelompok kontrol. Tipe antiretroviral memiliki korelasi rendah dengan konsentrasi EBV, namun penggunaan ART jangka panjang memiliki korelasi sedang dalam menurunkan konsentrasi EBV (korelasi negatif dengan r=0,295). Kenaikan jumlah EBV saliva pada pasien HIV secara signifikan memiliki korelasi sedang (korelasi positif dengan r=0,295), namun memiliki korelasi rendah dengan jumlah Limfosit T CD4. Kesimpulan: Terdapat perbedaan signifikan antara konsentrasi EBV pada pasien HIV dan kelompok kontrol. Penggunaan ART jangka panjang dan viral load HIV secara signifikan memiliki korelasi sedang dengan konsentrasi EBV pada saliva.

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Objective: To reveal concentration of salivary Epstein-Barr Virus with real-time PCR Technique in Kramat 128 General Hospital HIV patient and its correlation with antiretroviral therapy, CD4 and HIV viral load.

Method: This is an analytic descriptive cross-sectional study on HIV outpatient of Kramat 128 General Hospital in September-Oktober 2019 and employees of Kramat 128 as control group. All subjects (77 subject, with 53 HIV positive respondent and 24 non-HIVcontrol) willing to participate were asked to fill out a questionnare, followed by oral examination and saliva colection in stimulated and unstimulated method. The collected saliva then extracted and EBV concentration were count by real-time PCR using an EBV diagnostic kit at Center for Research on Institute of Human Virology and Cancer Biology Universitas Indonesia.

Result: The concentrations of salivary EBV were significantly higher in HIV patients than non-HIV controls, with median (min-max) values in HIV patient 13.950 (0-38.550.000) and 680 (0-733.000) in non-HIV controls. The type of ART has low correlation with EBV concentrations, but long-term ART has medium correlation in reducing EBV concentrations (negative correlation with r=0,279). Increase amount of EBV in HIV patient were significantly has medium correlation with HIV viral load (positive correlation with r=0,295) but has low correlation with CD4 cell count.

Conclusion: There are significant differences of salivary EBV concentrations in HIV patients and control group. Long term ART and HIV viral load significantly has medium correlation with EBV concentration."

"ABSTRAK Latar belakang. Infeksi human papillomavirus (HPV) pada genital laki-laki selain dapatmenyebabkan kutil kelamin dan kanker penis juga meningkatkan risiko infeksi HPV padapasangan. Walaupun saat ini telah terdapat banyak penelitian mengenai peran HPV risikotinggi terhadap karsinogenesis serviks dan semakin jelas peran laki-laki sebagai vektor virusHPV, namun pemeriksaan HPV pada laki-laki belum rutin dilakukan. Penelitian ini bertujuanmengetahui proporsi kepositivan, variasi genotipe HPV pada suami pasien kanker serviksserta kesamaan genotipe HPV antara suami pasien kanker serviks yang HPV positif denganpasien kanker serviks di RSUPN Dr Cipto Mangunkusumo. Metode. Penelitian potonglintang. Pemilihan SP dilakukan secara berurutan (consecutive sampling). Sampel diambildengan menggunakan kertas amplas dan dacron swab. Pada spesimen dilakukan pemeriksaanmenggunakan HPV express matrix Kalgen®. Hasil. Sebanyak 47 SP dilibatkan dalampenelitian ini, dengan rerata usia 50,7+10,6 tahun. Dari analisis spesimen diidentifikasi HPVgenital pada 9 (19%) SP, terdiri atas genotipe risiko rendah (3 SP) dan risiko tinggi (6 SP).Genotipe HPV yang ditemukan adalah 6, 18, 31, 39, 43, 53, dan 56, dengan tipe terseringadalah 18 dan 43. Tidak didapatkan kesamaan tipe HPV di antara pasangan HPV yangpositif. Kesimpulan. Proporsi kepositivan HPV pada suami pasien kanker serviks sebesar19% dengan tipe 18 dan 43 paling banyak didapatkan, namun tidak didapatkan kesamaan tipe HPV antara SP dengan pasien kanker serviks pasangannya.ABSTRACT Background. Human papillomavirus (HPV) infection on male genital could cause genitalwarts, penile cancer, but also increase the risk of HPV infection in their spouse. Despitemany current researches on role of high-risk HPV in cervix carcinogenesis and male partner?srole as HPV vector is well known, HPV examination on male is not yet routinely performed.The aim of this study is to find the positivity proportion and genotype variant of HPV oncervical cancer patient?s spouse, and also the genotype concordance between the spouse withHPV positive and the cervical cancer patient at dr Cipto Mangunkusumo hospital. Method.Cross-sectional design. Subject was chosen consecutively (consecutive sampling). Samplewas collected with emery paper and dacron swab. The specimen was then analyzed with HPVexpress matrix Kalgen®. Result. Fourty seven subject enrolled in this studi with mean age50,7+10,6 y.o. Specimen analysis identified genital HPV on 9 (19%) subject, with low risk (3subject) and high risk (6 subject) genotype. HPV genotypes found in this study are 6, 18, 31,39, 43, 53, dan 56, with 18 and 43 as the most frequent. No genotype concordance foundbetween the cervical cancer patient?s spouse with HPV positive and their partners. HPVgenotypes variation found on cervical cancer?s spouses are type 6, 18, 31, 39, 43, 53, dan 56.Conclusion. The positivity proportion of HPV on cervical cancer patient?s spouse was 19%,with genotype 18 and 43 as the most frequent with no HPV genotype concordance found between subjects and the spouse.;Background. Human papillomavirus (HPV) infection on male genital could cause genitalwarts, penile cancer, but also increase the risk of HPV infection in their spouse. Despitemany current researches on role of high-risk HPV in cervix carcinogenesis and male partner?srole as HPV vector is well known, HPV examination on male is not yet routinely performed.The aim of this study is to find the positivity proportion and genotype variant of HPV oncervical cancer patient?s spouse, and also the genotype concordance between the spouse withHPV positive and the cervical cancer patient at dr Cipto Mangunkusumo hospital. Method.Cross-sectional design. Subject was chosen consecutively (consecutive sampling). Samplewas collected with emery paper and dacron swab. The specimen was then analyzed with HPVexpress matrix Kalgen®. Result. Fourty seven subject enrolled in this studi with mean age50,7+10,6 y.o. Specimen analysis identified genital HPV on 9 (19%) subject, with low risk (3subject) and high risk (6 subject) genotype. HPV genotypes found in this study are 6, 18, 31,39, 43, 53, dan 56, with 18 and 43 as the most frequent. No genotype concordance foundbetween the cervical cancer patient?s spouse with HPV positive and their partners. HPVgenotypes variation found on cervical cancer?s spouses are type 6, 18, 31, 39, 43, 53, dan 56.Conclusion. The positivity proportion of HPV on cervical cancer patient?s spouse was 19%,with genotype 18 and 43 as the most frequent with no HPV genotype concordance found between subjects and the spouse.;Background. Human papillomavirus (HPV) infection on male genital could cause genitalwarts, penile cancer, but also increase the risk of HPV infection in their spouse. Despitemany current researches on role of high-risk HPV in cervix carcinogenesis and male partner?srole as HPV vector is well known, HPV examination on male is not yet routinely performed.The aim of this study is to find the positivity proportion and genotype variant of HPV oncervical cancer patient?s spouse, and also the genotype concordance between the spouse withHPV positive and the cervical cancer patient at dr Cipto Mangunkusumo hospital. Method.Cross-sectional design. Subject was chosen consecutively (consecutive sampling). Samplewas collected with emery paper and dacron swab. The specimen was then analyzed with HPVexpress matrix Kalgen®. Result. Fourty seven subject enrolled in this studi with mean age50,7+10,6 y.o. Specimen analysis identified genital HPV on 9 (19%) subject, with low risk (3subject) and high risk (6 subject) genotype. HPV genotypes found in this study are 6, 18, 31,39, 43, 53, dan 56, with 18 and 43 as the most frequent. No genotype concordance foundbetween the cervical cancer patient?s spouse with HPV positive and their partners. HPVgenotypes variation found on cervical cancer?s spouses are type 6, 18, 31, 39, 43, 53, dan 56.Conclusion. The positivity proportion of HPV on cervical cancer patient?s spouse was 19%,with genotype 18 and 43 as the most frequent with no HPV genotype concordance found between subjects and the spouse."

"Latar belakang: Infeksi virus Epstein-Barr (EBV) dapat menjadi infeksi oportunistik pada anak dengan HIV. Gejala infeksi EBV sulit dibedakan dengan infeksi HIV dan bersifat laten. Infeksi EBV laten dapat reaktivasi mulai dari gangguan limfoproliferatif hingga terjadinya keganasan. Di Indonesia belum ada data mengenai infeksi EBV pada anak dengan HIV. Tujuan: Mengetahui proporsi, karakteristik dan faktor-faktor yang berhubungan dengan terjadinya infeksi EBV pada anak dengan HIV di RSUPN Dr. Cipto Mangunkusumo Jakarta. Metode: Penelitian potong lintang untuk melihat karakteristik infeksi EBV pada anak dengan HIV dan faktor-faktor yang berhubungan di RSUPN Dr. Cipto Mangunkusumo Jakarta, periode bulan September 2020 hingga Februari 2021. Sampel darah diambil untuk dilakukan pemeriksaan PCR EBV kualitatif (whole blood), darah perifer lengkap, kadar CD4 dan viral load HIV. Hasil: Total subyek 83 anak dengan HIV. Proporsi subyek terinfeksi EBV sebesar 28,9%, dengan rerata usia 9,58 tahun. Limfadenopati merupakan gejala terbanyak, meskipun tidak dapat dibedakan dengan infeksi lain. Dua anak mengalami keganasan akibat EBV yaitu Limfoma Non Hodgkin dan leiomiosarkoma. Sebanyak 75% subyek terinfeksi EBV yang berusia di bawah 12 tahun mengalami anemia (rerata Hb 10,68 ± 2,86 g/dL), dapat disebabkan infeksi EBV atau penyebab lain. Hasil analisis bivariat menunjukkan kadar viral load HIV > 1000 kopi/mL berhubungan dengan terjadinya infeksi EBV pada subyek (OR 2,69 (1,015-7,141); P = 0,043). Simpulan: Proporsi anak dengan HIV yang terinfeksi EBV di RSUPN Dr. Cipto Mangunkusumo Jakarta adalah 28,9%, dengan kadar viral load HIV > 1000 kopi/mL berhubungan dengan terjadinya infeksi EBV pada anak dengan HIV.

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Background: Epstein-Barr virus (EBV) infection can be an opportunistic infection in HIV-infected children. EBV infection is difficult to be differentiated from HIV infection, and it can be latent. Latent EBV infection can reactivate into lymphoproliferative disorders and malignancy. There is no data on EBV infection in HIV-infected children in Indonesia.

Objective: To identify the proportion, manifestations and factors associated with EBV infection in HIV-infected children in Dr. Cipto Mangunkusumo National Central Hospital Jakarta.

Methods: Cross-sectional study to examine the manifestations of EBV infection in HIV-infected children and it’s associated factors in Dr. Cipto Mangunkusumo National Central Hospital Jakarta, during September 2020 to February 2021. Blood samples were taken to examine qualitative EBV PCR (whole blood), complete blood count, CD4 levels and HIV viral load.

Results: Total subjects were 83 HIV-infected children. The proportion of children infected with EBV was 28.9%, with mean age 9.58 years. Lymphadenopathy was the most common symptoms, although it was difficult to differentiate from other infections. Two children have malignancy due to EBV, namely Non-Hodgkin's lymphoma and leiomyosarcoma. Total 75% of EBV-infected subjects under 12 years of age were anemic (mean Hb 10.68 ± 2.86 g/dL), could be due to EBV infection or other causes. Bivariate analysis showed HIV viral load levels > 1000 copies/mL were associated with EBV infection in subjects (OR 2.69 (1.015-7.141); P = 0.043).

Conclusion: The proportion of EBV infection in HIV-infected children in Dr. Cipto Mangunkusumo National Central Hospital Jakarta is 28.9%, with HIV viral load levels > 1000 copies/mL were associated with the EBV infection in HIV-infected children."

"ABSTRAKLatar belakang: Diffuse large B-cell lymphoma DLBCL merupakan suatu entitas yang heterogen baik secara klinik maupun morfologik. Berdasarkan kriteria Hans melalui pemeriksaan imunohistokimia IHK CD10, Bcl-6 dan MUM1, DLBCL dikelompokkan menjadi 2 subtipe yaitu germinal center B-cell like GCB dan non-germinal center B-cell like non-GCB . Kesintasan subtipe GCB umumnya lebih baik daripada non-GCB, namun sebagian dapat berespon buruk. Penanda prognosis buruk c-Myc lebih sering ditemukan pada subtipe GCB, sedangkan infeksi EBV melalui NF-kB lebih sering ditemukan pada subtipe non-GCB. Penelitian ini bertujuan untuk mengetahui perbedaan ekspresi c-Myc dan EBV pada kedua subtipe DLBCL yang dapat berpengaruh pada kesintasan.Bahan dan cara: Penelitian ini menggunakan metode potong lintang, deskriptif analitik. Sampel terdiri atas 20 kasus untuk masing-masing subtipe. Dilakukan penilaian ulang diagnosis imunohistopatologik dari sediaan H E dan IHK sesuai kriteria Hans. Penilaian pulasan dilakukan oleh kedua pengamat dengan program ImageJ pada c-Myc dengan cut off ge; 60,4 dan EBV melalui EBER-ISH dengan nilai positivitas ge; 20 .Hasil: Hasil penilaian antar kedua pengamat menyimpulkan tidak ada perbedaan bermakna dengan p = 0,952. Ekspresi c-Myc tinggi secara bermakna lebih sering ditemukan pada subtipe GCB dibandingkan subtipe non-GCB p < 0,05 . Disisi lain EBV positif hanya ditemukan 4 kasus 10 dan cenderung lebih banyak pada subtipe non-GCB.Kesimpulan: DLBCL subtipe GCB lebih sering ditemukan ekspresi c-Myc tinggi, sedangkan infeksi EBV melalui NF-kB cenderung terdapat pada subtipe non-GCB. Positivitas c-Myc dan EBV ini diduga berkaitan dalam perbedaan kesintasan pada masing-masing subtipe DLBCL.

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ABSTRACT"Background Diffuse large B cell lymphoma DLBCL is clinically and morphologically heterogeneous groups of lymphoma. Based on Han 39 s immunohistochemistry IHC features consists of CD10, Bcl 6 and MUM1, DLBCL are grouped into 2 subtypes the germinal center B cell like GCB and non germinal center B cell like non GCB . GCB subtype generally has been shown to have better survival than non GCB, while some may respond poorly. c Myc is a worse prognosis marker more commonly found among GCB subtype, meanwhile the EBV infection through NF kB pathway that mostly found among non GCB subtype. The study aims was analyzed the difference of c Myc and EBV expression in both subtypes which could predict survival.Methods This research used cross sectional method. The samples were consist of 20 cases for each DLBCL subtype. The slides were rediagnosed based on immunohistopathologic diagnosis from H E and IHC slides based on Han rsquo s criteria. c Myc immunostaining cut off ge 60,4 and EBV with Eptein Barr early RNA in situ hibridization cut off 20 which are assesed using ImageJ programe by two independent observers. Result The results between two observers showed no significant difference with p 0,952. Expression of high c Myc is found to be significantly higher in GCB subtype p 0,05 . Whereas EBV positive were only found in 4 cases 10 , mostly in non GCB subtype. Conclusion The expression c Myc is higher in GCB than non GCB subtype. While the EBV infection found among non GCB subtype. Positivity of c Myc and EBV is believed to affect differences in survival for each subtype DLBCL."

"Kanker serviks merupakan kanker tersering kedua di dunia pada perempuan, namun merupakan kanker tersering di negara berkembang. Di Indonesia kanker serviks menjadi masalah besar karena kebanyakan pasien datang pada stadium lanjut, padahal stadium mempengaruhi pilihan terapi dan angka harapan hidup pasien. Tujuan: untuk mengetahui jumlah kasus baru, karakteristik, dan korelasi antara stadium dengan usia penderita kanker serviks di Departemen Patologi Anatomi RSCM pada tahun 2007. Metode: Penelitian dilakukan dengan metode potong lintang pada data pasien kanker serviks di Departemen Patologi Anatomi RSCM tahun 2007 dengan uji non-parametrik korelasi Spearman (p<0.05). Hasil: jumlah kasus baru kanker serviks di Departemen Patologi Anatomi RSCM tahun 2007 adalah 540 dengan subjek penelitian berusia antara 22-92 tahun, rata-rata usia 48,46 tahun dan simpang deviasi sebesar 9.237. Puncak sebaran usia penderita kanker serviks ada pada rentang 45-54 tahun (39%). Frekuensi tertinggi stadium kanker serviks adalah stadium IIIB. Persentase penderita kanker serviks di bawah 50 tahun pada stadium I adalah 69.5%, stadium II 59.9%, stadium III 51.2%, dan stadium IV 42,9%. Gambaran histopatologi terbanyak adalah karsinoma sel skuamosa (64,4%). Terdapat korelasi positif lemah (r 0.140) yang bermakna (p 0.001) antara stadium dengan usia pada penderita kanker serviks di Departemen Patologi Anatomi RSCM tahun 2007. Kesimpulan: semakin lanjut usia semakin tinggi stadium kanker serviks yang terdiagnosis.

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Cervical cancer is the second most common type of cancer found among woman worldwide, the first in developing countries. In Indonesia, cervical cancer has become major problem since most patients seek medical attention in their late stages; although, best medical treatment and survival rate depend on which stages they are in. Objective: to acknowledge the number of most recent diagnosed cervical cancer’s cases along with their characteristics, and the correlations among it stages and the age of people who have suffered by it particularly in the Department of Pathology and Anatomy in RSCM in the year of 2007. Methods: based on data (2007) from RSCM’s Department of Pathology and Anatomy, this research was conducted by using cross-sectional method with Spearman correlation (p< 0.05). Result: this research indicates that the number of women diagnosed with cervical cancer in the RSCM’s Department of Pathology and Anatomy for the year of 2007 has reached 540 new cases among the age of 22-92 years old. The average of women diagnosed with cervical cancer is 48.46 years old (SD 9.237). The highest number of cases was found in women with a group of age of 45-54 tahun (39%). From all the data that were derived, it was found that stage IIIB has the highest frequency. The percentage of patients below 50 years old diagnosed with stage I, stage II, stage III, and stage IV respectively are 69.5%, 59.9%, 51.2%, and 42.9%. Histopathologically, squamous cell carcinoma was the dominant one (64.4%). Based on this research, there is a weak positive correlation (r 0.140; p 0.001) between cervical cancer stages and the age of patients. Conclusion: high stages of cervical cancer were found significantly in older women."

"Salah satu metode clustering yang banyak digunakan karena unggul dari sisi kestabilannya adalah metode Self Organizing Map. Pada tesis ini dibahas penggunaan metode SOM pada DNA Human Papillomavirus (HPV) yang menjadi penyebab utama penyakit kanker serviks, yaitu penyakit kanker yang menempati urutan pertama di negara berkembang. DNA HPV yang digunakan adalah sebanyak 18 buah yang diambil berdasarkan complete genome terbaru. Dengan menggunakan program berbasis opensource R, proses clustering berhasil mengelompokkan 18 tipe HPV ke dalam dua buah cluster berbeda, yang terdiri dari 2 tipe HPV di cluster pertama sementara 16 tipe HPV lainnya di cluster ke dua. Hasil analisis 18 tipe HPV adalah berdasarkan tingkat keganasannya, atau tingkat kesulitan dalam penyembuhannya. Dua di antara tipe HPV yang berada di cluster pertama tergolong jenis HPV jinak, sementara 16 tipe HPV yang berada di cluster ke dua tergolong jenis HPV ganas.

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One of the most widely used clustering method, since it has advantage on its robustness is Self Organizing Map (SOM) method. This thesis discusses the application of SOM method on Human Papillomavirus (HPV) DNA which is a main cause of cervical cancer disease, the most dangerous cancer in developing countries. We use 18 types of HPV DNA based on the newest complete genome. By using open-source-based program R, clustering process can separate 18 types of HPV into two different clusters. There are two types of HPV in the first cluster while 16 others in the second cluster. The Analyzing result of 18 types HPV based on the malignancy of the virus (the difficultness to cure). Two of HPV types the first cluster can be classified as tame HPV, while 16 others in the second cluster are classified as vicious HPV."

"ABSTRAKLatar belakang: Human papillomavirus (HPV) merupakan etiologi kanker serviks dan kanker oral. Berbeda dengan kanker serviks, data infeksi HPV oral di Indonesia belum diketahui. Prevalensi infeksi HPV oral yang pernah diteliti pada populasi normal sebesar 1,3−9,2% dan meningkat pada pasien dengan infeksi HPV serviks (18,1%). Tujuan: Mengetahui prevalensi infeksi HPV oral pada pasien kanker serviks dan distribusi tipe HPV, serta mengevaluasi faktor yang berperan dalam terjadinya infeksi. Metode: Penelitian desain potong lintang pada 30 subjek penelitian kanker serviks. Dilakukan pengambilan sampel dari rongga mulut dan orofaring dengan menggunakan brushing untuk mendeteksi DNA HPV dengan nested-PCR elektroforesis dilanjutkan pemeriksaan genotyping HPV metode hibridisasi. Hasil: Prevalensi infeksi HPV oral pada pasien kanker serviks 56,7% dengan tipe HPV risiko tinggi ditemukan 43,3%. HPV tipe 51, 16, dan 18 merupakan tipe HPV risiko tinggi yang paling sering ditemukan di mukosa oral. Tidak didapatkan lesi oral pada seluruh subjek penelitian. Terdapat 1 subjek yang mempunyai tipe HPV yang sesuai antara oral dan serviks (11,1%). Simpulan: Hasil prevalensi infeksi HPV oral yang tinggi menunjukkan perlunya deteksi infeksi HPV oral dan mengetahui faktor risiko yang berhubungan dengan infeksi, serta perkembangannya dalam proses keganasan.

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ABSTRACTBackground: Human papillomavirus (HPV) is an etiologic agent for both oropharyngeal and cervical cancers. In contrast to cervical cancer, the data of oral HPV infection in Indonesia is not yet known. The prevalence of oral HPV infection in normal population is about 1,3−9,2% and increase in patients with cervical infection (18,1%). Objective: To evaluate the prevalence and type distributions of oral HPV infections in patients with cervical cancer, and evaluate the risk factor which contribute to its occurrence. Methods: Cross-sectional study on 30 subjects, previously diagnosed with cervical carcinoma. Oral mucosal cells were collected by brushing from their oropharyngeal area. HPV DNA detection was caried out using nested-PCR and the HPV Genotyping (HPV genoflow array test). Results: The prevalence of oral HPV infection of patients with cervical cancer is 56,7%, the high-risk HPV type prevalence is 43,3%. The HPV high risk 51, 16 and 18 were most found in oral mucosa. Clinically healthy oral mucosa without any lession was observed in all cases. Only one subject has same HPV type in oral and cervical mucosa (11,1%). Conclusion: Results show a high prevalence of oral HPV infection. It is important to detect HPV in oral and the risk factors associated with infection and progression to malignancy."

"Pendahuluan: Stres oksidatif selalu terjadi pada pasien kanker dan ditandai dengan kadar Malondialdehyde (MDA) serum yang tinggi dan rendahnya aktivitas antioksidan enzimatik serum katalase (CAT). Penelitian ini menganalisis kadar MDA dan aktifitas enzimatik CAT, yang mewakili status oksidan dan status antioksidan pada pasien dengan kanker serviks uteri stadium lanjut lokal dan bagaimana hubungannya dengan angiogenesis (VEGF), yang bertujuan untuk mengembangkan strategi terapi baru di berbagai kasus keganasan, terutama dalam kasus kanker serviks uteri di masa depan.Metode penelitian: Penelitian ini merupakan studi cross sectional terhadap 16 pasien kanker serviks uteri stadium lanjut lokal (IIB ? IIIB) pada bulan Juli 2013 sampai dengan September 2013 yang memenuhi kriteria inklusi di departemen Radioterapi RSCM. Kadar MDA dan aktifitas enzimatik CAT diperiksa dengan mengambil sampel dari darah sebelum terapi radiasi diberikan. Pemeriksaan angiogenesis diperiksa dengan mengambil sampel biopsi dari jaringan serviks, dan dilakukan pemeriksaan ELISA untuk mendapatkan ekspresi VEGF.Hasil: Pada studi ini didapatkan rerata kadar MDA serum sebesar 7,6 +/- 1,2 nmol/mL, dan median aktivitas CAT sebesar 0,95 (0,80 ? 1,36) U/mL. Ditemukan korelasi positif kuat antara kadar MDA dan ekspresi VEGF dengan koefisien korelasi r = +0.775, dan p < 0.001. Tetapi didapatkan korelasi negatif lemah antara aktivitas enzimatik katalase serum dengan VEGF dengan koefisien korelasi r = -0.310 dan p = 0,909.Kesimpulan: Hasil penelitian ini menunjukkan bahwa stress oksidatif terjadi pada pasien kanker serviks uteri stadium lanjut lokal yang ditandai dengan peningkatan kadar MDA serum yang tinggi dan aktifitas enzimatik katalase yang rendah. Terdapat korelasi positif kuat antara kadar MDA serum dengan VEGF jaringan tetapi didapatkan korelasi negatif yang lemah dan tidak signifikan antara VEGF dengan aktifitas enzim katalase.

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Introduction: Oxidative stress always occurs in cancer patient, which characterized with high level of serum Malondialdehyde (MDA) dan low activity of serum catalase enzymatic antioxidant. This study analyzed the levels of malondialdehyde (MDA) and catalase (CAT), which represents the oxidant and antioxidant status in patients with locally advanced uterine cervical cancer and how it relates to angiogenesis to develop new therapeutic strategies in various malignancies, especially in the case of uterine cervical cancer in the future.

Methods: Sixteen of locally advance cervical cancer stage IIB ? IIIB from July 2013 to September 2013 who had irradiated in Radiotherapy department Cipto Mangunkusumo general hospital and eligible for this cross sectional study. MDA levels serum and catalase enzyme serum activities were examined before radiotherapy. Tissue biopsy is taking before radiotherapy, for VEGF analysis is done by ELISA to asses angiogenesis activity.

Results: In this study, mean MDA level is 7.6 + /- 1.2 nmol / mL and catalase enzyme activity median is 0.95 ( 0.8 to 1.36 ) U / mL . paired t-test shows there is a strong significant positive correlation between MDA and VEGF (r = +0.775, p < 0.001). This suggest that increasing MDA serum levels as free radicals activity in line with increasing VEGF as angiogenesis activity, in the other side there is no correlation between VEGF and catalase enzyme serum activities ( r = -0.310 and p = 0.909).

Conclusion: This study showed that oxidative stress occurs in patients with locally advanced cervical cancer, increasing MDA serum levels as free radicals activity in line with increasing VEGF as angiogenesis activity but at the other side there is no correlation between VEGF and catalase enzyme serum activities."