KUSUMASTUTI, ETTY HARY
Departemen Patologi Anatomi Fakultas Kedokteran Universitas Airlangga Surabaya

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Perbedaan Ekspresi HBME-1 dan E-Cadherin pada Nodular Hiperplasia, Karsinoma Papiler, dan Folikular Tiroid ROOSANDRIS, PRIMA; KUSUMASTUTI, ETTY HARY; KURNIASARI, NILA
Indonesian Journal of Cancer Vol 11, No 4 (2017): October- December 2017
Publisher : Indonesian Journal of Cancer

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Abstract

Thyroid lesion can be neoplastic and non neoplastic, whether benign or malignant. There are some cases in which pathologists have difficulties to differentiated those lesions. Aim: To analyze the expression of HBME-1 and E-cadherin on nodular hyperplasia, papillary carcinomas and follicular carcinomas. Paraffin blocks of nodular hyperplasia, papillary carcinoma and follicular thyroid were collected from Departement of Pathology Dr Soetomo General Hospital from January 1st, 2012 to December 31th, 2014. Immunohistochemical staining for HBME-1 and E-cadherin were performed. The difference of expression HBME-1 and E-cadherin were analyzed by Mann Whitney test, and the correlation between HBME-1 and E-cadherin determined using Spearman test. There were significant difference of HBME-1 expression between Nodular hyperplasia and Thyroid carcinoma(p≤0,05). There were also significant difference of HBME-1 between papillary and follicular carcinoma thyroid(p≤0,05). There were no significant difference of E-cadherin expression between Nodular hyperplasia and Thyroid carcinoma(p≥0,05). Conclusion: HBME-1 can be used as a marker to distinguish benign and malignant lesion of thyroid gland, and also to distinguish papillary carcinoma and follicullar carcinoma thyroid. ABSTRAK Lesi tiroid dapat berupa lesi non-neoplastik dan neoplastik, baik jinak maupun ganas. Membedakan tumor tiroid jinak dan ganas sangat penting untuk penatalaksanaan klinis yang tepat sehingga sering kali patolog menemui kesulitan dalam membedakan lesi tiroid jinak dan ganas. Penelitian ini bertujuann membuktikan adanya perbedaan ekspresi HBME-1 dan E-cadherin antara nodular hiperplasi, karsinoma papiler, dan karsinoma folikular tiroid. Dilakukan pemeriksaan imunohistokimia pada blok parafin dari nodular hiperplasia, karsinoma papiler, dan karsinoma folikular yang tersimpan di Instalasi Patologi Anatomi RSUD Dr. Soetomo (1 Januari 2012 sampai dengan 31 Desember 2014 sebanyak 35 sampel sesuai kriteria inklusi) dengan antibodi HBME-1 dan E-cadherin. Ekspresi HBME-1 dan E-cadherin dianalisis dengan uji Mann Whitney, sedangkan korelasi antara HBME-1 dan E-cadherin diuji dengan Spearman Test. Hasil penelitian menunjukkan terdapat perbedaan ekspresi HBME-1 yang signifikan antara nodular hiperplasia dan karsinoma tiroid( p≤0,05); terdapat perbedaan ekspresi HBME-1 yang signifikan antara karsinoma papiler tiroid dan karsinoma folikular tiroid (p≤0,05). Tidak terdapat perbedaan ekspresi E-cadherin yang signifikan pada nodular hiperplasi dan karsinoma tiroid (p≥0,05). Penelitian ini menyimpulkan bahwa HBME-1 dapat digunakan sebagai marker untuk mebedakan lesi jinak dan ganas kelenjar tiroid, serta dapat digunakan untuk membedakan karsinoma papiler tiroid dan karsinoma folikular tiroid.
The Expression of CXCR4 and MMP13 in Colorectal Adenocarcinoma Dukes Stage A, B, C and D Anggoro, Rovi; Kusumastuti, Etty Hary
Indonesian Journal of Cancer Vol 12, No 1 (2018): Jan - Mar
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1730.339 KB) | DOI: 10.33371/ijoc.v12i1.550

Abstract

Background: Colorectal adenocarcinoma is the third most common cancer in the world with increasing incidence in Indonesia. Most presented ones were in late stage with more unfavorable prognosis. It is necessary to evaluate new markers for prognosis, identify staging and new possibilities for targeted therapy. Over-proliferating tumor cells will enhance the expression of CXCR4, a chemokine receptor. Activating CXCR4 will further activate various downstream signaling pathways, including one which will increase MMP13 secretion through MAPK/ERK signaling pathway. MMP13 then will degrade extracellular matrix, thus facilitate the migration or metastasis of tumor cells. Methods: A cross sectional study, conducted on 32 samples of colorectal adenocarcinoma. The samples were divided into four groups based on the Dukes staging system (A, B, C and D) and stained immunohistochemically with antibody against CXCR4 and MMP13. The expressions were assessed using immunoreactive score (IRS) and were statistically analyzed. Results: There were positive correlation between the expression of CXCR4 and MMP13 with Dukes staging, with rs = 0,628 and rs = 0,597, respectively. The expression of CXCR4 positively correlated with the expression of MMP13 with rs = 0,670 (p = 0,05). Conclusions: CXCR4 and MMP13 expressions were proven to correlate with the depth of invasion and migration of tumor cells in colorectal adenocarcinoma, hence could be considered as prognostic markers, however both could not be used as predictive marker for staging. Tailored therapies targeting these two proteins could be an interest for further investigation. ABSTRAKLatar Belakang: Adenokarsinoma kolorektal adalah keganasan terbanyak ketiga di dunia, dengan insidensi semakin meningkat di Indonesia. Sebagian besar kasus terdeteksi pada stadium lanjut dengan prognosis buruk. Diperlukan penemuan marker baru yang dapat membantu penentuan stadium, prognosis dan kemungkinan terapi target yang baru. Sel tumor yang berproliferasi berlebihan akan menyebabkan peningkatan ekspresi CXCR4, suatu reseptor kemokin. Aktivasi CXCR4 akan meningkatkan pelepasan proteinase MMP13 melalui jalur MAPK/ERK. MMP13 akan mendegradasi matriks ekstraseluler sehingga menyebabkan migrasi atau metastasis sel tumor. Metode: Studi cross sectional, dilakukan pada 32 sampel adenokarsinoma kolorektal. Sampel dibagi menjadi 4 grup; stadium Dukes A, B, C dan D. Dilakukan pulasan imunohistokimia dengan antibodi CXCR4 dan MMP13, ekspresi keduanya dinilai menggunakan immunoreactive score (IRS) dan dianalisis secara statistik. Hasil: Didapatkan korelasi positif bermakna antara ekspresi CXCR4 dan MMP13 dengan stadium Dukes, dengan rs = 0,628 dan rs = 0,597. Ekspresi CXCR4 berkorelasi positif dengan ekspresi MMP13 dengan rs = 0,670 (p = 0,05). Kesimpulan: Ekspresi CXCR4 dan MMP13 terbukti berkorelasi dengan kedalaman invasi dan migrasi sel ganas pada adenokarsinoma kolorektal. Keduanya dapat dipertimbangkan sebagai marker prognostik namun tidak dapat digunakan sebagai marker prediktif stadium. Targeted therapy untuk kedua protein ini menarik untuk dilakukan investigasi lebih jauh.
LYMPHOMA PADA TESTIS Lestari, Dian Yuliartha; Kusumastuti, Etty Hary
Saintika Medika: Jurnal Ilmu Kesehatan dan Kedokteran Keluarga Vol 14, No 1 (2018): JUNI 2018
Publisher : Universitas Muhammadiyah Malang

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (500.43 KB) | DOI: 10.22219/sm.Vol14.SMUMM1.6643

Abstract

Limfoma pada testis pertama kali dikenalkan oleh Malassez dan Curling pada tahun 1866. Keganasan limfomapada testis berkisar 1-7% dari seluruh keganasan pada testis, dan kurang dari 1% dari seluruh Non Hodgkin Lymphoma.Kami melaporkan kasus anak laki-laki berusia 6 tahun tanpa riwayat kesehatan sebelumnya, mengeluhkan adanya pembengkakanpada testis kanan dan periorbita sejak 6 bulan sebelum MRS. Pemeriksaan radiologis menunjukkan adanya pembesarankelenjar limfe paraaorta serta pseuodotumor bulbi. Pemeriksaan immunomarker dengan LDH, ß HcG, dan AFP menunjukkanhasil 2201 ì/l, <1 mì/l, and 0,75 IU/l. Pasien dilakukan orchidectomy dextradandidiagnosis sebagai Malignant Round CellTumor sesuai Non Hodgkin Lymphoma. Pemeriksaan immunohistokimiamenunjukkan positifuntuk CD45 dan negatifuntuk NSE. Limfoma pada testis merupakan keganasan yang termasuk jarang dimana diagnosis ditegakkan berdasarkanhistopatologi. Tidak ada etiologi dan predisposisi yang pasti untuk tumor ini. Terapi meliputi prosedur pembedahan,khemoterapi, dan radioterapi, akan tetapi tidak ada standarisasi untuk prosedur yang akurat. Faktor-faktor yang dihubungkandengan prognosis yang baik meliputi : usia pasien yang lebih muda, lokasi tumor, adanya seklerosis pada analisis patologi,ukuran tumor yang lebih kecil, grade tumor yang lebih rendah dan tidak adanya epididymal atau spermatic cord yang terlibat.Kata Kunci: Non Hodgkin Lymphoma, Testis
Analisa Ekspresi E-cadherin dan MMP-2 pada Karsinoma Sel Skuamosa Laring Tuti Andayani; Etty Hary Kusumastuti; Anny Setijo Rahaju
Majalah Patologi Indonesia Vol 27 No 3 (2018): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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Abstract

Latar belakangKarsinoma laring merupakan keganasan kedua terbanyak pada kepala dan leher dan lebih dari 90% berupa karsinoma sel skuamosa (KSS). Penanganan kanker laring berkaitan dengan diagnostik dan terapi, terutama ketika penyakit ini terdiagnosis pada stadium lanjut dengan keterlibatan kelenjar getah bening (KGB). Metastasis KSS pada KGB melibatkan beberapa protein yang berperan dalam adhesi sel seperti E-cadherin dan matrix metalloproteinase2 (MMP-2). Pada penelitian ini dilakukan analisis ekspresi E-cadherin dan MMP-2 pada KSS laring untuk menilai peran kedua protein tersebut dalam proses metastasis ke KGB leher.MetodePenelitian observasional analitik dengan pendekatan cross sectional. Sampel penelitian adalah blok parafin KSS laring di Departemen Patologi Anatomik RSUD Dr. Soetomo Surabaya selama Januari 2013-Desember 2014. Tiga puluh sampel terdiri atas dua kelompok, yaitu metastasis KGB dan non metastasis KGB dan dilakukan pemeriksaan imunohistokimia dengan antibodi E-cadherin dan MMP-2. Ekspresi E-cadherin dan MMP-2 dinilai secara semi kuantitatif dan dianalisis dengan tes Mann-Whitney, sedangkan korelasi antara ekspresi E-cadherin dan MMP-2 dengan tes Spearman.HasilTidak terdapat korelasi yang signifikan antara ekspresi E-cadherin dan MMP-2 pada KSS laring. Tidak terdapat perbedaan ekspresi E-cadherin dan MMP-2 yang signifikan antara KSS laring metastasis dan non metastasis ke KGB leher.KesimpulanEkspresi E-cadherin dan MMP-2 tidak berbeda bermakna karsinoma sel akuamosa laring tanpa dan metastasis ke KGB leher. Tidak terdapat korelasi ekspresi E-cadherin dan MMP-2 pada kejadian metastasis KGB leher pada KSS laring.
Analisis Ekspresi BRAF dan TERT pada Kasus Papillary Thyroid Carcinoma Berdasarkan Stratifikasi Risiko ATA Cempaka Harsa Sekarputri,; Etty Hary Kusumastuti,; Gondo Mastutik
Majalah Patologi Indonesia Vol 29 No 3 (2020): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (463.269 KB) | DOI: 10.55816/mpi.v29i3.444

Abstract

BackgroundPapillary thyroid carcinoma (PTC) is the most common malignancy in thyroid, accounting for more than 80% of all thyroid cancer.Rrecurrences of the disease reach 30% cases. It has been widely observed that BRAF and TERT is associated with aggressivenessbehaviors in human cancer. Both are involved in the pathogenesis of PTC that may be used as targets for new therapies. AmericanThyroid Association (ATA) risk stratification can define the risk of recurrence in PTC. No marker has been found to determine therisk of PTC recurrence. The purpose of this study is to analyzed BRAF and TERT expression in ATA risk stratification system inPTC classic variant samples.MethodsThe methods of this study is an analytical observational study with cross sectional approach, conducted on 56 samples of PTCclassic variant selected from Department of Anatomical Pathology Dr. Soetomo General Hospital between January 2015-December2017 by determined criteria in ATA risk stratification groups of low risk, intermediate risk and high risk. The expression BRAF andTERT observed using immunohistochemical staining of Santa Cruz monoclonal antibody.ResultsThe result for each group based on ATA risk stratification groups of low risk were 13 samples (23.20%), intermediate risk were 25samples (44.62%) and high risk were 18 samples (32.12%).The correlation was assessed with Spearman’s rho correlation test. There is significant correlation BRAF (p=0.004) with a value ofr=0.374 and TERT(p=0.032) with a value of r=0.287 for ATA risk stratification.ConclusionBRAF and TERT expression showed significant correlation to ATA risk stratification in classic variant PTC.
Skin Rejuvenation Profile in Dr. Soetomo General Hospital Surabaya Lutfia Ariska Ramadhani; Trisniartami Setyaningrum; Etty Hary Kusumastuti
Health Notions Vol 3, No 12 (2019): December
Publisher : Humanistic Network for Science and Technology (HNST)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33846/hn31204

Abstract

Skin aging is a condition in which cell and tissue changes occur due to mechanism abnormalities and a decrease in function of a tissue which can be triggered by intrinsic or extrinsic factors. Intrinsic factor is an aging process which originates from the body of an individual itself while extrinsic factor is an aging process caused by factors from the outside, such as excessive exposure to the UV light, smoking, or poor nutrition. Skin rejuvenation therapy, hopefully, would be able to restore or even slow down the aging process itself. This research was a descriptive observational using retrospective approach based on patients’ medical record in the Outpatient Clinic of Dermatology and Venereology Department in Dr. Soetomo General Hospital Surabaya in January to December 2017. This study obtained 203 samples (198 women/females and 5 men/males) with the most age group ranging from 45-
The Correlation Between Stress Levels and Acne Vulgaris Stage in 2016th Students Faculty of Medicine Universitas Airlangga Surabaya Cita Rosita Sigit Prakoeswa; Etty Hary Kusumastuti; Nadya Divina Baihaqi
Health Notions Vol 5, No 9 (2021): September
Publisher : Humanistic Network for Science and Technology (HNST)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33846/hn50907

Abstract

Introduction: Acne vulgaris is a common cutaneous inflammatory disorder affecting more than 85% of adolescents worldwide. More than quarter of medical students 2016th had suffers from acne and complaint stress. The stress levels could increase because lot of burden in academy assessment, and other factors that can induced stress like psychosocial psychological stress and triggers by other factors. Stresss levels measured by PSS questionnaire there is mild (≤ 13), moderate (14-26) and severe (>27). Although there is widespread acceptance of a relationship between stress and acne flares, not many studies have been conducted to assess this relationship. Therefore this research encourage, does the stress affect with the severity appearances of acne. Objectives: To correlate stress levels to acne vulgaris stage among students of Faculty of Medicine Universitas Airlangga. Methods: This research design used correlative analysis with cross sectional aproach and total sampling of all students medical students 2016th with the exclusion of students who are using corticosteroid, psychotherapy drugs and non acne vulgaris by staging the acne vulgaris using GAGS and stress level using PSS (perceived stress scale) questionnaires that relate to the research. Also taking pictures for assure the stage of respondent who suffers acne vulgaris, measure and correlate with spearmen correlation. Results: The total of subjects 69 students constituted the study population. This study was attended by 60 male 27,6% of the total number of respondents and 157 female 72,4%. There is 69 people who suffered from acne consist of 46 peoples 66,67% had mild acne stage, 17 peoples 24,63% had moderate acne stage and 6 peoples 8,7% had severe acne stage. The risk factor that mostly induced acne vulgaris stage were final exam (91.3%), eating habbit(87%), and premenstruation acne(71%). The correlation between stress levels and acne vulgaris stage shows .521 using SPSS program. Conclusion: There is significant correlation that the stress levels effect to the skin apearrance and stage of acne vulgaris, also the others factors have been asked on the questionnaire could be increase the acne become more aggressive growth on skin.Keywords: acne vulgaris stage; medical students; stress levels
LYMPHOMA PADA TESTIS Dian Yuliartha Lestari; Etty Hary Kusumastuti
Saintika Medika Vol. 14 No. 1 (2018): JUNI 2018
Publisher : Universitas Muhammadiyah Malang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22219/sm.Vol14.SMUMM1.6643

Abstract

Limfoma pada testis pertama kali dikenalkan oleh Malassez dan Curling pada tahun 1866. Keganasan limfomapada testis berkisar 1-7% dari seluruh keganasan pada testis, dan kurang dari 1% dari seluruh Non Hodgkin Lymphoma.Kami melaporkan kasus anak laki-laki berusia 6 tahun tanpa riwayat kesehatan sebelumnya, mengeluhkan adanya pembengkakanpada testis kanan dan periorbita sejak 6 bulan sebelum MRS. Pemeriksaan radiologis menunjukkan adanya pembesarankelenjar limfe paraaorta serta pseuodotumor bulbi. Pemeriksaan immunomarker dengan LDH, ß HcG, dan AFP menunjukkanhasil 2201 ì/l, <1 mì/l, and 0,75 IU/l. Pasien dilakukan orchidectomy dextradandidiagnosis sebagai Malignant Round CellTumor sesuai Non Hodgkin Lymphoma. Pemeriksaan immunohistokimiamenunjukkan positifuntuk CD45 dan negatifuntuk NSE. Limfoma pada testis merupakan keganasan yang termasuk jarang dimana diagnosis ditegakkan berdasarkanhistopatologi. Tidak ada etiologi dan predisposisi yang pasti untuk tumor ini. Terapi meliputi prosedur pembedahan,khemoterapi, dan radioterapi, akan tetapi tidak ada standarisasi untuk prosedur yang akurat. Faktor-faktor yang dihubungkandengan prognosis yang baik meliputi : usia pasien yang lebih muda, lokasi tumor, adanya seklerosis pada analisis patologi,ukuran tumor yang lebih kecil, grade tumor yang lebih rendah dan tidak adanya epididymal atau spermatic cord yang terlibat.Kata Kunci: Non Hodgkin Lymphoma, Testis
Three years survival rate of epithelial ovarian cancer patients in Dr. Kariadi Hospital, Semarang, Central Java Indah Nur Damayanti; Indra Yulianti; Etty Hary Kusumastuti
Majalah Obstetri dan Ginekologi Vol. 24 No. 3 (2016): September - December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (87.406 KB) | DOI: 10.20473/mog.V24I32016.100-104

Abstract

Objectives: to determine the association between prognostic factors of ovarian cancer with a 3-years survival rate of epithelial ovarian cancer patients.Material and Method:  Retrospective cohort study was conducted in 90 patients (during 2012) at Dr.Kariadi General Hospital. Kaplan meier, Log rank and Cox regression were used to analyse survival rate and prognostic factors that influence the disease.Result: Overall 3-years survival rate of epithelial ovarian cancer patients were 58.5% (Kaplan meier). Three-years survival rates were 89.3%, 44,4%, and 35.1% for patients in stage I, stage II, and stage III, respectively, and no patient survive up to 3 years in stage IV. Prognostic factors that associated with 3-years survival rate were stage of the disease, ascites, residual tumor, and type of histopathology {p<0,001; p=0,001; p=0,004; p=0,041, respectively (Log rank test)}, whereas age and size of tumor were not associated. After using multivariate analysis (Cox regression) only stage of the disease was associated with 3-years survival rate of epithelial ovarian cancer patients.Conclusion: There were an association between stage of the disease, ascites, residual tumor, type of histopathology, and 3-years survival rate of epithelial ovarian cancer patients. Stage of the disease was a prognostic factor that most influence 3-years survival rate of epithelial ovarian cancer patiens in this study.
Risk Factor Profile and Quality of Life of Psoriasis Vulgaris As'ad Naufal; Damayanti Damayanti; Etty Hary Kusumastuti; Afif Nurul Hidayati
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 33 No. 2 (2021): AUGUST
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V33.2.2021.129-134

Abstract

Background: Psoriasis is an autoimmune human skin disease. It is a chronic and recurrent lesion characterized by erythema patches with well-defined borders with rough, multi-layered, and transparent scales with a significant negative impact on patients' quality of life. Several risk factors for psoriasis can decrease patient’ quality of life. Purpose: To determine the risk factor profile and quality of life of psoriasis patients at the dermatology and venereology outpatient clinic at Dr. Soetomo General Academic Hospital Surabaya.  Methods: This was a cross-sectional study involving new and control psoriasis patients. Their risk factors were evaluated using questionnaires, and their quality of life was measured using the DLQI questionnaires. The data was collected at the Dermatology and Venereology outpatient unit Dr. Soetomo General Academic Hospital Surabaya. Result: Of the 24 patients, the biggest risk factor for psoriasis patients was trauma/ Koebner phenomenon, as reported in 15 patients (62.5%), and 11 patients’ (45.8%) quality of life was affected. Conclusion: Trauma was the largest risk factor for psoriasis, and psoriasis has significantly affected patient’ quality of life.