"[
ABSTRAKLatar 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.
ABSTRACTBackground : 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]"
