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"Tujuan penelitian ini adalah untuk melihat hubungan antara serum Prostate Specific Antigen ( PSA ), stadium klinis lokal, grading tumor dengan hasil bone scan dalam usaha mengevaluasi kemampuan serum PSA untuk memprediksi hasil bone scan pada penderita baru kanker prostat. Suatu penelitian retrospektif dilaksanakan terhadap data penderita kanker prostat yang didiagnosis di institusi penulis antara Januari 1995 hingga Desember 2003. Subyek penelitian ditolak apabila nilai PSA diperoleh setelah dilakukan manipulasi uretra atau sesudah penderita mendapatkan terapi. Hubungan antara hasil bone scan dengan serum PSA, stadium klinis lokal dan grading tumor dianalisis. Hasil penelitian menunjukkan dari 103 penderita yang termasuk dalam penelitian ini, 61 penderita ( 59,2% ) mempunyai hasil bone scan positif dengan rerata nilai PSA 471,13 ± 853,34 ng/ml, sedangkan 42 penderita (40,8% ) mempunyai hasil bone scan negatif dengan rerata nilai PSA 61,00 ± 124,47 ng/ml ( p < 0,05 ). Resiko untuk mendapatkan hasil bone scan positif bertambah besar dengan meningkatnya nilai PSA, stadium klinis lokal dan grading tumor ( p < 0,05 ). Dengan menggunakan kurva Receiver Operating Characteristic ( ROC ), terbukti bahwa PSA mempunyai korelasi terbaik dengan hasil bone scan ( Area Under Curve = 0,812 ). Kombinasi serum PSA, stadium klinis lokal dan grading tumor mempunyai kemampuan terbaik dalam memprediksi hasil bone scan. Dari 19 penderita dengan serum PSA < 10 ng/ml, terdapat 5 penderita yang mempunyai hasil bone scan positif; sedangkan dari 8 penderita dengan serum PSA < 10 ng/ml, stadium klinis T1 atau T2 dan grading tumor derajat 1 atau 2, tidak satupun menunjukkan metastasis tulang. Dari penelitian ini dapat disimpulkan bahwa pemeriksaan rutin bone scan tidak diperlukan bagi penderita baru kanker prostat dengan serum PSA < 10 ng/ml, stadium klinis T1 atau 2 dan grading tumor 1 atau 2. (Med J Indones 2004; 13: 151-5)

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The objective of this study is to assess the relation between serum Prostate Specific Antigen ( PSA ), clinical tumor stage, tumor grade and bone scan result in an attempt to seek the ability of serum PSA to predict bone metastases in newly diagnosed prostate cancer patients. A retrospective analysis was conducted on clinical files of prostate cancer patients which were diagnosed in our institutions between January 1995 and December 2003. Patients on which initial serum PSA were obtained after urethral manipulation or after receiving therapy were excluded. The results of bone scans were related to levels of serum PSA, clinical tumor stage and tumor grade. Of 103 patients who were included in this investigation, 61 patients ( 59.2% ) had a positive bone scan and 42 patients ( 40.8% ) had a negative bone scan with mean PSA value 471.13 ± 853.34 ng/ml and 61.00 ± 124.47 ng/ml respectively ( p < 0.05 ). The risk of having a positive bone scan increased with advancing serum PSA levels, clinical tumor stage and tumor grade ( p < 0.05 ). Using Receiver Operating Characteristic curves, PSA had the best correlation with bone scan results ( the area under curve was 0.812 ). Bone scan results were predicted best by the combination of serum PSA, clinical tumor stage and tumor grade. Bone scans were positive in 5 of 19 patients with PSA level < 10 ng/ml. None of 8 patients with PSA levels < 10 ng/ml, clinical tumor stage T1 or 2 and tumor grade 1 or 2 had a positive bone scan. In conclusion, we suggest that routine bone scan examination may not be necessary in patients with newly diagnosed, untreated prostate cancer, who have serum PSA level < 10 ng/ml with clinical tumor stage T1 or 2 and tumor grade 1 or 2 (Med J Indones 2004; 13: 151-5)."

"ABSTRAKTujuan: Mengetahui batasan nilai PSA untuk memprediksi adanya metastasis tulang pada pasien kanker prostat di RS Sardjito. Metode: Penelitian retrospektif, dengan mengumpulkan rekam medis pasien kanker prostat telah dilakukan bone scintigraphy di RS Sardjito tahun 2006 - 2011.Hasil: Dari 83 pasien kanker prostat yang telah dilakukan bone scintigraphy, terdapat 55 pasien (66%) mengalami metastasis tulang dan terdapat 28 pasien (34 %) yang tidak mengalami metastasis tulang. Dari 55 pasien yang mengalami metastasis tulang, terdapat 11 pasien (20 %) dengan PSA kurang dari 20 ng/ml dan terdapat 44 pasien (80 %) yang memiliki PSA lebih dari 20 ng/ml. Cut-off point PSA 17.65 ng/ml memiliki sensitivitas terbesar yaitu 85.5% dan spesifisitas 53.6%.Kesimpulan: Pemeriksaan bone scintigraphy dianjurkan pada pasien dengan PSA > 17.65 ng/ml, sedangkan pada pasien dengan PSA < 17.65 dianjurkan pada pasien dengan gejala klinis nyeri tulang.

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ABSTRACTObjective: Prostate cancer shows a strong predilection to spread to the bones, with bone metastases identified at autopsy in up to 90 % of patients dying from prostate cancer. Serum prostate specific antigen (PSA) concentration has been widely applied as a biomarker to diagnose and monitor prostate cancer. Technetium-99m methylene diphosphate (Tc—99m MDP) whole body bone scintigraphy is currently a well-accepted diagnostic procedure for bone metastasis in malignancy. The aim of this study was to establish a useful serum PSA cut-off value to predict the presence of bone metastasis in men with prostate cancer. Material and Methods: Consecutive male patients diagnosed with prostate cancer were retrospectively analyzed. All of the subjects had received Tc-99m MDP whole body bone scintigraphy and had their serum PSA concentration measured at Sardjito Hospital, Yogyakarta. The proper cut-off value was established based on statistical analysis in order to predict the possibility of bone metastasis among prostate cancer patients.Results: In total, 83 consecutive male patients with prostate cancer were enrolled, and 55 patients (66 %) were confirmed by scintigraphic findings to have bone metastases. A serum PSA concentration of 17,65 ng/ml gave the best sensitivity (78,33 %) and specificity (65,21 %). The positive predictive value, negative predictive value were 85,45 % and 53,57 %, respectively (p<0,05).Conclusion: A cut-off value of 17,65 ng/ml appears to be an appropriate benchmark for stratifying metastatic bone disease in prostate cancer patients at Sardjito Hospital, Yogyakarta, such that if a patient with newly diagnosed prostate cancer and without any skeletal symptoms has a serum PSA concentration of less than 17,65 ng/ml,we suggest that they would not need to undergo bone scintigraphy."

"[Tujuan: Mengidentifikasi korelasi dan insiden metastasis tulang pada pasien kanker prostat dengan Gleason Score (GS) dan Prostate Specific Antigen (PSA) yang rendah.Material dan Metode: Studi deskriptif retrospektif pada pasien kanker prostat di Rumah Sakit Cipto Mangunkusumo periode 2006-2011. Ada 478 pasien dengan kanker prostat. Pasien kanker prostat dengan PSA rendah, telah menjalani pemeriksaan histopatologi, dan bone scan diikutsertakan dalam studi, sehingga didapatkan 358 pasien sebagai subjek penelitian.Nilai PSA diukur dengan sandwich electrochemiluminescent immunoassay. Pemeriksaan histopatologi diklasifikasikan menurut sistem grading Gleason dan dibagi menjadi 3 kategori: diferensiasi baik (GS ≤6), diferensiasi sedang (GS 7), dan diferensiasi buruk (GS 8-10). Bone scan dikerjakan dengan dengan agen radiofarmaka (Tc99m methylenendiphosphonate) dan kemudian gambar ditangkap dengan kamera gamma.Hasil: Rerata usia 67.52±7.8 tahun, rerata GS 7.7±1.3, dan median PSA adalah 56.9 (rentang: 0,48-17000 ng/mL). Ada 11 orang pasien (3,0%) dengan bone scan positif dengan PSA <20 ng/mL dan GS<8. Lebih lanjut, ada 2 pasien (0,6%) dengan GS≤6 dan PSA<10 ng/mL memperlihatkan metastasis ke tulang.Kesimpulan: Pada studi ini, ada sebagian kecil pasien mengalami metastasis tulang dengan PSA (PSA<10 mg/mL) dan GS (GS≤6) rendah., Objective This study was aimed to identify correlation and incidence of bone metastases in prostate cancer patient with low Gleason Score GS and Prostate Specific Antigen PSA Materials and Methods A descriptive restrospective study to patients with prostate cancer in Cipto Mangunkusumo Hospital in 2006 2011 There were 478 patient with prostate cancer Patients with prostate cancer who had PSA value histological examination and bone scan were included in the study resulting in 358 eligible patients for the study PSA value was measured using the sandwich electrochemiluminescent immunoassay Histological examination was graded according to Gleason rsquo s grading system and divided into 3 category well differentiated GS le 6 moderately differentiated GS 7 and poorly differentiated GS 8 10 Bone scan was done using radiopharmaceuticals agent Tc 99m methylenen diphosphonate and then the image was captured using gamma camera Results The mean age was 67 52 7 8 mean GS was 7 7 1 3 and median PSA was 56 9 range 0 48 17000 ng mL There were 11 patients 3 0 with positive bone scan with PSA]"

"Latar belakang : Dalam pembuktian kasus persetubuhan, anamnesis dan pemeriksaan fisik memiliki nilai bukti yang rendah. Dokter Forensik hanya dapat membuktikan persetubuhan dengan ditemukannya cairan mani atau sel sperma pada pemeriksaan penunjang. Baru-baru ini dikembangkan rapid test SD Bioline Semen Inspection yang sensitif dan spesifik untuk menemukan prostate-spesific antigen (PSA) yang merupakan salah satu dari kandungan cairan mani. Diharapkan metode ini dapat menjadi alternatif dalam pembuktian kasus persetubuhan. Tujuan : Untuk mengetahui nilai diagnostik alat SD Bioline Semen Inspection dalam mendeteksi adanya PSA pada usapan vagina, dan gambaran perbandingan nilai diagnostiknya pada subyek yang bersetubuh antara 1-3 hari dan 4-7 hari sebelum dilakukan pemeriksaan. Metode : Uji diagnostik dengam metode potong lintang, membandingkan antara rapid test SD Bioline Semen Inspection dengan Automatic Immuno Assay (AIA). Hasil : Nilai diagnostik alat SD Bioline Semen Inspection pada penelitian ini menunjukkan sensitivitas 44,44%, spesifisitas 100%, nilai duga positif 100%, nilai duga negatif 86,11%, prevalensi 22,5% dan akurasi 87,5%. Pada subyek yang bersetubuh antara 1-3 hari sebelum pemeriksaan menunjukkan nilai diagnostik sensitivitas 50%, spesifisitas 100%, nilai duga positif 100%, nilai duga negatif 89,29%, prevalensi 9,35% dan akurasi 90,32%. Pada subyek yang bersetubuh antara 4-7 hari sebelum pemeriksaan menunjukkan nilai diagnostik sensitivitas 33,33%, spesifisitas 100%, nilai duga positif 100%, nilai duga negatif 75%, prevalensi 33,33% dan akurasi 77,78%. Kesimpulan : SD Bioline Semen Inspection dapat digunakan dalam pelayanan kedokteran Forensik untuk membuktikan adanya PSA, namun perlu dilakukan uji konfirmasi dengan modalitas lain jika didapatkan hasil negatif.

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Background : History and physical examination alone could not prove a sexual intercourse. Thus, forensic doctors also need to find evidence of seminal fluid or sperm in determining sexual intercourse. Recently, there is an advancement in diagnostic tool in examining prostate specific antigen (PSA) in seminal fluid, which is a SD Bioline Semen Inspection. As a rapid test, this diagnostic tool is expected to be used in daily practice as an alternative method in determining sexual intercourse.

Objective : To determine diagnostic value of SD Bioline Semen Inspection in detecting Prostate Specific Antigen ( PSA) from vaginal swabs; To have an overview of diagnostic value of SD Bioline Semen Inspection in detecting Prostate Specific Antigen ( PSA) between 1-3 days and 4-7 days of intercourse prior to the examination.

Methods: This study is a cross-sectional research to compare SD Bioline Semen Inspection tool to Automatic Immuno Assay (AIA).

Results: This study showed SD Bioline Semen Inspection tool has 44.44% sensitivity, 100% specificity, 100% positive predictive value, 86,11% negative predictive value, prevalence is 22.5% and 87.5% accuracy. On the subject who have history of intercourse between 1-3 days prior to the examination, it showed 50% sensitivity, 100% specificity, 100 % positive predictive value, 89,29% negative predictive value, prevalence is 9.35% and 90.32% accuracy. On the subject who have history of intercourse between 4-7 days prior to the examination, it showed 33.33% sensitivity, 100% specificity, 100% positive predictive value, 75% negative predictive value , prevalence is 33.33%, and 77.78% accuracy.

Conclusion: The SD Bioline semen Inspection can be used in forensic medical services to prove the existence of PSA, but if the results are negative it still needs confirmation from other diagnostic modalities."

"Pendahuluan: Kanker prostat adalah keganasan terbanyak pada pria, penyebab kematian kedua terbesar akibat keganasan. Colok dubur adalah pemeriksaan dasar dan deteksi dini untuk mendiagnosis kanker prostat. Saat ini pemeriksaan Prostate-Specific Antigen (PSA) dianggap sebagai tumor marker yang paling bermanfaat untuk mendeteksi kanker prostat. The American Cancer Society dan American Urologic Association merekomendasikan penyaringan kanker prostat setiap tahun dengan pemeriksaan colok dubur dan PSA. Tujuan: Tujuan penelitian ini adalah untuk mengetahui hubungan antara pemeriksaan colok dubur dan nilai PSA pada pasien kanker prostat di RSUP DR Sardjito Yogyakarta periode Januari 2011 sampai Desember 2011. Metode Penelitian: Penelitian ini adalah kasus kontrol. Data dikumpulkan secara retrospektif dari catatan medis RSUP DR Sardjito pada pasien dengan colok dubur yang abnormal atau colok dubur normal dengan nilai PSA ≥ 10 ng/dl selama periode Januari 2011 sampai Desember 2011. Hasil pemeriksaan colok dubur dan nilai PSA didapatkan pada saat kunjungan pertama pasien ke rumah sakit. Analisis data nominal menggunakan Chi Square dengan SPSS 18. Hasil: Terdapat 87 pasien yang berhasil dikumpulkan selama periode Januari 2011 sampai Desember 2011 yang memiliki hasil pemeriksaan colok dubur abnormal atau colok dubur normal dengan nilai PSA ≥ 10 ng/dl. Pasien memiliki usia rata-rata 70 tahun, nilai median PSA 10,9 ng/dl. Pada pasien ini ditemukan colok dubur abnormal 43 (49,4%), colok dubur normal 44 (50,6%), PSA ≥ 10 ng/dl 69 (79,3%) dan PSA < 10 ng/dl 18 (20,7%). Pemeriksaan colok dubur dan PSA dinilai signifikan secara statistik untuk mendeteksi kanker prostat, hasil secara berurutan 67,2% vs 32,8% (p < 0,001) and 71,9% vs 28,1% (p = 0,002. Semua pasien dengan colok dubur abnormal dan PSA ≥ 10 ng/dl terdiagnosis kanker prostat (p < 0,001). Simpulan: Pemeriksaan colok dubur dan Prostate Specific Antigen (PSA) adalah prediktor terbaik untuk kanker prostat.

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Introduction: Prostate cancer is the most frequent form of cancer in males, being also second cause of death by cancer. Digital Rectal Examination (DRE) is the basic examination and early diagnosis for prostate cancer. The Prostate-Specific Antigen (PSA) assay is currently considered the most useful tumor marker for detecting prostate cancer. Both the American Cancer Society and American Urologic Association recommended annual cancer screening with both Digital Rectal Examination (DRE) and PSA.

Objective: The objective of this study is to understand the correlation between DRE and PSA level in prostate cancer at Sardjito General Hospital Yogyakarta during januari 2011 until december 2011.

Research Method: This is a case control study. The data were retrospectively collected from medical record in sardjito general hospital who had abnormal DRE or normal DRE with PSA ≥ 10 ng/dl during januari 2011 until December 2011. The DRE and PSA value were examined in the first time they came to the hospital. A chi-square was performed to analyzed the nominal data with SPSS 18.

Result: There are 87 patients were collected during januari 2011 until December 2011 who had abnormal DRE or normal DRE with PSA ≥ 10 ng/dl. The median age was 70 years, median PSA level was 10,9 ng/dl. Of these patient, we found abnormal DRE in 43 (49,4%), normal DRE in 44 (50,6%), PSA ≥ 10 ng/dl was 69 (79,3%) and PSA < 10 ng/dl was 18 (20,7%). Digital Rectal Examination and PSA was statistically significant to detected prostate cancer, 67,2% vs 32,8% (p < 0,001) and 71,9% vs 28,1% (p = 0,002), respectively. All patient who had abnormal DRE and PSA ≥ 10 ng/dl were diagnosed with prostate cancer (p < 0,001).

Conclusion: Digital Rectal Examination (DRE) and Prostate Specific Antigen (PSA) are the best predictor for prostate cancer. "

"Latar belakang: Adenokarsinoma prostat adalah keganasan tersering kedua yang dialami pria di Indonesia. Skor Gleason digunakan untuk mengklasifikasi tingkat diferensiasi dari tumor sedangkan menghitung kadar PSA digunakan sebagai salah satu cara untuk mendiagnosis kanker prostat.Tujuan: Riset ini bertujuan untuk mengetahui korelasi antara skor Gleason dengan kadar PSA pada pasien adenokarsinoma prostat di departemen Patologi Anatomik RSCM. Metode Penelitian: Data dikumpulkan dari 77 sampel yang didapat dari form pemeriksaan hasil diagnosis pasien adenokarsinoma prostat tahun 2011 sampai 2014 di arsip Department Patologi Anatomik RSCM. Data diolah menggunakan analisis uji korelasi Kendall Tau-b di program SPSS 20.Hasil: Sebagian besar pasien datang dengan skor Gleason yang sudah tinggi skor Gleason >7. Nilai PSA terkecil yang didapat dari arsip departemen Patologi Anatomik sebesar 2,73 ng/ml, nilai tertinggi mencapai 7100 ng/ml. Nilai rata-rata PSA meningkat dengan meningkatnya skor Gleason. Rata-rata nilai PSA dari skor Gleason 6, 7, 8, 9, dan 10 adalah 46,641 ng/ml, 63,935 ng/ml, 231,762 ng/ml, 542,146 ng/ml, and 1044,348 ng/ml p = 0,003, r = 0,254. Kesimpulan: Terdapat korelasi yang lemah antara skor Gleason dengan nilai PSA pada pasien adenokarsinoma prostat di Department Patologi Anatomik RSCM. Nilai PSA meningkat seiring meningkatnya skor Gleason.

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Background: Prostatic adenocarcinoma is the second most frequent malignancies occur in men in Indonesia. Gleason score is used to classify the grading of the tumor and PSA is used as one of diagnostic tools for prostate cancer.

Aim: To identify the correlation between Gleason score and PSA level in patients with prostate adenocarcinoma at Department of Anatomical Pathology Cipto Mangunkusumo Hospital. Method The data was obtained from 77 samples taken from request forms from patients with prostatic adenocarcinoma from 2011 to 2014 in the archive of Department of Anatomical Pathology and analyzed using Kendall Tau b rsquo s Rank Correlation in SPSS 20.

Result: Most patient came with high Gleason Score Gleason score 7 . The minimum PSA level obtained from the arcieve in Department of Anatomical Pathology is 2.73 ng ml and the highest value reached up to 7100 ng ml. The average PSA level increased with the Gleason score. Gleason score 6, 7, 8, 9, and 10 has the average PSA level of 46.641 ng ml, 63.935 ng ml, 231.762 ng ml, 542.146 ng ml, and 1044.348 ng ml respectively p 0.003, r 0.254.

Conclusion: There is statistically weak significant correlation between Gleason score and PSA level in patients with prostatic adenocarcinoma in Department of Anatomical Pathology Cipto Mangunkusumo Hospital. PSA increased as the Gleason score increase."

"Peningkatan PSA dapat ditemukan pada semua kelainan terkait prostat, baik keganasan kanker prostat maupun non-keganasan prostatitis . Terdapat hipotesis bahwa pemberian antibiotik diperkirakan dapat menurunkan kadar PSA. Penelitian ini bertujuan melihat pengaruh pemberian antibiotik terhadap penurunan kadar PSA pada pasien yang menderita LUTS yang memiliki kadar PSA tinggi. Penelitian ini menggunakan metode randomisasi-terkontrol yang dibagi menjadi 2 kelompok, kelompok yang mendapat terapi antibiotik dan kelompok yang mendapat plasebo diberikan selama 2 minggu. Nilai PSA diperiksa saat awal dan saat selesai obat. Biopsi prostat dilakukan pada saat selesai konsumsi obat. Tidak terdapat pengaruh yang signifikan antara penggunaan antibiotik dengan penurunan kadar PSA pada penderita LUTS.

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To see the effect of antibiotic administrations on PSA level reduction in patients with LUTS who have high PSA level, subjects were collected from urology outpatient clinic of Cipto Mangunkusumo National Hospital using consecutive sampling. Patients who have LUTS went through a selection process using inclusion and exclusion criteria. Selected patients were randomized into two different groups control who receive antibiotics and placebo group. Both groups were then given two weeks length of therapy, assessments for PSA levels before and after drug administrations, and a prostate biopsy at the end of drug administrations.There is no significant association between antibiotic and PSA level reduction in LUTS patients."