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Abstrak :
Latar belakang: Keganasan pankreas merupakan salah satu penyebab morbiditas dan mortalitas signifikan di dunia dengan 90% kasus adalah adenokarsinoma yang umumnya terdiagnosis stadium lanjut karena tidak memiliki gejala klinis spesifik dan keterbatasan dalam menegakkan diagnosis. Adenokarsinoma pankreas disebabkan oleh perubahan histologik dari neoplasma intraepitelial pankreas (PanIN) dan mutasi genetik antara lain aktivasi onkogen KRAS serta inaktivasi gen supresor tumor seperti CDKN2A/p16, p53, BRCA2 dan Small Mothers Against Decapentaplegic 4 (SMAD4) atau disebut juga Deleted in Pancreatic Cancer, locus 4 (DPC4). Mutasi DPC4 ditemukan pada 55% kasus dan relatif spesifik pada adenokarsinoma pankreas. Penelitian ini dilakukan untuk menilai ekspresi DPC4 pada adenokarsinoma pankreas dengan sampel fine-needle aspiration biopsy (FNAB) dengan tujuan meningkatkan akurasi diagnosis. Bahan dan cara: Penelitian ini menggunakan desain potong lintang. Sampel diambil dari data arsip Departemen Patologi Anatomik FKUI/RSCM terdiri atas kelompok data berpasangan dengan 9 kasus adenokarsinoma dan 5 kasus nonadenokarsinoma dari Januari 2012-Agustus 2018 serta kelompok data tidak berpasangan dengan 10 kasus adenokarsinoma dari Januari 2017-Agustus 2018. Dilakukan pulasan DPC4 pada sampel sitologi dan histopatologik. Penilaian mengunakan persentase cut off positif >50% sel tumor. Hasil: Ekspresi DPC4 negatif didapatkan pada 5 kasus adenokarsinoma dan 0 kasus nonadenokarsinoma data berpasangan, serta 5 kasus adenokarsinoma data tidak berpasangan. Uji Fisher s exact yang dilakukan mendapatkan hasil ekspresi DPC4 pada adenokarsinoma dan nonadenokarsinoma data berpasangan tidak berbeda bermakna dengan nilai p>0.05. Kesimpulan: Tidak didapatkan perbedaan yang bermakna antara ekspresi DPC4 pada adenokarsinoma dan nonadenokarsinoma. ......Background: Pancreatic malignancy is one of the causes of significant morbidity and mortality in the world with 90% of cases were adenocarcinomas which are generally diagnosed in advanced stages because there is no specific clinical symptom and limitation in making a diagnosis. Pancreatic adenocarcinoma is caused by histological changes of intraepithelial pancreatic neoplasms (PanIN) and genetic mutations including activation of KRAS oncogenes and inactivation of tumor suppressor genes such as CDKN2A/p16, p53, BRCA2 and Small Mothers Against Decapentaplegic 4 (SMAD4) or also called Deleted in Pancreatic Cancer, locus 4 (DPC4). DPC4 mutations is found in 55% of cases and relatively specific in pancreatic adenocarcinoma. This study was conducted to assess the expression of DPC4 in pancreatic adenocarcinoma using a fine-needle aspiration biopsy (FNAB) sample to increase diagnosis accuracy. Materials and methods: This was a cross-sectional study. Samples were taken from archival data of the Anatomical Pathology Department of FKUI/RSCM consisting of paired data group with 9 cases of adenocarcinoma and 5 cases of nonadenocarcinoma from January 2012 to August 2018 and unpaired data group with 10 cases of adenocarcinoma from January 2017 to August 2018. All cytology and histopathologic samples were stained with DPC4 antibody and evaluated using a positive cut-off> 50% of tumor cells. Results: Negative DPC4 expression was found in 5 cases of adenocarcinoma and 0 cases of nonadenocarcinoma in paired data group, and 5 cases of unpaired data group adenocarcinoma. The Fisher s exact showed no significant difference of DPC4 expression between adenocarcinoma and nonadenocarcinoma paired data group with p value> 0.05. Conclusion: There was no significant difference in the expression of DPC4 between adenocarcinoma and nonadenocarcinoma.

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Latar belakang. Adenokarsinoma kolorektal AKR merupakan keganasan gastrointestinal yang sering ditemukan dan mempengaruhi lebih dari satu juta individu di seluruh dunia. Identifikasi histologis invasi limfovaskular telah dikenali sebagai indikasi potensial untuk metastasis KGB dan indikasi prognostik dan prediktor dari luaran pasien.Metode.Penelitian ini adalah penelitian retrospektif dengan regresi logistik multivariat.Hasil. Hasil penelitian didapatkan faktor usia, diferensisasi tumor, pT, dan jenis kelamin tidak mempengaruhi kejadian invasi limfovaskular. AKR diferensiasi sedang dan jenis kelamin laki-laki didapatkan kejadian invasi limfovaskular yang lebih besar dibanding diferensiasi lain dan jenis kelamin perempuan.Kesimpulan. Faktor-faktor yang mepengaruhi invasi limfovaskular yaitu diferensiasi tumor, usia, jenis kelamin, lokasi tumor dan derajat patologis T tidak bermakna secara statistik. Invasi limfovaskular merupakan prediktor terjadinya metastasis KGB. ......Background. Adenocarcinoma colon and rectum are the most common gastrointestinal malignancy and afflict more than one million individual worlds wide. Histologic finding of limphovascular invasion has known as potensial indication for lymphatic metastatic and prognostic indication and predictor of patient outcome.Methods. This studi was retrospective, logistic regression test was used for multivariate analysis.Result. Result of this study ara gender, age, tumor differentiation and pT not significantly related to lymphovascular invasion. Mild differentiation and male gender recorded had bigger risk to had lymphovascular invasion descriptively.Conclusion. Factors affecting lymphovascular invasion ie tumor differentiation, age, sex, tumor location and pathologic T degree were not statistically significant. Lymphovascular invasion is a predictor of limph nodes metastasis.

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CA 19-9 merefleksikan derajat keparahan adenokarsinoma kaput pankreas ditunjukkan oleh beberapa studi berhasil menemukan korelasi peningkatan CA 19-9 dengan resektabilitas adenokarsinoma kaput pankreas. Penelitian ini bertujuan melakukan evaluasi hubungan dan nilai diagnostik CA 19-9 dalam memprediksi resektabilitas adenokarsinoma kaput pankreas. Penelitian dilakukan secara potong lintang mengambil data dari rekam medis Rumah Sakit dr. Cipto Mangunkusumo tahun 2016–2019. Pasien terdiagnosis adenokarsinoma kaput pankreas secara histopatologis atau pencitraan abdomen, berusia ≤65 tahun, dan memiliki catatan pemeriksaan kadar CA 19-9 diikutsertakan dalam penelitian ini. Selain kadar CA 19-9, peneliti juga menilai factor terkait operabilitas. Tercatat 54 subjek dengan rerata usia 53,78±11,13 tahun. Ditemukan adanya korelasi positif (0,850) dan signifikan antara tingginya kadar CA 19-9 dengan resektabilitas tumor kaput pankreas. Untuk operabilitas, ditemukan perbedaan bermakna kadar CA 19-9, albumin, dan skor Karnofsky pada kelompok pasien tumor kaput pankreas resectable dan unresectable. Titik potong kadar CA 19-9 tercatat sebesar 140,65 U/mL, dengan sensitivitas sebesar 82,76% (64,23%–94,15%), spesifisitas sebesar 72,00% (50,61%–87,93%), dan AUC sebesar 0,784. CA 19-9 berhubungan secara signifikan dengan resektabilitas tumor kaput pankreas. CA 19-9 memiliki nilai diagnostik yang baik dalam mempredisksi resektabilitas tumor ini. ......CA 19-9 reflects the degree of severity of pancreatic head adenocarcinoma shown by several studies to find a correlation of elevated CA 19-9 with resectability of pancreatic head adenocarcinoma. This study aimed to evaluate the relationship and diagnostic value of CA 19-9 in predicting resectability of pancreatic head adenocarcinoma. The study was conducted in a cross-sectional manner, taking data from the medical records of dr. Cipto Mangunkusumo 2016–2019. Patients diagnosed with adenocarcinoma of the head of the pancreas by histopathologic or abdominal imaging, aged ≤65 years, and who had a record CA level of 19-9 were included in this study. In addition to CA levels of 19-9, the investigators also assessed operability-related factors. There were 54 subjects with a mean age of 53.78 ± 11.13 years. Found a positive correlation (0, 850) and significant between high levels of CA 19-9 with resectability of head tumors of the pancreas. For operability, there were significant differences in CA 19-9 levels, albumin, and Karnofsky scores in the resectable and unresectable group of pancreatic head tumors. The cut-off point for CA 19-9 levels was recorded at 140.65 U / mL, with a sensitivity of 82.76% (64.23% -94.15%), a specificity of 72.00% (50.61% -87.93 %), and AUC of 0.784. CA 19-9 was significantly associated with pancreatic head tumor resectability. CA 19-9 has a good diagnostic value in predicting the resectability of these tumors. The cut-off point for CA 19-9 levels was 140.65 U / mL, with a sensitivity of 82.76% (64.23% -94.15%), a specificity of 72.00% (50.61% -87.93 %), and AUC of 0.784. CA 19-9 was significantly associated with pancreatic head tumor resectability. CA 19-9 has a good diagnostic value in predicting the resectability of these tumors. The cut-off point for CA 19-9 levels was 140.65 U / mL, with a sensitivity of 82.76% (64.23% -94.15%), a specificity of 72.00% (50.61% -87.93 %), and AUC of 0.784. CA 19-9 was significantly associated with pancreatic head tumor resectability. CA 19-9 has a good diagnostic value in predicting the resectability of these tumors

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Latar belakang: Adenokarsinoma prostat merupakan salah satu jenis kanker yang paling banyak didiagnosis pada laki-laki di seluruh dunia, dengan mayoritas pasien berusia di antara 60 ndash; 80 tahun. Usia adalah salah satu faktor risiko yang paling berperan, dan diperkirakan mempunyai andil dalam perkembangan penyakit ini. Tujuan: Untuk menentukan korelasi antara usia dengan skor Gleason pada pasien dengan adenokarinoma prostat. Metode Data mengenai usia dan skor Gleason diperoleh dari 101 sampel yang diambil dari lembar permintaan pemeriksaan pasien dari tahun 2011 sampai 2014, di Departemen Patologi Anatomik, Rumah Sakit Cipto Mangunkusumo. Analisis statistik Kendall's tau-b digunakan untuk menentukan korelasi. Hasil: Usia rata-rata pasien adenokarsinoma prostat pada penelitian ini adalah 67,87 tahun dan kebanyakan pasien memiliki skor Gleason 9 48 pasien . Pada uji korelasi antara usia dan skor Gleason pasien didapat nilai p = 0,012 dan r = -0,193. Pasien di bawah 65 tahun memiliki rata-rata skor Gleason 8,588, pasien di atas 65 tahun tahun memiliki rata-rata skor Gleason 8,239. Pada uji non parametrik Mann ndash; Whitney didapat nilai p = 0,009. Kesimpulan: Terdapat korelasi sangat lemah antara usia dengan skor Gleason pada pasien dengan adenokarsinoma prostat. dengan pasien muda cenderung memiliki skor Gleason yang lebih tinggi.

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Background: Prostatic adenocarcinoma is one of the most common cancers diagnosed in men worldwide, with most patients being 60 ndash 80 years old. Age is one of the significant risk factors of the disease's development and progression. Aim: To determine the correlation between age and Gleason score in patients with prostatic adenocarcinoma. Methods: Data in regard to age and Gleason score of patients with prostatic adenocarcinoma were obtained from 101 samples from patients'request forms in 2011 to 2014, in Department of Anatomical Pathology, Cipto Mangunkusumo Hospital. Kendall's tau b statistical analysis was used to determine the correlation. Results Mean age of patients in prostatic adenocarcinoma in this study is 67.87 years old, and most patients have Gleason score of 9 48 patients. On statistical analysis to determine correlation between age and Gleason score, we acquire p value of 0.012 and r value of 0.193. Patients below 65 years old have average Gleason score of 8.588, patients above 65 years old have average Gleason score of 8.239. On Mann ndash Whitney non parametric test, we acquire p value of 0.009. Conclusion There was a very weak correlation between age and Gleason score in patients with prostatic adenocarcinoma with younger patients tend to have higher Gleason score.

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Latar belakang: Pada penelitian in vitro, kombinasi gefitinib dan radioterapi telah diamati memiliki efek sinergis dan anti-proliferasi terhadap KPKBSK. Tujuan: Mengetahui efikasi dan toleransi kombinasi radioterapi dan TKI pada pasien adenokarsinoma paru dengan mutasi EGFR. Metode: Penelitian observasional kohort retrospektif analitik di Rumah Sakit Umum Pusat Persahabatan. Data diambil dari Rekam Medis Rumah Sakit Umum Pusat Persahabatan dan dilakukan dengan total sampling pada periode 1 Januari 2013 sampai Desember 2016. Hasil: Sampel penelitian 31 subjek, dengan karateristik pasien laki-laki 51.61 median usia 54,5 tahun, range usia 38-70 tahun dan pasien adenokarsinoma paru perempuan 48,38 median usia 57 tahun, range usia 38-77 tahun . Lokasi mutasi EGFR didapatkan mutasi pada exon 21 L858R sebanyak 61,30 , exon 21 L861Q 16,12 dan delesi ekson 19 sebanyak 22,58 . Dosis radioterapi yang diberikan 30-60 Gy. Keadaan klinis pada saat penelitian SVKS 35,5 , klinis progresif 22,6 dan lain-lain 41,9 . Toksisitas non hematologi yang terbanyak adalah skin rash diikuti diare dan paronikia dengan derajat ringan. Toksisitas hematologi tersering adalah anemia derajat 1-2 sebanyak 15 orang. Progression free survival PFS 185 hari IK95 ; 123,69-246,30 , overall survival OS 300 hari IK95 ;130,94-469,06 dan 1 years survival 45,2 . Kesimpulan: Kombinasi radioterapi dan gefitinib dapat meningkatkan PFS pada pasien adenokarsinoma paru dengan klinis SVKS dan meningkatkan OS pada pasien dengan klinis yang progresif.. Kata kunci: Adenokarsinoma, Efikasi, Gefitinib, Radioterapi

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ABSTRACT Background In vitro studies, combinations of gefitinib and radiotherapy have been observed to have synergistic and anti proliferative effects on lung adenocarsinoma.Objective To evaluate the efficacy and tolerance of combination radiotherapy and TKI in patients with pulmonary adenocarcinoma with EGFR mutation. Methods A cohorts retrospective observational analytical analytical at RSUP Persahabatan, Jakarta. In this study we use total sampling. Data was optained from January 2013 until December 2016. Results Data from 31 lung adenocarcinoma with EGFR mutations patients were collected , which is characterized male 51.61 median age 54.5 years, range 38 70 years and female patients 48.38 median age 57 years, range 38 77 year . Epidermal Growth Favtor Reseptor EGFR mutation in exon 21 L858R of 61.30 , exon 21 L861Q 16.12 and 19 exon delions of 22.58 . Radiotherapy dose were given 30 60 Gy. Clinical finding in this study SVCS 35,5 , progressive 22,6 and others 41,9 .The non hematological toxicities are skin rash, diarrhea and paronychia with mild degree. The common haematological toxicity is mild anemia 15 patients . Progression free survival PFS in radiation gefitinib are 185 days CI95 123,69 246,30 , overall survival OS are 300 days CI95 130,94 469,06 and 1 yeqrs survival 45,2 .Conclusion Combination therapy radiation gefitinib in Lung adenocarsinoma with SVCS increasing PFS and patient lung adenocarcinoma with progressive disease increasing OS.Keywords Lung adenocarcinoma, efficacy, gefitinib, radiation