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Segal Abdul Aziz
Kadar procalcitonin dan perannya sebagai biomarker sepsis pada pasien tumor padat dengan metastasis jauh = Level of procalcitonin and its role as a sepsis biomarker in patient with metastatic solid tumor
"ABSTRAK
Latar Belakang: Pengaruh metastasis sebagai penyebab peningkatan procalcitonin
(PCT) pada pasien tumor padat nonsepsis masih belum jelas. Studi-studi
sebelumnya memberikan hasil yang tidak konklusif. Nilai titik potong PCT untuk
diagnosis sepsis pada tumor padat metastasis juga belum diketahui.
Tujuan: Mengetahui peran PCT dalam diagnosis sepsis pada pasien tumor padat
dengan metastasis.
Metode: Studi potong lintang terhadap pasien tumor padat yang berobat di RSCM
September-Desember 2015. Pada pasien ditentukan ada tidaknya sepsis
menggunakan kriteria sepsis ACCP/SCCM 2001, dilakukan pemeriksaan darah
perifer, serta PCT. Dilakukan analisis untuk mengetahui perbedaan kadar PCT
pasien tumor padat metastasis dan tanpa metastasis yang tidak sepsis. Selain itu,
dilakukan pula pencarian nilai titik potong PCT untuk diagnosis sepsis pada pasien
tumor padat metastasis dengan menggunakan ROC.
Hasil dan Pembahasan: Didapatkan 112 pasien tumor padat, pria sebanyak 51%,
dengan rerata usia 47,9 ±12,47 tahun. Sebanyak 71 (63,4%) pasien sudah
didapatkan metastasis, 36 (32,1%) diantaranya sepsis, dan 6 (5,3%) mengalami
SIRS. Dari 41 (36,6%) pasien tanpa metastasis, 9 (8%) mengalami sepsis, dan 5
(4,4%) SIRS. Terdapat perbedaan bermakna kadar PCT pada pasien tumor padat
metastasis dibandingkan tanpa metastasis pada kondisi nonsepsis [0,25 ng/mL
(0,07-1,76) vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Pasien tumor padat metastasis
yang mengalami sepsis memiliki kadar PCT lebih tinggi dibandingkan nonsepsis
[3,5 ng/mL (0,66-189,4) vs. 0,25 ng/mL (0,07-1,76); p<0,001]. Dari kurva ROC
kadar PCT pada tumor padat metastasis, didapatkan AUC [0,956, IK 0,916-0,996]
untuk mendiagnosis sepsis. Nilai titik potong PCT untuk diagnosis sepsis pada
pasien tumor padat metastasis adalah 1,14 ng/mL dengan sensitivitas 86% dan
spesifisitas 88%.
Kesimpulan: Pada kondisi nonsepsis, kadar PCT pasien tumor padat metastasis
lebih tinggi dibandingkan pasien tanpa metastasis. Nilai titik potong PCT untuk diagnosis sepsis pada tumor padat metastasis adalah 1,14 ng/mL. ABSTRACT
Background: The effect of metastasis as a cause of increased procalcitonin (PCT)
in patients with solid tumors without sepsis remains unclear. Previous studies did
not provide conclusive results. Cut off point of PCT for sepsis diagnosis in
metastatic solid tumors is also unknown.
Objective: To determine the role of PCT in the diagnosis of sepsis toward
metastatic solid tumors patients.
Methods: A cross sectional study was conducted in solid tumor patients who were
admitted to Cipto Mangunkusumo, Jakarta between September 2015 and December
2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS in
patients. Procalcitonin level, as well as routine blood examination, was performed
to determine the differences of PCT level among solid tumor patients with and
without metastasis. Cut off point of PCT for diagnosing sepsis in patients with
metastatic solid tumors was determined using ROC curve.
Results and Discussion: There were 112 patients with solid tumors, 51% male,
with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,
while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41
(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. In
the absence of sepsis, the PCT level was significantly higher in patients with
metastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)
vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsis
had PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.
0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsis
in metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCT
for sepsis in patients with metastatic solid tumors was 1.14 ng / mL with a
sensitivity of 86% and specificity of 88%.
Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solid
tumors is higher than patients without metastasis. Cut off point of PCT for sepsis
diagnosis in metastatic solid tumors was 1,14 ng / mL. ;Background: The effect of metastasis as a cause of increased procalcitonin (PCT)
in patients with solid tumors without sepsis remains unclear. Previous studies did
not provide conclusive results. Cut off point of PCT for sepsis diagnosis in
metastatic solid tumors is also unknown.
Objective: To determine the role of PCT in the diagnosis of sepsis toward
metastatic solid tumors patients.
Methods: A cross sectional study was conducted in solid tumor patients who were
admitted to Cipto Mangunkusumo, Jakarta between September 2015 and December
2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS in
patients. Procalcitonin level, as well as routine blood examination, was performed
to determine the differences of PCT level among solid tumor patients with and
without metastasis. Cut off point of PCT for diagnosing sepsis in patients with
metastatic solid tumors was determined using ROC curve.
Results and Discussion: There were 112 patients with solid tumors, 51% male,
with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,
while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41
(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. In
the absence of sepsis, the PCT level was significantly higher in patients with
metastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)
vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsis
had PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.
0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsis
in metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCT
for sepsis in patients with metastatic solid tumors was 1.14 ng / mL with a
sensitivity of 86% and specificity of 88%.
Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solid
tumors is higher than patients without metastasis. Cut off point of PCT for sepsis
diagnosis in metastatic solid tumors was 1,14 ng / mL. ;Background: The effect of metastasis as a cause of increased procalcitonin (PCT)
in patients with solid tumors without sepsis remains unclear. Previous studies did
not provide conclusive results. Cut off point of PCT for sepsis diagnosis in
metastatic solid tumors is also unknown.
Objective: To determine the role of PCT in the diagnosis of sepsis toward
metastatic solid tumors patients.
Methods: A cross sectional study was conducted in solid tumor patients who were
admitted to Cipto Mangunkusumo, Jakarta between September 2015 and December
2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS in
patients. Procalcitonin level, as well as routine blood examination, was performed
to determine the differences of PCT level among solid tumor patients with and
without metastasis. Cut off point of PCT for diagnosing sepsis in patients with
metastatic solid tumors was determined using ROC curve.
Results and Discussion: There were 112 patients with solid tumors, 51% male,
with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,
while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41
(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. In
the absence of sepsis, the PCT level was significantly higher in patients with
metastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)
vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsis
had PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.
0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsis
in metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCT
for sepsis in patients with metastatic solid tumors was 1.14 ng / mL with a
sensitivity of 86% and specificity of 88%.
Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solid
tumors is higher than patients without metastasis. Cut off point of PCT for sepsis
diagnosis in metastatic solid tumors was 1,14 ng / mL. ;Background: The effect of metastasis as a cause of increased procalcitonin (PCT)
in patients with solid tumors without sepsis remains unclear. Previous studies did
not provide conclusive results. Cut off point of PCT for sepsis diagnosis in
metastatic solid tumors is also unknown.
Objective: To determine the role of PCT in the diagnosis of sepsis toward
metastatic solid tumors patients.
Methods: A cross sectional study was conducted in solid tumor patients who were
admitted to Cipto Mangunkusumo, Jakarta between September 2015 and December
2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS in
patients. Procalcitonin level, as well as routine blood examination, was performed
to determine the differences of PCT level among solid tumor patients with and
without metastasis. Cut off point of PCT for diagnosing sepsis in patients with
metastatic solid tumors was determined using ROC curve.
Results and Discussion: There were 112 patients with solid tumors, 51% male,
with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,
while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41
(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. In
the absence of sepsis, the PCT level was significantly higher in patients with
metastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)
vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsis
had PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.
0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsis
in metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCT
for sepsis in patients with metastatic solid tumors was 1.14 ng / mL with a
sensitivity of 86% and specificity of 88%.
Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solid
tumors is higher than patients without metastasis. Cut off point of PCT for sepsis
diagnosis in metastatic solid tumors was 1,14 ng / mL. ;Background: The effect of metastasis as a cause of increased procalcitonin (PCT)
in patients with solid tumors without sepsis remains unclear. Previous studies did
not provide conclusive results. Cut off point of PCT for sepsis diagnosis in
metastatic solid tumors is also unknown.
Objective: To determine the role of PCT in the diagnosis of sepsis toward
metastatic solid tumors patients.
Methods: A cross sectional study was conducted in solid tumor patients who were
admitted to Cipto Mangunkusumo, Jakarta between September 2015 and December
2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS in
patients. Procalcitonin level, as well as routine blood examination, was performed
to determine the differences of PCT level among solid tumor patients with and
without metastasis. Cut off point of PCT for diagnosing sepsis in patients with
metastatic solid tumors was determined using ROC curve.
Results and Discussion: There were 112 patients with solid tumors, 51% male,
with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,
while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41
(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. In
the absence of sepsis, the PCT level was significantly higher in patients with
metastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)
vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsis
had PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.
0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsis
in metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCT
for sepsis in patients with metastatic solid tumors was 1.14 ng / mL with a
sensitivity of 86% and specificity of 88%.
Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solid
tumors is higher than patients without metastasis. Cut off point of PCT for sepsis
diagnosis in metastatic solid tumors was 1,14 ng / mL. "
Fakultas Kedokteran Universitas Indonesia, 2016
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UI - Tugas Akhir  Universitas Indonesia Library
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Nyoman Gede Bimantara
Analisis Hubungan Kadar Cluster Of Differentiation 133 (Cd133) Dan C-X-C Chemokine Receptor 4 (Cxcr4) Dengan Kejadian Metastasis Dan Tanpa Metastasis Pada Pasien Osteosarkoma Di Rsupn Dr. Ciptomangunkusumo Dan Rsup Prof. Dr. I.G.N.G. Ngoerah = Analysis Of The Association Between Cluster Of Differentiation 133 (Cd133) And C-X-C Chemokine Receptor 4 (Cxcr4) Levels With The Incidence Of Metastasis And Without Metastasis In Osteosarcoma Patients At Dr. Cipto Mangunkusumo Hospital And Prof. Dr. I.G.N.G. Ngoerah
"Insiden osteosarkoma di seluruh dunia mencapai 3,4 kasus per satu juta penduduk per tahun. Sebanyak 10%-20% pasien osteosarkoma ditemukan telah mengalami metastasis. Kemampuan metastasis yang tinggi pada osteosarkoma ini didukung dengan karakteristik populasi selnya yang memiliki tingkat proliferasi yang tinggi, serta peran cancer stem cells (CSC) dalam proses tumorigenesis dan metastasis osteosarkoma. Salah satu metode untuk mendeteksi CSC adalah dengan mendeteksi marker permukaan dan ekspresi stem-like gene, antara lain CD133 dan CXCR4. Tujuan penelitian ini untuk mengetahui hubungan kadar CD133 dan CXCR4 dengan kejadian metastasis pada pasien osteosarkoma. Penelitian ini menggunakan pendekatan cross sectional, dengan sampel serum darah pasien yang didiagnosis osteosarkoma berdasarkan hasil histopatologi di RSCM dan RSUP Prof. Dr. I.G.N.G. Ngoerah. Pemeriksaan kadar CD133 dan CXCR4 menggunakan KIT ELISA Reed Biotech dengan menilai absorbansi secara kuantitatif. Data metastasis diperoleh dari rekam medik. Hubungan kadar CD133 dan CXCR4 dengan kejadian metastasis pada osteosarkoma dianalisis dengan uji chi-square dengan tingkat kemaknaan p<0,05 dianggap signifikan. Penelitian ini melibatkan 40 orang dengan 80% diantaranya berusia <40 tahun. Rerata kadar CD133 yang diperolah sebesar 0.23±0.02 pg/ml, sedangkan rerata kadar CXCR4 yang diperoleh sebesar 6015.82±2345.55 pg/ml. Dari penelitian ini didapatkan adanya hubungan yang signifikan antara kadar CD133 dan CXCR4 dengan kejadian metastasis.
The incidence of osteosarcoma worldwide reaches 3.4 cases per million population per year. As many as 10%- 20% of osteosarcoma patients are found to have experienced metastasis. The high metastatic ability in osteosarcoma is supported by the characteristics of its cell population which has a high proliferation rate, as well as the role of cancer stem cells (CSC) in the process of tumorigenesis and metastasis of osteosarcoma. One method to detect CSC is to detect surface markers and stem-like gene expression, including CD133 and CXCR4. The purpose of this study was to determine the relationship between CD133 and CXCR4 levels and the incidence of metastasis in osteosarcoma patients. This study used a cross-sectional approach, with blood serum samples from patients diagnosed with osteosarcoma based on histopathology results at RSCM and Prof. Dr. I.G.N.G. Ngoerah Hospital. Examination of CD133 and CXCR4 levels using the Reed Biotech ELISA KIT by assessing absorbance quantitatively. Metastasis data were obtained from medical records. The relationship between CD133 and CXCR4 levels with the incidence of metastasis in osteosarcoma was analyzed using the chi-square test with a significance level of p<0.05 considered significant. This study involved 40 people with 80% of them aged <40 years. The average CD133 level obtained was 0.23±0.02 pg/ml, while the average CXCR4 level obtained was 6015.82±2345.55 pg/ml. From this study, a significant relationship was found between CD133 and CXCR4 levels with the incidence of metastasis."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2024
D-pdf
UI - Disertasi Membership  Universitas Indonesia Library
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Prinindita Artiara Dewi
Perbedaan Appendicular Skeletal Muscle Index pada Tumor Metastasis dengan dan Tanpa Keterlibatan Sistem Saraf Pusat = Appendicular Skeletal Muscle Index Difference in Metastatic Tumors With and Without Involving the Central Nervous System
"Latar Belakang: Kanker primer tahap lanjut dapat bermetastasis ke sistem saraf pusat (SSP) yaitu otak dan spinal, maupun ke selain SSP. Perbedaan gejala klinis antara metastasis SSP dan tanpa keterlibatan SSP adalah defisit neurologis pada metastasis SSP. Kedua metastasis tersebut dapat berisiko menyebabkan indeks massa otot skeletal yang rendah akibat gejala klinis dan peningkatan metabolisme akibat kanker. Namun, belum diketahui perbedaan di antara keduanya. Tujuan penelitian ini untuk mengetahui perbedaan appendicular skeletal muscle index (ASMI) pada pasien metastasis dengan dan tanpa keterlibatan SSP. Metode: Penelitian ini adalah studi potong lintang pada subjek berusia 18-65 tahun. Karakteristik subjek berupa usia, jenis kelamin, indeks massa tubuh, status gizi berdasarkan ASPEN, lokasi tumor primer, lokasi metastasis, waktu terdiagnosis metastasis, defisit neurologis, asupan energi dan protein, Karnofsky Performance Scale, kemoterapi, terapi glukokortikoid, dan nilai ASMI. Analisis bivariat digunakan untuk menilai perbedaan nilai ASMI antara metastasis SSP dan tanpa keterlibatan SSP. Hasil: Terdapat 59 subjek dengan nilai ASMI rendah. Rerata nilai ASMI pada metastasis SSP lebih rendah (3,81±1,19 kg/m2) dibandingkan dengan metastasis tanpa keterlibatan SSP (3,97±0,93 kg/m2) dengan perbedaan tidak signifikan pada kedua kelompok (p = 0,568). Terdapat perbedaan bermakna antara ASMI rendah dengan jenis kelamin (p=0,000), asupan energi (p=0,012), disfagia (p=0,027), nyeri kepala (p=0,033), dan gangguan kognitif (p=0,032). Kesimpulan: Tidak ditemukan perbedaan bermakna antara subjek yang memiliki ASMI rendah pada metastasis SSP dan tanpa keterlibatan SSP. Perbedaan bermakna ditemukan antara ASMI dengan karakteristik subjek yaitu jenis kelamin, asupan energi, disfagia, nyeri kepala, dan gangguan kognitif.
Background: Advanced primary cancer can metastasize to the central nervous system (CNS), namely the brain and spinal cord, or to other than the CNS. The difference in clinical symptoms between CNS metastases and those without CNS involvement is the neurological deficit in CNS metastases. Both metastases may be at risk for low skeletal muscle mass index due to clinical symptoms and increased metabolism due to cancer. However, the differences between them are unknown. The aim of this study was to determine the difference of appendicular skeletal muscle index in metastatic patients with and without CNS involvement. Methods: This study was a cross-sectional study on subjects aged 18-65 years. Subject characteristics included age, gender, body mass index, nutritional status based on ASPEN, primary tumor location, metastasis location, time of metastasis diagnosis, neurological deficits, energy and protein intake, Karnofsky Performance Scale, chemotherapy, glucocorticoid therapy, and ASMI value. Bivariate analysis was used to assess the difference in ASMI value between CNS metastasis and without CNS involvement Results: There were 59 subjects with low ASMI values. The mean ASMI value in CNS metastasis was lower (3,81±1,19 kg/m2) compared to metastasis without CNS involvement (3,97±0,93 kg/m2) without significant difference in both groups (p=0,568). There was a significant difference between low ASMI and gender (p=0,000), energy intake (p=0,012), dysphagia (p=0,027), headache (p=0,033), and cognitive impairment (p=0,032). Conclusion: No significant difference was found between subjects who had low ASMI in CNS metastasis and without CNS involvement. Significant differences were found between ASMI and subject characteristics such as gender, energy intake, dysphagia, headache, and cognitive impairment."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2024
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UI - Tugas Akhir  Universitas Indonesia Library
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Islam Akbar Alam
Penilaian ekspresi fibroblast groeth factor 2 (FGF2) pada kanker payudara stadium dini dihubungkan dengan metastasis kelenjar getah bening aksila = Expression of fibroblast growth factor 2 (FGF2) in early stage breast cancer related to axillary lymph node metastasis
"Latar Belakang : FGF2 merupakan ligan bagi Fibroblast Growth Factor Receptor2(FGFR2). Interaksi dengan reseptor ini memediasi dimerisasi reseptor, fosforilasi, dan aktivasi jalur pensinyalan, seperti jalur Ras-MAPK dan PI3K. Mutasi yang berlebihan melalui sumbu FGF / FGFR dapat menginduksi proliferasi sel kanker, memicu angiogenesis dan limfogenesis, yang mendorong terjadinya metastasis. Penelitian ini mencoba mengevaluasi peran FGF2 pada metastasis kelenjar getah bening aksila pada pasien kanker payudara stadium dini.
Tujuan : Mengetahui hubungan nilai ekspresi FGF 2 pada tumor primer terhadap kejadian metastasis kelenjar getah bening aksila.
Metode : Digunakan studi potong lintang dengan mengevaluasi ekspresi FGF2 pada 47 pasien kanker payudara stadium dini yang menjalani mastektomi di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSCM) pada periode Januari 2014 sampai Desember 2018. Ekspresi FGF2 diperiksa dengan pemeriksaan imunohistokimia, kemudian dievaluasi dan dihubungkan antara ekspresi FGF2 dengan metastasis kelenjar getah bening aksila.
Hasil : Uji Chi Square memperlihatkan nilai p=0.044 (p<0.05) yang menunjukkan bahwa terdapat hubungan yang signifikan antara nilai FGF2 pada tumor payudara dengan kejadian metastasis kelenjar getah bening aksila. Odds ratio 4,22 (CI 95% 0,983-18,1).
Kesimpulan : Peran FGF2 dalam metastasis kelenjar getah bening berhubungan dengan interaksi antara berbagai faktor limfangiogenik dalam mempromosikan limfangiogenesis dan metastasis limfatik. Ekspresi FGF2 yang tinggi memiliki korelasi signifikan dengan angka kejadian metastasis kelenjar getah bening aksila.
Background : FGF2 is a ligand for Fibroblast Growth Factor Receptor 2 (FGFR2). Interaction with this receptor mediate dimerization of receptor, phosphorilation, and activation of signaling pathway, such as Ras-MAPK and PI3K. Overmutation through FGF/FGFR induced proliferation of cancer cells, promoted angiogenesis, lymphogenesis, and metastasis. This study tried to evaluate the role of FGF2 in axillary lymph node metastasis in early-stage breast cancer patients.
Aim : To determined the relationship of FGF 2 expression values in primary tumors to the incidence of axillary lymph node metastases.
Methods :A cross-sectional study was used by evaluating the expression of FGF2 in 47 early-stage breast cancer patients who underwent a mastectomy at the Cipto Mangunkusumo National Center General Hospital (RSCM) from January 2014 to Desember 2018. FGF2 expression was examined by immunohistochemistry, then evaluated and linked between expression FGF2 with axillary lymph node metastases.
Results : The Chi Square test had a value of p=0.044 (p<0.05) that showed there was a significant relationship between FGF2 value in breast tumors with the incidence of axillary lymph node metastasis. Odds ratio 4.22 (95% CI 0.983-18.1).
Conclusions The role of FGF2 in lymph node metastasis is related to the interaction between various lymphangiogenic factors in promoting lymphangiogenesis and lymphatic metastasis. High expression of FGF2 has a significant correlation with the incidence of axillary lymph node metastasis."
Depok: Fakultas Kedokteran Universitas Indonesia, 2019
T58590
UI - Tesis Membership  Universitas Indonesia Library
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Nopriansyah Darwin
Uji Kesintasan pada Kanker Payudara yang Dilakukan Pemeriksaan Vimentin dengan Kejadian Metastasis = Expression of Vimentin and Its Associaton With Metastases and Survival In Breast Cancer Patients
"Latar Belakang: Kanker payudara merupakan jenis kanker yang paling sering terjadi pada wanita di seluruh dunia dan menyumbangkan angka mortalitas yang tinggi akibat risiko metastasis. Metastasis dapat terjadi meskipun pasien telah diterapi secara adekuat. Epitel-mesenchymal transition (EMT) adalah salah satu mekanisme utama terjadinya metastasis. Sel yang mengalami perubahan fenotip menjadi mesenkimal bersifat agresif, motil dan potensial menjadi metastasis. Vimentin merupakan salah satu biomarker spesifik yang muncul ketika sel mengadopsi fenotip mesenkim. Vimentin dapat memprediksi metastasis dan survival pada kanker payudara. Tujuan: Mengetahui hubungan antara ekspresi vimentin terhadap kejadian metastasis dan survival pada pasien kanker payudara. Metode: Desain studi ini adalah kohort retrospektif. Subjek berasal dari pasien kanker payudara di RSUP dr. Ciptomangunkusumo periode 2017–2018. Dilakukan pemeriksaan imunohistokimia untuk mengetahui ekspresi vimentin. Pasien diobservasi selama 4 tahun untuk mengetahui keluaran metastasis dan survival. Hasil: Terdapat 43 subjek, terdiri dari 39 ekspresi vimentin positif (90,7%), 10 subjek metastasis (23,3%), 16 subjek meninggal (37,2%). Pasien dengan ekspresi vimentin positif memiliki risiko 2,99 kali terjadi metastasis. Rerata overall survival (OS) pasien ekspresi vimentin positif lebih rendah dibandingkan negatif (162,0 minggu vs 174,5 minggu). Namun, secara statistik tidak terdapat hubungan bermakna antara vimentin terhadap kejadian metastasis (p=1,000) dan survival (p=0.971). Kesimpulan: Ekspresi vimentin tidak berhubungan dengan kejadian metastasis dan survival. Namun, ekspresi vimentin positif memiliki kecenderungan meningkatkan risiko metastasis dan mortalitas yang lebih cepat pada pasien kanker payudara.
Background: Breast cancer is the most common of cancer in women around the world and contributes to a high mortality rate because of the risk of metastases. Metastases can still occur even if the patient has been adequately treated. Epithelial-mesenchymal transition (EMT) is one of the main mechanisms of metastasis. Cells that have a phenotypic change to mesenchymal are aggressive, motile, and prone to become metastatic. Vimentin is the specific biomarker that appears when cells have changed to mesenchymal phenotype. Vimentin can predict metastasis and survival in breast cancer. Aim: to find the association between vimentin expression with metastases and survival in breast cancer patients. Methods: This study design is a retrospective cohort. The subjects are breast cancer patients at Dr. Ciptomangunkusumo from 2017 to 2018. Immunohistochemical staining was performed to analyze the expression of vimentin. Patients were followed-up for 4 years to determine metastasis event and survival outcome. Results: There were 43 subjects, consist of 39 positive vimentin expressions (90.7%), 10 metastases (23.3%), and 16 death (37.2%). Patients with positive vimentin expression have 2.99-times the risk of developing metastases. The mean overall survival (OS) of patients with positive was lower than negative vimentin expression (162.0 weeks vs. 174.5 weeks). However, the association between vimentin with metastatic (p=1,000) and survival (p=0.971) outcome was not statistically significant. Conclusion: Vimentin expression is not associated with metastatic events and survival outcome. However, positive vimentin expression tends to increase the risk of metastasis and increase mortality rates in breast cancer patients."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Zaenal Hakiki Fiantoro
Hubungan Resistensi Insulin dengan Kejadian Metastasis pada Kanker Payudara = Corelation between Insulin Resistance and the Event of Metastasis in Breast Cancer.
"Latar Belakang/Tujuan. Angka kematian dan kejadian metastasis kanker payudara cukup tinggi. Faktor metabolik termasuk resistensi insulin mempunyai peranan terhadap progresivitas kanker payudara namun terdapat hanya sedikit penelitian yang menilai hubungan resistensi insulin dengan kejadian metastasis kanker payudara. Terdapat hubungan yang erat antara beberapa variabel dalam kelompok pasca-menopause terhadap kejadian metastasis, pemberian terapi hormonal aromatase inhibitor dan kemoterapi terhadap nilai HOMA-IR. Mengetahui hubungan resistensi insulin yang dinilai menggunakan nilai homeostatic model assessment for insulin resistance (HOMA-IR) dengan kejadian metastasis kanker payudara.
Metode. Studi potong lintang yang meneliti 150 pasien kanker payudara di Rumah Sakit Cipto Mangunkusumo (RSCM) dan Rumah Sakit Siloam Mochtar Riady Comprehensive Cancer Centre (MRCCC) Jakarta dalam rentang waktu agustus 2019-april 2020. Terdapat 150 subjek penelitian, nilai titik potong HOMA-IR ditentukan dengan kurva receiver operating curve (ROC). Dilakukan analisis subgrup kelompok pasca menopause terhadap metastasis, terapi hormonal dan kemoterapi terhadap HOMA-IR.
Hasil. Tidak didapatkan nilai titik potong optimal HOMA-IR terhadap kejadian metastasis (Area under curve (AUC) 0,50, P : >0,05, interval kepercayaan (IK) 95% : 0,406-0,593). Tidak terdapat hubungan bermakna variabel pasca-menopause dengan kejadian metastasis dan kemoterapi terhadap nilai HOMA-IR. Terdapat hubungan bermakna pemberian terapi hormonal aromatase inhibitor terhadap peningkatan nilai HOMA-IR, P : <0,01
Simpulan. Tidak terdapat hubungan yang bermakna antara resistensi insulin dengan kejadian metastasis pada pasien kanker payudara.
Background/Purpose. Mortality and incidence rate of metastatic breast cancer is quite high.
Metabolic factors including insulin resistance have a role in the progression of breast cancer,
but there are only a few studies that assess the relationship of insulin resistance with the incidence of breast cancer metastases. There is a close relationship between variables in the postmenopausal group for the occurrence of metastases, administration of hormonal aromatase inhibitors and chemotherapy to the value of HOMA-IR. Knowing the relationship of insulin resistance which was assessed using the value of
the homeostatic model assessment for insulin resistance (HOMA-IR) with the incidence of metastatic breast cancer.
Method. A cross-sectional study examining 150 breast cancer patients at Cipto Mangunkusumo General Hospital and Siloam Hospital Mochtar Riady Comprehensive Cancer Center Jakarta in August 2019-April 2020. There are 150 subjects research, the HOMA-IR cutoff value is determined by the receiver operating curve (ROC) curve. Postmenopausal subgroups were analyzed for metastases, hormonal therapy and chemotherapy for HOMA-IR.
Results. There was no optimal HOMA-IR cut off value for metastatic events (Area under curve (AUC) 0.50,
P:> 0.05, 95% confidence interval (IK): 0.406-0.593). There was no significant relationship between postmenopausal variables with the incidence of metastasis and chemotherapy on the value of HOMA-IR. There was a significant
relationship between the administration of hormonal aromatase inhibitor therapy to the increase of HOMA-IR value, P: <0.01"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
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Erwin Danil Yulian
Peran Simvastatin dalam Menghambat Migrasi dan Proliferasi Sel Kanker Payudara untuk Mencegah Metastasis Melalui Sinyal Rho/Rho- Associated Coiled-Coil Containing Protein Kinase = The Role of Simvastatin in Inhibiting Migration and Proliferation of Breast Cancer Cells through Rho/Rho-Associated Coiled-Coil- Containing Protein Kinase Signal
"Karsinoma payudara (KPD) merupakan kanker terbanyak pada perempuan dan lebih dari 90% kematian akibat kanker diebabkan oleh adanya metastasis. Diperlukan terapi yang tidak hanya fokus pada proliferasi, tetapi juga fokus pada proses metastasis. Jalur Rho/ROCK diketahui memengaruhi invasi dan metastasis. Studi terbaru menunjukkan bahwa jalur Rho/ROCK berperan penting pada regulasi migrasi dan proliferasi sel, sehingga dapat dijadikan target terapi. Selain mereduksi biosintesis kolesterol melalui inhibisi 3-hydroxy-3-methylglutaryl coenzyme A reductase, statin juga mengurangi formasi isoprenoid intermediates yang diperlukan untuk mediasi pensinyalan melalui jalur Rho/ROCK. Statin diduga dapat menghambat jalur Rho/ROCK dan aman digunakan dalam jangka panjang.
Penelitian ini bertujuan untuk mengetahui efek antimetastasis (migrasi dan proliferasi) simvastatin terhadap KPD melalui jalur Rho/ROCK. Penelitian ini merupakan uji intervensi perioperative "window", parallel unmatching, randomized, double-blinded, dan placebo-controlled yang berlangsung sejak November 2014 hingga Juli 2015. Sebanyak 30 pasien KPD diberikan terapi simvastatin 40 mg/hari dan plasebo selama 4-6 minggu lalu dilakukan mastektomi di RSCM, RSPAD Gatot Subroto, RS Persahabatan, dan RSUD Koja. Perubahan migrasi (indeks migrasi, aktivitas ROCK dan kadar mRNA RhoC, CXCR4, dan CD44) dan reduksi proliferasi (ekspresi Ki67) yang didapat dari jaringan biopsi dan mastektomi dievaluasi sebelum dan sesudah terapi. Kemudian karakteristik yang berbeda bermakna dianalisis juga hubungannya dengan kadar kolesterol darah, grade, status ER/PR, dan status HER-2. Simvastatin 40 mg/harimenurunkan indeks migrasi (p=0,006), aktivitas ROCK (p=0,002), kadar mRNA CXCR4 (p=0,045) dan ekspresi Ki67 (p<0,001) secara bermakna.
Terdapat tren penurunan kadar mRNA RhoC (p=0,163) dan CD44 (p=0,094). Penurunan aktivitas ROCK berhubungan dengan kolesterol tinggi (p=0,008), grade rendah (p=0,019) dan amplifikasi HER- 2 (p=0,009). Penurunan kadar mRNA CXCR4 berhubungan dengan kolesterol tinggi (p=0,024), ER/PR positif (p=0,013), dan amplifikasi HER-2 (p=0,018). Penurunan ekspresi Ki67 berhubungan dengan kolesterol tinggi (p=0,001), grade rendah (p=0,017) dan tinggi (p=0,018), HER-2 (p=0,002) dan negatif (p=0,034), serta ER/PR positif (p=0,007) dan negatif (p=0,042). Simvastatin dapat menginhibisi migrasi dan menyupresi proliferasi pada KPD melalui jalur Rho/ROCK, sehingga dapat digunakan sebagai terapi pencegahan metastasis kanker payudara.
Breast cancer is the most common cancer among women and more than 90% of cancer deaths are caused by metastasis. There is an urgent need for the development of therapeutic intervention specifically targeted to the metastatic process. The Rho/ROCK pathway is found to be involved in invasion and metastasis. Recent studies have revealed that the Rho/ROCK pathway plays a critical role in regulation of cancer cell migration and proliferation, making it a potential therapy target. Besides reducing cholesterol biosynthesis by inhibiting 3-hydroxy-3-methylglutaryl coenzyme A reductase, statins also decrease the formation of isoprenoids intermediates essential for mediating the Rho/ROCK signalling. Statin is thought to inhibit the Rho/ROCK pathway and is safe for long-term use.
This study aimed to determine the antimetastasis (migration and proliferation) effect of simvastatin on breast cancer through the Rho/ROCK pathway. In a parallel unmatching, randomized, double-blinded, placebo-controlled, perioperative "window" interventional trial conducted from November 2014 until July 2015, 30 breast cancer subjects were treated with simvastatin 40 mg/day or placebo for 4-6 weeks followed by mastectomy (n=15 in each arm) at Cipto Mangunkusumo Hospital, Gatot Subroto Army Hospital, Persahabatan Hospital and Koja Hospital. Changes in migration (migration index, ROCK activity, mRNA RhoC, CXCR4 and CD44 level) and proliferation (Ki67 expression) from biopsy and final surgical specimen were obtained before and after intervention. The relationships of significant factors with blood cholesterol level, grade, ER/PR and HER-2 status were analyzed.
Simvastatin 40 mg/d significantly reduced migration index (p = 0.006), ROCK activity (p = 0.002), mRNA CXCR4 level (p = 0.045) and reduced Ki67 expression (p < 0.001). Decreased was also observed for mRNA RhoC (p = 0.163) and CD44 level (p = 0.094). Reduced ROCK activity was related to high cholesterol level (p = 0.008), low grade (p = 0.019) and HER-2 amplification (p = 0.009). Reduced CXCR4 transcription was related to high cholesterol level (p = 0.024), positive ER/PR (p = 0.013) and HER-2 amplification (p = 0.018). Ki67 expression was related to high cholesterol level (p = 0.001), low (p = 0.017) and high grade (p= 0.018), with (p = 0.002) and without HER-2 amplification (p = 0.034), and positive (p = 0.007) and negative (p = 0.042) ER/PR status. Simvastatin inhibits the migration and proliferation in breast cancer through Rho/ROCK pathway, hence holds a promising potential as prophylaxis for breast cancer metastasis."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2016
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Pramita Nastiti
Asuhan Keperawatan pada Pasien dengan Kanker Orofaring Metastasis Spinal Paska Dekompresi Stabilisasi Posterior dengan Intervensi Latihan Rentang Gerak Sendi = Nursing Care for Patients with Spinal Metastasis from Oropharyngeal Cancer, Post Decompression, Posterior Stabilization with Range of Motion Exercise
"Kanker orofaring termasuk kedalam kanker kepala dan leher, dimana kanker terjadi di bagian tengah tenggorokan yang berada tepat di belakang rongga mulut. Pada stadium lanjut, kanker ini dapat menyebar ke organ yang jauh. Tiga puluh dari 772 penderita kanker ini (3,9%) memiliki bukti klinis adanya metastase sel kanker ke area tulang belakan (Suzuki et al, 2020). Penyebaran sel kanker ke daerah tulang sering disebut dengan penyakit metastasis tulang atau Metastatic Bone Disease (MBD). Adanya fraktur patologis di segmen vetebra merupakan salah satu tanda adanya penyebaran kanker ke daerah spinal. Saraf spinalis pun berisiko mengalami cedera karena berada tepat dibawah dan di sepanjang tulang belakang. Pada kasus ini pasien mengeluh kedua kakinya tidak mampu digerakkan dan tidak dapat mengontrol BAK. Hal ini menunjukan adanya cedera neurologis di bagian saraf spinalis pasien. Tatalaksana medis yang sudah dilakukan adalah berupa dekompresi dan stabilisasi posterior di daerah thorakal dan lumbal. Pemasangan implan tersebut tidak serta merta mengembalikan fungsi sensorik dan motorik pasien, sehingga diperlukan adanya latihan untuk mempertahankan bagian tubuh yang terdampak. Selama 5 hari penulis melakukan interveni ROM untuk mempertahankan kekuatan otot dan fleksibilitas sendi pasien. Penulis juga melibatkan keluarga dalam latihan yang dilakukan 2 kali sehari selama 30 menit. Hasil yang didapat adalah kekuatan motorik ekstremitas atas 5555/5555 dan motorik ekstremitas bawah 1111/1111. Jari-jari kaki kiri dapat bergerak minimal. Kontraksi otot pasien makin teraba dan terlihat walau sedikit. Tidak ada spastisitas pada otot, kontraktur sendi maupun deformitas.
Oropharyngeal cancer is included in head and neck cancer, where cancer occurs in the middle of the throat which is right behind the oral cavity. In advanced stages, this cancer can spread to distant organs. Thirty of the 772 cancer sufferers (3.9%) had clinical evidence of cancer cell metastases to the spine area (Suzuki et al, 2020). The spread of cancer cells to the bone area is often called metastatic bone disease (MBD). The presence of a pathological fracture in the spinal segment is a sign of the spread of cancer to the spinal area. The spinal nerves are also at risk of injury because they are located directly below and along the spine. In this case the patient complained that he could not move his legs and could not control his urination. This indicates a neurological injury to the patient's spinal cord. The medical treatment that has been carried out is in the form of decompression and posterior stabilization in the thoracic and lumbar areas. Installation of these implants does not immediately restore the patient's sensory and motor function, so training is needed to maintain the affected body parts. For 5 days the author carried out ROM intervention to maintain the patient's muscle strength and joint flexibility. The author also involves the family in exercises which are carried out twice a day for 30 minutes. The results obtained were upper extremity motor strength 5555/5555 and lower extremity motor strength 1111/1111. The toes of the left foot can move minimally. The patient's muscle contractions become more palpable and visible, although slightly. There is no spasticity in muscles, joint contractures or deformities."
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2024
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Yusak Kristianto
Perbandingan antara klasifikasi Jepang dan sistem TNM dalam menentukan stadium keganasan sigmoid dan rektum di RSCM-RSF (laporan pendahuluan) = Comparison of Japanese classification with the tnm system in determining stage classification of sigmoid and rectal cancer patients at Cipto Mangunkusumo Hospital Fatmawati Hospital (preliminary study)
"[ABSTRAK
Pendahuluan Metastasis KGB pada keganasan kolorektal merupakan penentu independen faktor prognosis dan tatalaksana lanjutan Saat ini sistem baku penentuan stadium keganasan kolorektal adalah menurut sistem TNM dengan melihat jumlah KGB yang positif anak sebar Klasifikasi Jepang KJ menentukan stadium keganasan kolorektal dengan melihat distribusi metastasis KGB parakolika pararektal intermediate dan pangkal arteri mesenterika tanpa melihat jumlah KGB nya Metode Studi pendahuluan ini melakukan analisis terhadap 15 pasien keganasan sigmoid dan rektum yang menjalani pembedahan di RSCM dan RSUP Fatmawati periode September Oktober 2015 Dilakukan penilaian histopatologi terhadap spesimen tumor aspek yang dinilai adalah jumlah KGB yang positif anak sebar dan distribusi metastasis KGB Berdasarkan hasil tersebut dilakukan penentuan stadium menurut sistem TNM dan Klasifikasi Jepang serta dilakukan analisis kesesuaian Hasil dan pembahasan Didapatkan ge 12 KGB dari semua sampel Menurut sistem TNM terdapat 7 pasien stadium II 3 pasien stadium IIIb dan 5 pasien stadium IIIc sedangkan pada Klasifikasi Jepang terdapat 7 pasien stadium II 1 pasien stadium IIIa dan 7 pasien stadium IIIb Kecocokan antara kedua sistem klasifikasi dalam mendapatkan stadium II adalah 46 67 Penentuan stadium IIIa KJ dan stadium IIIa b TNM dengan kecocokan sebesar 6 7 Kecocokan sebesar 13 3 dalam menentukan stadium IIIb KJ dan stadium IIIc TNM Analisis kesesuaian terhadap kedua sistem klasifikasi didapatkan nilai Kappa sebesar 49 3 Kategori Sedang dengan P value 0 04 Kesimpulan Pada studi pendahuluan ini didapatlkan tingkat kesesuaian antara kedua sistem klasifikasi dalam menentukan stadium keganasan sigmoid dan rektum dengan kategori sedang Klasifikasi Jepang dapat dijadikan salah satu pertimbangan Diperlukan sampel yang lebih besar untuk meningkatkan akurasi tingkat kesesuaian Kata kunci metastasis KGB kolorektal sistem TNM Klasifikasi jepangPendahuluan Metastasis KGB pada keganasan kolorektal merupakan penentu independen faktor prognosis dan tatalaksana lanjutan Saat ini sistem baku penentuan stadium keganasan kolorektal adalah menurut sistem TNM dengan melihat jumlah KGB yang positif anak sebar Klasifikasi Jepang KJ menentukan stadium keganasan kolorektal dengan melihat distribusi metastasis KGB parakolika pararektal intermediate dan pangkal arteri mesenterika tanpa melihat jumlah KGB nya Metode Studi pendahuluan ini melakukan analisis terhadap 15 pasien keganasan sigmoid dan rektum yang menjalani pembedahan di RSCM dan RSUP Fatmawati periode September Oktober 2015 Dilakukan penilaian histopatologi terhadap spesimen tumor aspek yang dinilai adalah jumlah KGB yang positif anak sebar dan distribusi metastasis KGB Berdasarkan hasil tersebut dilakukan penentuan stadium menurut sistem TNM dan Klasifikasi Jepang serta dilakukan analisis kesesuaian Hasil dan pembahasan Didapatkan ge 12 KGB dari semua sampel Menurut sistem TNM terdapat 7 pasien stadium II 3 pasien stadium IIIb dan 5 pasien stadium IIIc sedangkan pada Klasifikasi Jepang terdapat 7 pasien stadium II 1 pasien stadium IIIa dan 7 pasien stadium IIIb Kecocokan antara kedua sistem klasifikasi dalam mendapatkan stadium II adalah 46 67 Penentuan stadium IIIa KJ dan stadium IIIa b TNM dengan kecocokan sebesar 6 7 Kecocokan sebesar 13 3 dalam menentukan stadium IIIb KJ dan stadium IIIc TNM Analisis kesesuaian terhadap kedua sistem klasifikasi didapatkan nilai Kappa sebesar 49 3 Kategori Sedang dengan P value 0 04 Kesimpulan Pada studi pendahuluan ini didapatlkan tingkat kesesuaian antara kedua sistem klasifikasi dalam menentukan stadium keganasan sigmoid dan rektum dengan kategori sedang Klasifikasi Jepang dapat dijadikan salah satu pertimbangan Diperlukan sampel yang lebih besar untuk meningkatkan akurasi tingkat kesesuaian Kata kunci metastasis KGB kolorektal sistem TNM Klasifikasi jepang;ABSTRACT Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification;Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification;Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification;Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification, Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification]"
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Annals of Laboratory Medicine
Seoul: The Korean Society for Laboratory Medicine,
610 ALM
Majalah, Jurnal, Buletin  Universitas Indonesia Library
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