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Latar belakang: Interpretasi cairan peritoneum yang tepat secara sitopatologi sangat mempengaruhi tatalaksana dan prognosis pasien, padahal pemeriksaan sitopatologi cairan peritoneum masih memiliki nilai negatif palsu dan positif palsu yang cukup tinggi, dan hingga saat ini penelitian tentang arsitektur sitopatologi maupun penanda sitomorfologi yang mengarahkan pada adanya sel neoplasma di cairan peritoneum masih menunjukkan hasil yang beragam. Bahan dan cara kerja: Penelitian potong lintang dengan data sekunder berupa slaid dan formulir sediaan sitopatologi cairan peritoneum yang memiliki data berpasangan dengan diagnosis histopatologi. Diagnosis klinis berupa neoplasma epitelial ovarium. Slaid dan formulir diambil dari arsip Departemen Patologi Anatomik FKUI/RSCM tahun 2011 ? 2012, dilakukan pembacaan ulang semua slaid sitopatologi dengan diagnosis akhir dikategorikan sebagai positif atau negatif, peneliti membaca pula sediaan histopatologi untuk mengetahui morfologi sel pada lesi, kemudiaan dilakukan penilaian terhadap arsitektur sitopatologi berupa: selularitas, sel berkelompok, struktur papiler, intercelular windows, group contours, jisim psamoma, dan penanda sitomorfologi berupa: atipia inti, inti bertumpuk, anak inti, rasio inti:sitoplasma, ukuran inti, dan ukuran sel. Hasil penelitian: Sampel penelitian sejumlah 47 sediaan sitopatologi dengan diagnosis sitopatologi akhir 34 kasus (72.3%) negatif, 13 kasus (27.7%) positif. Terdapat perbedaan bermakna arsitektur sitopatologi berupa: selularitas (p = 0.017), sel berkelompok (p = 0.001), intercellular windows (p = 0.00), group contours (p = 0.00), dan gambaran sitomorfologi berupa: atipia inti (p = 0.00), inti bertumpuk (p = 0.001), anak inti (p = 0.001), rasio inti:sitoplasma (p = 0.00), ukuran inti (p = 0.00), ukuran sel (p = 0.00) antara cairan peritoneum positif dan negatif. Melalui uji multivariat didapatkan penanda yang paling berpengaruh terhadap diagnosis sitopatologi positif atau negatif yaitu: intercellular windows, atipia inti, dan selularitas. Kesimpulan: Terdapat tiga penanda yang paling berpengaruh terhadap diagnosis positif ditemukannya sel neoplasma ganas dalam cairan peritoneum pada kasus dengan lesi ovarium, secara berturut - turut yaitu: tidak ditemukannya intercellular windows pada kelompokan sel, sel memiliki atipia inti sedang hingga berat, dan selularitas lebih dari 20 kelompok dari keseluruhan sediaan apus.

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Background : Peritoneal fluid cytopathology interpretation profoundly influences patients management and prognosis, however this practice still has high false positive and false negative value, and until now research concerning the architectural and cytomorphology features for detecting malignant cells in peritoneal fluid still has various result. Materials and Methods : Cross sectional study using secondary data of peritoneal fluid cytopathology and histopathology slides and form, from patients with clinical diagnosis of ovarian epithelial neoplasm. The data was taken from the archive of Anatomical Pathology Department Cipto Mangunkusumo Hospital 2011 ? 2012. The researchers examined the cytopathology slides and also examined the histopatology slide for morphology comparison, and then make a final cytopathological diagnosis of positive peritoneal fluid containing neoplastic cells or negative. Architectural features including: cellularity, cells grouping, papillary structure, intercellular windows, group contours, psamoma bodies, and cytomorphology features including: nuclear atypia, overlapping nuclei, nucleoli, nuclei : cytoplasm ratio, the dimension of the nuclei and cells were also examined. Result : There were 47 samples with final cytopathology diagnosis: 34 cases (72.3%) negative for neoplastic cells in the peritoneal fluid and 13 cases (27.7%) positive. There were significant differences in cytopathology architectural including cellularity (p = 0.017), cells grouping (p = 0.001), intercellular windows (p = 0.00), group contours (p = 0.00) and cytomorphology features including nuclear atypia (p = 0.00), overlapping nuclei (p = 0.001), nucleoli (p =0.001), nuclei : cytoplasm ratio (p = 0.00), the dimension of nuclei (p = 0.00), the dimension of cell (p = 0.00) between the positive and negative peritoneal fluid cytopathology. Using multivariate analysis there were 3 cytological features that have the strongest association with positive or negative peritoneal cytopathology diagnosis, they were: intercellular windows, nuclear atypia, and cellularity. Conclusion: In peritoneal fluid cytopathology for examining ovarian lesion there were 3 cytological features that have the strongest association with finding neoplastic cells in peritoneal fluid, they were: the absent of intercellular windows, moderate to severe cytological atypia, and cellularity more than 20 groups in all smear preparation, Background : Peritoneal fluid cytopathology interpretation profoundly influences patients management and prognosis, however this practice still has high false positive and false negative value, and until now research concerning the architectural and cytomorphology features for detecting malignant cells in peritoneal fluid still has various result. Materials and Methods : Cross sectional study using secondary data of peritoneal fluid cytopathology and histopathology slides and form, from patients with clinical diagnosis of ovarian epithelial neoplasm. The data was taken from the archive of Anatomical Pathology Department Cipto Mangunkusumo Hospital 2011 – 2012. The researchers examined the cytopathology slides and also examined the histopatology slide for morphology comparison, and then make a final cytopathological diagnosis of positive peritoneal fluid containing neoplastic cells or negative. Architectural features including: cellularity, cells grouping, papillary structure, intercellular windows, group contours, psamoma bodies, and cytomorphology features including: nuclear atypia, overlapping nuclei, nucleoli, nuclei : cytoplasm ratio, the dimension of the nuclei and cells were also examined. Result : There were 47 samples with final cytopathology diagnosis: 34 cases (72.3%) negative for neoplastic cells in the peritoneal fluid and 13 cases (27.7%) positive. There were significant differences in cytopathology architectural including cellularity (p = 0.017), cells grouping (p = 0.001), intercellular windows (p = 0.00), group contours (p = 0.00) and cytomorphology features including nuclear atypia (p = 0.00), overlapping nuclei (p = 0.001), nucleoli (p =0.001), nuclei : cytoplasm ratio (p = 0.00), the dimension of nuclei (p = 0.00), the dimension of cell (p = 0.00) between the positive and negative peritoneal fluid cytopathology. Using multivariate analysis there were 3 cytological features that have the strongest association with positive or negative peritoneal cytopathology diagnosis, they were: intercellular windows, nuclear atypia, and cellularity. Conclusion: In peritoneal fluid cytopathology for examining ovarian lesion there were 3 cytological features that have the strongest association with finding neoplastic cells in peritoneal fluid, they were: the absent of intercellular windows, moderate to severe cytological atypia, and cellularity more than 20 groups in all smear preparation]

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Latar Belakang:Pada KKR, miofibroblas merupakan komponen sel utama dalam stroma desmoplastik yang memiliki peran penting dalam proses metastasis. Persentase antara karsinoma dengan stroma desmoplastik dikenal sebagai Carcinoma Percentage CP berperan sebagai independent predictor metastasis. D2-40/ Podoplanin PDPN dikenal sebagai marker spesifikLymphatic Endothelial Cell LEC , digunakan untuk menilai Lymphatic Microvessel Density LMVD danLymphatic Vessel Invasion LVI . Tujuan penelitian untuk mengetahui korelasi dan hubungan CP, LMVD dan LVI dengan metastasis sel tumor ke kelenjar getah bening KGB .Bahan dan Metode:Dilakukan penilaian CP terhadap 44 sampel adenokarsinoma Not Otherwise Specified NOS kolorektal dan pulasan D2-40/Podoplanin untuk menilai LMVD dan LVI. Uji statistik dilakukan untuk mencari korelasi antara CP dan LMVD, serta hubungan antara CP, LVI serta metastasis KGB.Hasil:Terdapat korelasi kuat antara CP dan LMVD area intratumoral dan peritumoral dengan arah korelasi negatif. Terdapat hubungan bermakna p=0,00 antara LMVD area intratumoral dan area peritumoral dengan adanya LVI. Terdapat hubungan bermakna antara LVI dengan kejadian metastasis KGB p=0,03 . Area intratumoral menunjukkan hubungan bermakna dengan kejadian metastasis KGB nilai p=0,04 , sedangkan area peritumoral tidak menunjukkan hubungan bermakna nilai p=0,17 .Kesimpulan:Pemeriksaan CP pada sediaan histopatologi dapat digunakan untuk memprediksi tinggi/rendahnya kejadian metastasis sel tumor ke KGB, didasarkan adanya korelasi kuat antara CP dan LMVD. Kata kunci:Carcinoma Percentage, Lymphatic Microvessel Density, Lymphatic Vessel Invasion, Lymphatic Endothelial Cell

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ABSTRACT
Background In CRC, myofibroblast are the main component cells in tumour stroma which have an important role in the metastases process. The precentage between carcinoma and desmoplastic stroma known as Carcinoma Percentage CP , can be used as an independent predictor metastases. D2 40 Podoplanin PDPN known as a spesific marker forLymphatic Endothelial Cell LEC , which used to assess Lymphatic Microvessel Density LMVD and Lymphatic Vessel Invasion LVI . This study aims to determine correlation and association between CP, LMVD and LVI with the metastases process to lymph node LN .Materials and Methods CP assessment conducted on 44 samples of adenocarcinoma Not Otherwise Specified NOS colorectal and examination D2 40 Podoplanin to assess LMVD and LVI. The statistical test is performed to find the correlation between CP and LMVD, as well as the relationship between CP, LVI and metastasis KGB.Result There were a strong correlation between CP and LMVD intratumoral and peritumoral area with the negative correlation. There were a significant association p 0,00 between LMVD intratumoral and peritumoral area with the LVI. There was a significant association between LVI and lymph node metastases p 0,03 . Intratumoral area showed significant association with lymph node metastases nilai p 0,04 , whereas peritumoral area showed no significant association nilai p 0,17 .Conclusion CP examination in histopathology specimen can be used to predict high low rate of tumour cells metastases to the lymph node, based on a strong correlation between CP and LMVD.

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Latar Belakang:Adenokarsinoma musinosum mempunyai prognosis lebih buruk dari pada adenokarsinoma Not Otherwise Specified NOS kolorektal. Ekspresi podoplanin pada Cancer associated fibroblasts CAF dan nilai Lymphatic Microvessel Density LMVD yang tinggi merupakan petanda prognosis yang buruk. Pada penelitian ini dilakukan analisis terhadap CAF, LMVD dan metastasis kelenjar getah bening KGB pada adenokarsinoma musinosum dan adenokarsinoma NOS. CAF merupakan komponen utama pada stroma desmoplastik yang memiliki peran penting dalam proses metastasis. LMVD merupakan penilaian densitas pembuluh limfatik pada massa tumor primer.Bahan dan Metode:Penelitian dilakukan terhadap 44 kasus yang terdiri atas 22 kasus adenokarsinoma musinosum dan 22 kasus adenokarsinoma NOS kolorektal. Pulasan podoplanin digunakan untuk melihat ekspresinya pada CAF dan nilai LMVD.Hasil:CAF yang terekspresi podoplanin pada adenokarsinoma NOS lebih tinggi daripada adenokarsinoma musinosum kolorektal p=0,000 . Tidak terdapat perbedaan bermakna nilai LMVD antara adenokarsinoma NOS dengan adenokarsinoma musinosum kolorektal p=0,381 . Tidak terdapat korelasi antara CAF yang terekspresi podoplanin dengan nilai LMVD pada adenokarsinoma musinosum p=0,248 dan adenokarsinoma NOS p=0,448 . Tidak terdapat korelasi antara CAF yang terekspresi podoplanin dengan metastasis KGB pada adenokarsinoma musinosum p=0,240 dan adenokarsinoma NOS p=0,791 .Kesimpulan:Ekspresi podoplanin pada CAF pada adenokarsinoma NOS lebih tinggi daripada adenokarsinoma musinosum. Tidak terdapat korelasi antara CAF yang terekspresi podoplanin dengan LMVD dan metastasis KGB pada adenokarsinoma musinosum dan adenokarsinoma NOS. Ekspresi podoplanin pada CAF tidak dapat digunakan untuk menentukan prognosis metastasis KGB pada adenokarsinoma musinosum. Terdapat kecenderungan nilai LMVD pada adenokarsinoma musinosum sedikit lebih tinggi daripada adenokarsinoma NOS kolorektal.

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Background Mucinous adenocarcinoma has worse prognosis than the Not Otherwise Specified NOS colorectal adenocarcinoma. High expression of podoplanin in Cancer Associated Fibroblasts CAF and high lymphatic Microvessel Density LMVD values is a marker of poor prognosis. This study analyzed CAF, LMVD and lymph node metastasis in mucinous adenocarcinoma and NOS adenocarcinoma.CAF are the main component of desmoplastic stroma which have an important role in the metastatic processes. LMVD is an assessment of the density of the lymphatic vessels in the primary tumor.Materials and methods The study consists of 44 cases including 22 cases of mucinous adenocarcinoma and 22 cases of NOS adenocarcinoma colorectal. Podoplanin is used to see its expression CAF and LMVD values. Results CAF expressed podoplanin at NOS adenocarcinoma is higher than mucinous adenocarcinoma p 0.000 . There was no significant difference in LMVD values between NOS adenocarcinoma and mucinous adenocarcinoma p 0.381 . There was no correlation between CAF expressed podoplanin with LMVD values in mucinous adenocarcinoma p 0.248 and NOS adenocarcinoma p 0.448 . There was no significant correlation between CAF expressed podoplanin with KGB metastasis in adenocarcinoma musinosum p 0,240 and NOS adenocarcinoma p 0.791 . Conclusion CAF expressed podoplanin at NOS adenocarcinoma is higher than that of the mucinous adenocarcinoma. There is no correlation between CAF expressed podoplanin with LMVD and KGB metastasis in NOS mucinous adenocarcinoma and NOS adenocarcinoma. Podoplanin expression in CAF can not be used to determine the prognosis of KGB metastasis in mucinous adenocarcinoma. There is a tendency for LMVD values in mucinus adenocarcinoma to be slightly higher than NOS adenocarcinoma.

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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: Karsinoma sel skuamosa rongga mulut (KSSRM) menempati urutan keenam dari keganasan yang paling sering terjadi di Asia. Kebanyakan pasien datang berobat dalam kondisi stadium lanjut sehingga KSSRM memiliki mortalitas yang tinggi. Angka kesintasan KSSRM satu tahun dan dua tahun di RSCM adalah 58,6% dan 43,1%; angka kesintasan spesifik penyakit adalah 66,9%. Studi ini bertujuan untuk mencari faktor-faktor yang memengaruhi kesintasan KSSRM. Metode: Studi ini merupakan kohort retrospektif berdasarkan data rekam medis pasien. Variabel yang diteliti adalah usia, jenis kelamin, lokasi tumor, stadium klinis, derajat diferensiasi sel tumor, derajat invasi tumor, dan batas sayatan. Analisis kesintasan menggunakan Kaplan-Meier dan uji log-rank. Analisis bivariat dan multivariat menggunakan regresi Cox untuk mendapatkan hazard ratio (HR). Hasil: Ada 169 subjek yang menderita KSSRM dan diterapi di RSCM tahun 2014 – 2018. Mayoritas pasien merupakan laki-laki (51,5%) dengan usia di atas 50 tahun (55,6%). Lokasi tumor paling banyak dijumpai di lidah (72,8%) diikuti mukosa bukal (13%). 82,2% pasien datang pada stadium IV, 60,4% memiliki diferensiasi baik, dan 53,8% memiliki grade rendah. Berdasarkan analisis bivariat, didapatkan bahwa ukuran dan ekstensi tumor (T), keterlibatan kelenjar getah bening regional (N), stadium klinis, dan batas sayatan memengaruhi kesintasan KSSRM (p <0,05). Keterlibatan KGB (HR: 1,212; 95% CI: 0,997-1,474; p <0,05) dan stadium klinis (HR: 1,749; 95% CI: 1,261-2,425; p <0,05) memengaruhi mortalitas secara signifikan. Kesimpulan: Faktor-faktor yang memengaruhi kesintasan KSSRM adalah stadium klinis dan keterlibatan kelenjar getah bening regional (N). ......Background: Oral squamous cell carcinoma (OSCC) is the sixth most common malignancy in Asia. Most patients were diagnosed in advanced stage; thus, the mortality rate is high. The one-year and two-year overall survival rate in Cipto Mangunkusumo Hospital are 58.6% and 43.1%, the disease-specific survival rate is 66.9%. This study is aimed to investigate the prognostic factors correlated with OSCC. Methods: A retrospective cohort study was done on OSCC patients diagnosed and treated in Cipto Mangunkusumo Hospital from 2014 to 2018. Data regarding age, gender, site of the primary lesion, clinical stage of the disease, tumor differentiation, invasion, and surgical margins were collected. Prognostic variables were identified with bivariate analysis using Kaplan-Meier curves and log-rank testing for comparison. Results: One hundred and sixty nine patients were included. Majority of patients were male (51.5%), age above 50 years old (55.6%). The most prevalent tumor site was the tongue (72.8%) followed by buccal mucosa (13%). 82.2% of patients had advanced (clinical stage IV) disease at diagnosis. Majority of patients had well-differentiated tumor (60.4%) and low-grade tumor (53.8%). Bivariate analysis showed that tumor size (T), nodal status (N), clinical stage, and marginal status significantly affected the overall survival (p <0.05). Nodal status (HR: 1.212; 95% CI: 0.997-1.474; p <0.05) and clinical stage (HR: 1.749; 95% CI: 1.261-2.425; p < 0.05) were independently associated with the risk of death. Conclusion: Clinical stage and lymph node involvement are the most significant prognostic factors of OSCC.

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Latar belakang:Karsinoma sebasea palpebra merupakan karsinoma adneksa mata terbanyak dan memiliki prognosis buruk. Penyebaran pagetoid pada karsinoma sebasea palpebra merupakan faktor yang mempengaruhi prognosis buruk. Hasil retrospektif karsinoma sebasea palpebra di Departemen Patologi Anatomik FKUI/RSCM Jakarta tahun 2010 sampai 2015 didapatkan 89 kasus memiliki prognosis buruk. Pemeriksaan imunohistokimia IHK Ki67 merupakan salah satu marker yang digunakan utuk menentukan prognosis. Pada penelitian ini akan diteliti hubungan ekspresi Ki67 pada karsinoma sebasea palpebra dengan penyebaran pagetoid dan tanpa penyebaran pagetoid.Bahan dan cara: Penelitian ini menggunakan desain potong lintang. Sampel terdiri atas 40 kasus karsinoma sebasea palpebra di Departemen Patologi Anatomik FKUI/RSCM periode Januari 2009 sampai September 2016.Sampel dibagi menjadi dua kelompok yaitu kelompok dengan penyebaran pagetoid dan tanpa penyebaran pagetoid.Dilakukan pulasan imunohistokimia Ki67, kemudian dihitung persentase positivitasnya.Hasil: Ekspresi Ki67 pada semua kasus mempunyai rentang antara 2,8 sampai 88 , ekspresi Ki67 tinggi sebanyak 30 kasus 75 . Tidak terdapat perbedaan bermakna ekspresi Ki67antara karsinoma sebasea palpebra dengan penyebaran pagetoid dan tanpa penyebaran pagetoid p=0,136 . Ekspresi Ki67 pada kelompok penyebaran pagetoid cenderung lebih tinggi mean 43,83 dibandingkan tanpa penyebaran pagetoid mean 34,10 . Tidak terdapat perbedaan bermakna ekspresi Ki67 antara karsinoma sebasea palpebra berdiferensiasi baik, sedang dan buruk p=0,396 .Kesimpulan: Ditemukan ekspresi tinggi Ki67 pada karsinoma sebasea palpebra.Tidak terdapat perbedaan ekspresi Ki67 pada karsinoma sebasea palpebra dengan penyebaran pagetoid dan tanpa penyebaran pagetoid.Ekspresi Ki67 cenderung lebih tinggi pada penyebaran pagetoid dari pada tanpa penyebaran pagetoid.

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ABSTRACT
Background Eyelid sebaceous carcinoma is the most common adnexal carcinoma of the eye and has a poor prognosis. Pagetoid spread is a factor of poor prognosis in eyelid sebaceous carcinoma. The retrospective study of eyelid sebaceous carcinoma in Anatomical Pathology Department Cipto Mangunkusumo Hospital Faculty of Medicine Universitas Indonesia between 2010 and 2015 found 89 cases with poor prognosis. Ki67 is a marker of immunohistochemical which is used to determinate the prognosis. This present study was designed to investigate the Ki67 expression in eyelid sebaceous carcinoma with and without pagetoid spread.Materials and methods This study used a cross sectional design. The sample was consist of 40 cases of eyelid sebaceous carcinoma in Anatomical Pathology Department Cipto Mangunkusumo Hospital Faculty of Medicine Universitas Indonesia between January 2009 and September 2016 period. The samples were divided into two groups with and without pagetoid spread. All cases stained by Ki67 immunohistochemistry and evaluated by the percentages of positivityResults Ki67 expression in all cases have a range between 2.8 to 88 , high Ki67 expression was found in 30 cases 75 . There were no significant differences of Ki67 expression between eyelid sebaceous carcinoma with and without pagetoid spread p 0.136 . Ki67 expression was higher in pagetoid spread mean 43.83 than without pagetoid spread mean 34.10 . There was no significant difference of Ki67 expression in eyelid sebaceous carcinoma between well differentiated, moderately differentiated and poorly differentiated p 0.396 .Conclusion Ki67 expression was high in eyelid sebaceous carcinoma. Ki67 expression was no different in eyelid sebaceous carcinoma with and without pagetoid spread. Eyelid sebaceous carcinoma with pagetoid spread tend to be higher Ki67 expression than without pagetoid spread.

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Latar belakang: Karsinoma sebasea palpebra merupakan karsinoma adneksa mata terbanyak dan memiliki prognosis buruk. Penyebaran pagetoid pada karsinoma sebasea palpebra merupakan faktor yang mempengaruhi prognosis buruk. Hasil retrospektif karsinoma sebasea palpebra di Departemen Patologi Anatomik FKUI/RSCM Jakarta tahun 2010 sampai 2015 didapatkan 89 kasus memiliki prognosis buruk. Pemeriksaan imunohistokimia IHK Ki67 merupakan salah satu marker yang digunakan utuk menentukan prognosis. Pada penelitian ini akan diteliti hubungan ekspresi Ki67 pada karsinoma sebasea palpebra dengan penyebaran pagetoid dan tanpa penyebaran pagetoid.Bahan dan cara: Penelitian ini menggunakan desain potong lintang. Sampel terdiri atas 40 kasus karsinoma sebasea palpebra di Departemen Patologi Anatomik FKUI/RSCM periode Januari 2009 sampai September 2016. Sampel dibagi menjadi dua kelompok yaitu kelompok dengan penyebaran pagetoid dan tanpa penyebaran pagetoid. Dilakukan pulasan imunohistokimia Ki67, kemudian dihitung persentase positivitasnya.Hasil: Ekspresi Ki67 pada semua kasus mempunyai rentang antara 2,8 sampai 88 , ekspresi Ki67 tinggi sebanyak 30 kasus 75 . Tidak terdapat perbedaan bermakna ekspresi Ki67antara karsinoma sebasea palpebra dengan penyebaran pagetoid dan tanpa penyebaran pagetoid p=0,136 . Ekspresi Ki67 pada kelompok penyebaran pagetoid cenderung lebih tinggi mean 43,83 dibandingkan tanpa penyebaran pagetoid mean 34,10 . Tidak terdapat perbedaan bermakna ekspresi Ki67 antara karsinoma sebasea palpebra berdiferensiasi baik, sedang dan buruk p=0,396 .Kesimpulan: Ditemukan ekspresi tinggi Ki67 pada karsinoma sebasea palpebra. Tidak terdapat perbedaan ekspresi Ki67 pada karsinoma sebasea palpebra dengan penyebaran pagetoid dan tanpa penyebaran pagetoid. Ekspresi Ki67 cenderung lebih tinggi pada penyebaran pagetoid dari pada tanpa penyebaran pagetoid.

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ABSTRACT
This study aimed to determine whetherBackground Eyelid sebaceous carcinoma is the most common adnexal carcinoma of the eye and has a poor prognosis. Pagetoid spread is a factor of poor prognosis in eyelid sebaceous carcinoma. The retrospective study of eyelid sebaceous carcinoma in Anatomical Pathology Department Cipto Mangunkusumo Hospital Faculty of Medicine Universitas Indonesia between 2010 and 2015 found 89 cases with poor prognosis. Ki67 is a marker of immunohistochemical which is used to determinate the prognosis. This present study was designed to investigate the Ki67 expression in eyelid sebaceous carcinoma with and without pagetoid spread.Materials and methods This study used a cross sectional design. The sample was consist of 40 cases of eyelid sebaceous carcinoma in Anatomical Pathology Department Cipto Mangunkusumo Hospital Faculty of Medicine Universitas Indonesia between January 2009 and September 2016 period. The samples were divided into two groups with and without pagetoid spread. All cases stained by Ki67 immunohistochemistry and evaluated by the percentages of positivityResults Ki67 expression in all cases have a range between 2.8 to 88 , high Ki67 expression was found in 30 cases 75 . There were no significant differences of Ki67 expression between eyelid sebaceous carcinoma with and without pagetoid spread p 0.136 . Ki67 expression was higher in pagetoid spread mean 43.83 than without pagetoid spread mean 34.10 . There was no significant difference of Ki67 expression in eyelid sebaceous carcinoma between well differentiated, moderately differentiated and poorly differentiated p 0.396 .Conclusion Ki67 expression was high in eyelid sebaceous carcinoma. Ki67 expression was no different in eyelid sebaceous carcinoma with and without pagetoid spread. Eyelid sebaceous carcinoma with pagetoid spread tend to be higher Ki67 expression than without pagetoid spread.

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Latar belakang: Diffuse large B-cell lymphoma (DLBCL) adalah Limfoma Non Hodgkin (LNH) yang paling banyak dan paling heterogen dengan prevalensi 25 hingga 30% di negara maju dan 42,5% di negara berkembang. Pemeriksaan imunohistokimia dengan kriteria Hans dapat digunakan sebagai pengganti gene-expression profiling (GEP) dan menggolongkan limfoma ini menjadi subtipe germinal centre B-cell like (GCB) dan non-GCB. Penggunaa terapi yang ada saat ini, masih didapatkan 30% hingga 40% kasus DLBCL mengalami kekambuhan atau residif. Ditemukannya ekspresi CD30 pada DLBCL di beberapa penelitian telah membuka peluang alternatif terapi target baru. Tujuan penelitian ini adalah mengetahui ekspresi CD30 pada DLBCL dan perbedaan ekspresinya pada subtipe GCB dan non-GCB.

Bahan dan cara: Penelitian ini menggunakan desain potong lintang. Sampel terdiri atas 50 kasus DLBCL yang terbagi menjadi 25 kasus subtipe GCB dan 25 kasus subtipe non-GCB berdasarkan pemeriksaan imunohistokimia di RSCM tahun 2014 sampai 2017. Dilakukan pulasan CD30 dan penilaian menggunakan persentase dengan nilai cut off positif >0%, >10% dan >20% sel tumor.

Hasil: Ekspresi CD30 positif didapatkan pada 8(16%), 4(8%), 3(6%) dari 50 kasus DLBCL dengan nilai cut off positif >0%, >10%, >20% secara berurutan. Uji Fisher’s exact yang dilakukan mendapatkan ekspresi CD30 pada subtipe GCB dan non-GCB tidak berbeda bermakna dengan nilai p>0,05.

Kesimpulan: Tidak didapatkan perbedaan yang bermakna antara ekspresi CD30 pada DLBCL subtipe GCB dan non-GCB

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Background: Diffuse large B-cell lymphoma (DLBCL) is the most common and most heterogeneous Non Hodgkin lymphoma (NHL) with  prevalence 25 until 30% in developed countries and 42.5% in developing countries. Immunohistochemical examination using Hans criteria can be used to surogate gene-expression profiling (GEP) and classifies DLBCL as germinal center B-cell like (GCB) and non-GCB subtype. Using recent therapies is still result in 30 to 40% of disease relapse or refractory. Expression of CD30 on DLBCL in several studies has opened up opportunities for new alternative therapeutic targets. The aim of this study is to determine CD30 expression on DLBCL and the difference expression in GCB and non-GCB subtypes.

Materials and methods: This was a cross-sectional study with 50 cases of DLBCL consist of 25 cases of GCB subtypes and 25 cases of non-GCB subtypes based on immunohistochemical examination at RSCM in 2014 until 2017. All cases were stained by CD30 antibody and evaluated using percentage with cut off  value >0%, >10% dan >20% tumor cells. 

Result: Positive CD30 expression was obtained at 8 (16%), 4 (8%), 3 (6%) out of 50 DLBCL cases with cut off values >0%, >10%, >20% respectively. The Fisher's exact test showed no significant difference of CD30 expression between GCB and non-GCB subtypes with p value >0.05.

Conclusion: There is no significant difference in the expressions of CD30 between DLBCL GCB and non-GCB subtypes.

 

Abstrak :
ABSTRAK Karsinoma ovarium adalah salah satu keganasan paling mematikan di bidang ginekologik. Penyebab keganasan belum diketahui pasti dan umumnya tidak memiliki gejala klinik yang jelas. Karsinoma ovarium tipe I khususnya karsinoma endometrioid dan karsinoma sel jernih diketahui dapat berasal dari endometriosis. Karsinoma yang berasal dari endometriosis dikenal sebagai endometriosis-associated ovarian carcinoma (EAOC). Pengembangan model hewan coba karsinoma ovarium yang berhubungan dengan endometriosis diperlukan untuk penelitian dasar dan uji klinik menggantikan jaringan manusia. Pada penelitian ini dikembangkan model hewan coba karsinoma ovarium dengan teknik autoimplantasi dan induksi DMBA. Penelitian ini mengunakan blok parafin dari tikus yang sebelumnya telah mendapatkan operasi plasebo (SHAM), autoimplantasi endometrium, kombinasi autoimplantasi endometrium dan induksi DMBA yang dikorbankan pada minggu ke-5,10, dan 20. Dilakukan penilaian histopatologik dan pulasan imunohistokimia ARID1A dengan penilaian persentase positivitas pada 200 sel. Penelitian ini menghasilkan lesi endometriosis atipik sebanyak 1 (20%) dan karsinoma sel jernih sebanyak 1 (20%) pada implantasi dan induksi DMBA 10 minggu dan karsinoma endometrioid sebanyak 100% pada kelompok induksi DMBA. Pulasan ARID1A tidak menunjukkan perbedaan bermakna (p=0,313) pada seluruh kelompok perlakuan.

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ABSTRACT Ovarian carcinoma is one of the most deadly malignancies in the gynecologic field. The cause of malignancy is not known for sure and generally do not have clear clinical symptoms. Type I ovarian carcinoma especially endometrioid carcinoma and clear cell carcinoma is known to originate from endometriosis. Carcinoma originating from endometriosis is known as endometriosis-associated ovarian carcinoma (EAOC). The development of experimental animal models of ovarian carcinoma associated with endometriosis is needed for basic research and clinical trials replace human tissue. In this study an experimental model of ovarian carcinoma was developed with autoimplantation and DMBA induction techniques.This study used paraffin blocks from mice that had previously received placebo surgery (SHAM), endometrial autoimplantation, combination of endometrial autoimplantation and DMBA induction and were sacrificed at 5,10 and 20 weeks. Assessment of ARID1A expression by assessing the percentage of positivity in 200 cells.This study resulted in 1 (20%) atypical endometriosis lesions and 1 (20%) clear cell carcinoma in 10 weeks DMBA implantation and 100% endometrioid carcinoma in the DMBA induction group. ARID1A ekspression did not show a significant difference (p = 0.313) in all treatment groups.

 

Abstrak :
Diffuse large B-cell lymphoma (DLBCL) adalah limfoma non-Hodgkin yang paling banyak ditemukan, sebanyak 25% hingga 35% pada negara maju, dan 86,6% di negara berkembang. Algoritma Hans membagi DLBCL menjadi dua kelompok yaitu germinal centre B-cell like (GCB) dan non-GCB, di mana kelompok GCB memiliki prognosis yang lebih baik. Meskipun DLBCL merupakan keganasan yang memiliki potensi untuk sembuh, namun 40% pasien akan meninggal karena resisten terhadap pengobatan atau mengalami relapse. Gen p63 memiliki beberapa isoform yang bekerja secara antagonis. Salah satu isoform berfungsi untuk membantu p53 sebagai tumor suppressor, dan isoform lainnya sebagai onkogen yang memicu tumorigenesis. Terdapat sebuah spekulasi bahwa p63 terletak dekat dengan poin translokasi yang sering ditemukan pada DLBCL, yaitu BCL6. Berdasarkan WHO, rearrangement BCL6 terjadi lebih tinggi pada DLBCL subtipe ABC, yaitu sebanyak 25-30% dibandingkan subtipe GCB, yaitu sebanyak 15%. Berdasarkan hal ini, dibutuhkan penelitian terhadap p63 untuk membuktikan kaitannya dengan DLBCL subtipe GCB dan non-GCB. Penelitian ini menggunakan desain potong lintang. Sampel terdiri atas 30 kasus DLBCL subtipe GCB dan 30 kasus DLBCL subtipe non-GCB yang sudah ditegakkan diagnosisnya berdasarkan pemeriksaan IHK di RSCM dari Januari 2014 sampai Desember 2017. Dilakukan pulasan p63 dan penilaian menggunakan H-score. Hasil: Titik potong H-score pada ekspresi p63 didapatkan 4,4 dengan sensitivitas dan spesifisitas 46,7%. Ekspresi p63 positif didapatkan pada 16 kasus DLBCL subtipe GCB dan 14 kasus non-GCB. Tidak terdapat perbedaan ekspresi p63 pada DLBCL subtipe GCB dan non-GCB. ...... Diffuse Large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma, approximately 25% to 35% in developed countries and 86,6% in developing countries. The Hans' algorithm classifies DLBCL into two subtypes, the germinal center B-cell like (GCB) and the non-germinal center B-cell like (non-GCB), where GCB subtype has a better outcome. Although DLBCL is a potentially curable disease, 40% of patients would suffer bad prognosis due to a relapse or refractory disease. The p63 gene produces two isoforms that work antagonistically. One of the isoforms supports p53 as a tumor suppressor, and the other isoform functions as an oncogene which triggers tumorigenesis. There is speculation that p63 is located close to the translocation points that are often found in DLBCL, namely BCL6. According to WHO, BCL6 rearrangement occurs higher in ABC subtype DLBCL compared to GCB subtype (25%-30% vs 15%). Based on this, research on p63 is needed to prove its relation to GCB and non-GCB subtypes. This was a cross-sectional study with 30 cases of DLBCL GCB subtype and 30 cases of non-GCB that had been diagnosed based on immunohistochemistry examination at RSCM from January 2014 to December 2017. All cases stained by p63 antibody and evaluated using H-score. The H-score cut-off point on p63 expression was obtained at 4.4 with 46.7% sensitivity and specificity. The positive p63 expression was obtained in 16 cases of GCB subtype and 14 cases of non-GCB subtype. Conclusion: There are no different expressions of p63 on DLBCL GCB subtype and non-GCB subtype.