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Retno Widyawati
"ABSTRAK
Latar belakang: Endometriosis merupakan kelainan ginekologik yang paling
sering ditemukan. Seperti halnya endometrium di uterus juga dapat terjadi
berbagai perubahan pada epitel yang melapisi kista endometriosis di ovarium,
antara lain metaplasia, hiperplasia, atipia bahkan perubahan ke arah keganasan.
Saat ini banyak penelitian yang menghubungkan antara endometriosis dan kanker
ovarium terutama jenis clear cell dan dikenal dengan istilah endometriosisassociated
ovarian carcinoma (EAOC) dan dilaporkan adanya mutasi yang
menginaktifkan gen supresor tumor (ARID1A), sehingga protein BAF250a tidak
diekpresikan pada Clear cell carcinoma (CCC) ovarii.
Bahan dan cara: Dilakukan pulasan imunohistokimia ARID1A pada sampel 20
kasus endometriosis non atipik, 20 kasus atipik dan 20 kasus CCC ovarii tahun
2012 hingga Maret 2015. Dari kelompok kasus CCC didapatkan 9 kasus EAOC.
Selanjutnya dilihat adakah perbedaan persentase ekspresi ARID1A pada
endometriosis non atipik, atipik, CCC ovarii serta endometriosis disertai CCC
(EAOC).
Hasil: Pada kelompok kasus endometriosis non atipik, atipik dan CCC ada
perbedaan bermakna persentase ekspresi ARID1A (uji Kruskal-Wallis p=0,0035).
Selanjutnya dilakukan analisis Post Hoc uji Mann-Whitney dan didapatkan
perbedaan bermakna persentase ekspresi ARID1A antara endometriosis non atipik
dan atipik dengan CCC ovarii (p=0,001 dan p=0,0015). Pada kelompok kasus
endometriosis non atipik, atipik dan endometriosis pada EAOC, didapatkan ada
perbedaan bermakna persentase ekspresi ARID1A (Uji Kruskal-Walis p=0,011).
Selanjutnya dilakukan analisis Post Hoc uji Mann-Whitney dan ada perbedaan
bermakna persentase ekspresi ARID1A antara endometriosis non atipik dan atipik
dengan EAOC (p=0,005 dan p=0,008).
Kesimpulan: Ekspresi ARID1A pada endometriosis non atipik dan atipik lebih
tinggi bermakna dibanding CCC ovarii dan EAOC. Sehingga ekspresi ARID1A
kemungkinan dapat digunakan sebagai petanda adanya transformasi ganas pada
endometriosis.
ABSTRACT
Background: Endometriosis is one of the most common gynecological
abnormalities found. Endometriosis cyst in the ovary also exhibited changes in
epithelial cyst just like endometrium in the uterus. Changes in the epithelial cells
also include metaplasia, hyperplasia, atyphia even changes toward malignan
characteristics. Nowadays, there are some research that linked endometriosis and
clear cell ovarian cancer which is known with endometriosis-associated ovarian
carcinoma (EAOC) it is reported that there?s a mutation that activated tumor
suppressor gene (ARID1A), so protein BAF250a is not expressed in Clear Cell
Carcinoma (CCC) in the ovarium.
Materials and Methods: Immunohistochemistry staining of ARID1A were done
in 20 samples of non-atypical endometriosis, 20 samples of atypical
endometriosis, 20 samples of CCC in the ovarium from the year 2012 until march
2015. From the group that experienced CCC we get 9 cases of EAOC. After that,
we see if there?s any difference in the percentage of ARID1A expression in nonatypical
endometrosis, atypical endometriosis, CCC in the ovarium and
endometriosis with CCC( EAOC).
Results: In non-atypical endometriosis, atypical and CCC cases groups there are
significant differences on the percentage of ARID1A expression (Kruskal-Walis
test p=0,0035). Post Hoc analysis were done using Mann-Whitney test and there
are significant differences on ARID1A expression between non-atypical and
atypical endometriosis with CCC (p=0,001 and p=0,0015). In non-atypical
endometriosis, atypical and EAOC groups there are significant differences on the
percentage of ARID1A expression (Kruskal-Walis test p=0,011). Post Hoc
analysis were done using Mann-Whitney test and there are significant differences
on ARID1A expression between non-atypical and atypical endometriosis with
EAOC (p=0,005 and p=0,008).
Conclusion: Expression of ARID1A in non atypical and atypical endometriosis
are significantly higher compared to ovarian CCC and EAOC. So, we can say that
ARID1A may be used as a marker for malignancy transformation in
endometriosis.
;Background: Endometriosis is one of the most common gynecological
abnormalities found. Endometriosis cyst in the ovary also exhibited changes in
epithelial cyst just like endometrium in the uterus. Changes in the epithelial cells
also include metaplasia, hyperplasia, atyphia even changes toward malignan
characteristics. Nowadays, there are some research that linked endometriosis and
clear cell ovarian cancer which is known with endometriosis-associated ovarian
carcinoma (EAOC) it is reported that there?s a mutation that activated tumor
suppressor gene (ARID1A), so protein BAF250a is not expressed in Clear Cell
Carcinoma (CCC) in the ovarium.
Materials and Methods: Immunohistochemistry staining of ARID1A were done
in 20 samples of non-atypical endometriosis, 20 samples of atypical
endometriosis, 20 samples of CCC in the ovarium from the year 2012 until march
2015. From the group that experienced CCC we get 9 cases of EAOC. After that,
we see if there?s any difference in the percentage of ARID1A expression in nonatypical
endometrosis, atypical endometriosis, CCC in the ovarium and
endometriosis with CCC( EAOC).
Results: In non-atypical endometriosis, atypical and CCC cases groups there are
significant differences on the percentage of ARID1A expression (Kruskal-Walis
test p=0,0035). Post Hoc analysis were done using Mann-Whitney test and there
are significant differences on ARID1A expression between non-atypical and
atypical endometriosis with CCC (p=0,001 and p=0,0015). In non-atypical
endometriosis, atypical and EAOC groups there are significant differences on the
percentage of ARID1A expression (Kruskal-Walis test p=0,011). Post Hoc
analysis were done using Mann-Whitney test and there are significant differences
on ARID1A expression between non-atypical and atypical endometriosis with
EAOC (p=0,005 and p=0,008).
Conclusion: Expression of ARID1A in non atypical and atypical endometriosis
are significantly higher compared to ovarian CCC and EAOC. So, we can say that
ARID1A may be used as a marker for malignancy transformation in
endometriosis.
;Background: Endometriosis is one of the most common gynecological
abnormalities found. Endometriosis cyst in the ovary also exhibited changes in
epithelial cyst just like endometrium in the uterus. Changes in the epithelial cells
also include metaplasia, hyperplasia, atyphia even changes toward malignan
characteristics. Nowadays, there are some research that linked endometriosis and
clear cell ovarian cancer which is known with endometriosis-associated ovarian
carcinoma (EAOC) it is reported that there?s a mutation that activated tumor
suppressor gene (ARID1A), so protein BAF250a is not expressed in Clear Cell
Carcinoma (CCC) in the ovarium.
Materials and Methods: Immunohistochemistry staining of ARID1A were done
in 20 samples of non-atypical endometriosis, 20 samples of atypical
endometriosis, 20 samples of CCC in the ovarium from the year 2012 until march
2015. From the group that experienced CCC we get 9 cases of EAOC. After that,
we see if there?s any difference in the percentage of ARID1A expression in nonatypical
endometrosis, atypical endometriosis, CCC in the ovarium and
endometriosis with CCC( EAOC).
Results: In non-atypical endometriosis, atypical and CCC cases groups there are
significant differences on the percentage of ARID1A expression (Kruskal-Walis
test p=0,0035). Post Hoc analysis were done using Mann-Whitney test and there
are significant differences on ARID1A expression between non-atypical and
atypical endometriosis with CCC (p=0,001 and p=0,0015). In non-atypical
endometriosis, atypical and EAOC groups there are significant differences on the
percentage of ARID1A expression (Kruskal-Walis test p=0,011). Post Hoc
analysis were done using Mann-Whitney test and there are significant differences
on ARID1A expression between non-atypical and atypical endometriosis with
EAOC (p=0,005 and p=0,008).
Conclusion: Expression of ARID1A in non atypical and atypical endometriosis
are significantly higher compared to ovarian CCC and EAOC. So, we can say that
ARID1A may be used as a marker for malignancy transformation in
endometriosis.
;Background: Endometriosis is one of the most common gynecological
abnormalities found. Endometriosis cyst in the ovary also exhibited changes in
epithelial cyst just like endometrium in the uterus. Changes in the epithelial cells
also include metaplasia, hyperplasia, atyphia even changes toward malignan
characteristics. Nowadays, there are some research that linked endometriosis and
clear cell ovarian cancer which is known with endometriosis-associated ovarian
carcinoma (EAOC) it is reported that there?s a mutation that activated tumor
suppressor gene (ARID1A), so protein BAF250a is not expressed in Clear Cell
Carcinoma (CCC) in the ovarium.
Materials and Methods: Immunohistochemistry staining of ARID1A were done
in 20 samples of non-atypical endometriosis, 20 samples of atypical
endometriosis, 20 samples of CCC in the ovarium from the year 2012 until march
2015. From the group that experienced CCC we get 9 cases of EAOC. After that,
we see if there?s any difference in the percentage of ARID1A expression in nonatypical
endometrosis, atypical endometriosis, CCC in the ovarium and
endometriosis with CCC( EAOC).
Results: In non-atypical endometriosis, atypical and CCC cases groups there are
significant differences on the percentage of ARID1A expression (Kruskal-Walis
test p=0,0035). Post Hoc analysis were done using Mann-Whitney test and there
are significant differences on ARID1A expression between non-atypical and
atypical endometriosis with CCC (p=0,001 and p=0,0015). In non-atypical
endometriosis, atypical and EAOC groups there are significant differences on the
percentage of ARID1A expression (Kruskal-Walis test p=0,011). Post Hoc
analysis were done using Mann-Whitney test and there are significant differences
on ARID1A expression between non-atypical and atypical endometriosis with
EAOC (p=0,005 and p=0,008).
Conclusion: Expression of ARID1A in non atypical and atypical endometriosis
are significantly higher compared to ovarian CCC and EAOC. So, we can say that
ARID1A may be used as a marker for malignancy transformation in
endometriosis.
"
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Fitri Adinda Novianti
"ABSTRAK
Latar Belakang: Kanker ovarium menjadi penyebab mortalitas yang tinggi pada wanita. Di Indonesia, kanker ovarium menempati urutan ketiga keganasan pada sistem reproduksi wanita dengan angka kejadian 4,27 dari 100.000 wanita. Di Indonesia, kejadian OCCC dari seluruh tipe histopatologi keganasan ovarium adalah 11-14%. Di Indonesia, belum ada penelitian yang membahas mengenai karakteristik klinikopatologi pasien OCCC. Hal ini disayangkan mengingat besarnya masalah yang mungkin terjadi pada pasien OCCC. Pertumbuhan OCCC yang lambat dan karakteristiknya yang tidak berespons dengan kemoterapi memerlukan tindakan operasi yang benar-benar bersih. Hal ini perlu dilakukan agar angka rekurensi dan komplikasi yang tinggi dapat diturunkan karena apabila terjadi rekurensi, maka dapat dicurigai pasien mengalami resistensi kemoterapi. Pentingnya pengetahuan mengenai karakteristik klinikopatologi OCCC diperlukan dalam hal diagnosis dan tatalaksana pasien. Oleh sebab itu penelitian ini bermaksud untuk memberikan gambaran lebih lanjut mengenai karakteristik klinikopatologi pasien OCCC yang berobat di RSUPN Ciptomangunkusumo.
Tujuan: Untuk mengetahui karakteristik klinikopatologi pasien ovarian clear cell ovarium di Indonesia
Metode: Dari tahun 2010-2015, 80 pasien dengan ovarian clear cell carcinoma teridentifikasi melalui data rekam medis dan INASGO yang didapatkan dari pasien yang berobat di RS Cipto Mangunkusumo
Hasil: Rerata usia pasien OCCC adalah 53 tahun dengan jumlah paritas terbanyak adalah 0 (46,2%). Stadium IC sebanyak 46,2% dengan riwayat operasi complete surgical staging sebesar 71,25% dan sebanyak 55% pasien OCCC melakukan kemoterapi namun tidak komplit. Jenis kemoterapi yang sering digunakan adalah multiple drug CT-platinum analogue taxane compound full course completed sebesar 10 kasus (4.4%). Hasil patologi anatomi ditemukan metastasis paling banyak pada omentum sebesar 47,5%. Respons kemoterapi komplit ditemukan pada 47,5% kasus dan status pasien ditemukan paling banyak hidup dengan penyakit sebesar 47,5%.
Kesimpulan: OCCC paling banyak ditemukan pada usia 53 tahun dengan paritas paling banyak adalah 0. Stadium ditemukan paling banyak pada stadium awal yaitu IC dengan terapi yang dilakukan juga sejalan yaitu complete surgical staging. Sebanyak 55% pasien OCCC melakukan kemoterapi namun tidak komplit dengan regimen yang paling banyak digunakan adalah multiple drug CT-platinum analogue taxane compound full course completed. Diferensiasi histopatologi ditemukan paling banyak adalah poor or undifferentiated dan metastasis ditemukan paling banyak pada omentum. Ditemukan sebanyak 47,5% respon terapi komplit dan sebanyak 47,5% pasien hidup dengan penyakit. Sebagian besar hasil penelitian ini sejalan dengan penelitian terdahulu yang dilakukan namun penelitian lanjutan tetap perlu dilakukan dengan jumlah sampel yang lebih banyak dan menggunakan data primer"
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library