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Marselus Merung, Marselus
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Biochemistry, Genetics & Molecular Biology Health Professions

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Terapi pada Pasien Kanker Payudara Stadium Lanjut Menurunkan Kadar C- Reaktif Protein dan Meningkatkan Kadar Albumin Wawolumaja, Arya; Pontoh, Victor; Merung, Marselus
Jurnal Biomedik : JBM Vol 11, No 2 (2019): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.11.2.2019.23324

Abstract

Abstract: Breast cancer is one of the malignancies that has a high prevalence and can occur in both sexes. Albeit, more than 70% of these patients were detected at late stage. Inflammation could accelerate the tumor growth, invasion, angiogenesis, and metastasis. Increased serum CRP indicates uncontrolled infection or pathological process. Meanwhile, serum albumin is used to evaluate the nutrition status, the severity of disease, and prognosis. This study was aimed to evaluate the influence of serum CRP and albumin levels in female patients with breast cancer after treatment. This was an interventional analytical study with a cross sectional design. This study was conducted at Prof. Dr. R. D. Kandou Hosppital Manado. Subjects were all female patients with breast cancer from May to August 2018. The results showed that there were 43 patients of late stage breast cancer, mean age of 52.16 years. After treatment there was a decrease in the mean serum CRP level from 17.05 mg/dL to 6.40 mg/dL and the paired t test obtained a t value of 3.269 and a P value of 0.001. Moreover, there was an increase in the mean serum albumin level from 3.59 mg/L to 3.76 mg/L and the paired t test obtained a t value of -2,896 and a P value of =0.003. Conclusion: Chemotherapy and or surgery performed on female patients with breast cancer could decrease the serum CRP level and increase the serum albumin level.Keywords: breast cancer, serum CRP, serum albuminAbstrak: Kanker payudara merupakan salah satu jenis keganasan yang memiliki prevalensi cukup tinggi dan dapat terjadi baik pada laki-laki maupun perempuan. Lebih dari 70% penderita kanker payudara ditemukan pada stadium lanjut. Keadaan inflamasi dapat mempercepat pertumbuhan tumor, invasi, angiogenesis, dan metastasis. Hadirnya CRP serum yang meningkat mengindikasikan adanya infeksi atau proses patologik yang tidak teratasi. Albumin serum secara umum digunakan untuk menilai status nutrisi, derajat keparahan penyakit, perkembangan penyakit, dan prognosisnya. Penelitian ini bertujuan untuk menilai pengaruh kadar CRP dan albumin serum pada pasien perempuan dengan kanker payudara stadium lanjut setelah terapi. Jenis penelitian ialah intervensional analitik dengan desain potong lintang Penelitian dilakukan di RSUP Prof. Dr. R. D. Kandou Manado. Subjek penelitian ini ialah semua penderita kanker payudara berjenis kelamin perempuan pada periode Mei 2018 s/d Agustus 2018. Hasil penelitian mendapatkan 43 pasien dengan kanker payudara stadium lanjut dengan usia rerata 52,16 tahun. Setelah terapi terjadi penurunan rerata kadar CRP serum dari 17,05 mg/dL menjadi 6,40 mg/dL dan uji t berpasangan menunjukkan nilai t=3,269 dengan P=0,001. Selain itu, terjadi peningkatan rerata kadar albumin serum dari 3,59 mg/L menjadi 3,76 mg/L dan uji t berpasangan menunjukkan nilai t=-2,896 dengan P=0,003. Simpulan: Modalitas kemoterapi dan/atau operasi pada pasien kanker payudara stadium lanjut secara bermankna menurunkan kadar CRP serum tetapi meningkatkan kadar albumin serum.Kata kunci: kanker payudara, CRP serum, albumin serum
Neutrofil Darah Tepi pada Pasien Kanker Payudara Stadium Lanjut Sebelum dan Sesudah Dilakukan Tindakan Asri, Rizky; Pontoh, Victor; Merung, Marselus
Jurnal Biomedik : JBM Vol 11, No 1 (2019): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.11.1.2019.23213

Abstract

Abstract: Worldwide, there were around 2.1 million breast cancer cases diagnosed in 2018. There was nearly 1 of 4 cancer cases among women with an incidence of 38,1 per 100.000 and mortality of 14,1 per 100.000. This study was aimed to determine whether there was a change in response score of systemic inflammation by using peripheral blood neutrophil level in female patients with advanced stage of breast cancer before and after treatment. This was an interventional analytical study with a cross sectional design, conducted at Prof. Dr. R. D. Kandou Hospital Manado. The results showed that there were 43 patients in the period of May 2018 to August 2018. The youngest age was 34 years and the oldest age was 70 years with a mean of 52.16 years (SD±10.002). The most frequent stage was III B (58.1%), followed by IIIC (25.6%), IIIA (11.6%), and IV (4.7%). Before treatment, the highest level of neutrophil was 55%, the lowest level was 12%, with a mean of 27.84% (SD±10.005). After treatment, the highest level of neutrophil was 45%, the lowest level was 11%, with a mean of 22.7% (SD±6.635). The paired-t test showed a very significant difference in peripheral blood neutrophil level between before and after treatment (P<0.001). Conclusion: There was a significant decrease of peripheral blood neutrophil level in breast cancer patients after treatment.Keywords: plasma neutrophil, advanced stage of breast cancerAbstrak: Di seluruh dunia, terdapat sekitar 2,1 juta kasus kanker payudara wanita yang didiagnosis pada tahun 2018, serta terhitung hampir 1 dari 4 kasus kanker di kalangan wanita dengan insidensi 38,1 per 100.000 dan kematian sebanyak 14,1 per 100.000. Penelitian ini bertujuan untuk untuk menilai adanya perubahan skor respons peradangan sistemik dengan menggunakan kadar neutrofil darah tepi pada pasien kanker payudara stadium lanjut sebelum dan setelah terapi. Jenis penelitian ialah intervensional analitik dengan desain potong lintang, yang dilakukan di RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian mendapatkan 43 pasien sejak Mei 2018 s/d Agustus 2018. Usia termuda 34 tahun dan usia tertua 70 tahun dengan rerata usia 52,16 tahun (SD±10,002). Stadium terbanyak ialah stadium IIIB (58,1%), diikuti stadium IIIC (25,6%), stadium IIIA (11,6%), dan stadium IV (4,7%). Sebelum dilakukan tindakan didapatkan kadar neutrofil tertinggi 55%, kadar terendah 12%, dan rerata 27,84% (SD±10,005). Setelah dilakukan tindakan didapatkan kadar neutrofil tertinggi 45%, terendah 11%, dan rerata 22,7% (SD±6,635). Hasil uji t berpasangan mendapatkan perbedaan yang sangat bermakna dari kadar neutrofil sebelum dan sesudah terapi (P<0,001). Simpulan: Terdapat penurunan bermakna dari kadar neutrofil darah tepi pada pasien kanker payudara setelah dilakukan tindakan.Kata kunci: neutrofil darah tepi, kanker payudara stadium lanjut
PROFIL PENDERITA TUMOR KELENJAR LIUR DI RSUP PROF. DR. R.D. KANDOU MANADO PERIODE JULI 2012-JUNI 2015 Iman, Wirawan; Merung, Marselus; Aschorijanto, Ainun
e-CliniC Vol 4, No 1 (2016): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.4.1.2016.10976

Abstract

Abstract: Salivary glands tumours are relatively rare to find. There is still no adequate data about the incidence of salivary gland tumours in Indonesia. The main objective of this research was to cognise the profile of salivary glands tumours patients in Prof. Dr. R.D. Kandou Central General Hospital Manado from July 2012 to June 2015. Methods used is descriptive retrospective. The results showed there are 37 patients with salivary gland(s) tumour(s). Male was 59,5% and female was 40,5%. By age groups found that <19 years for 2.7%, 19-30 years for 8,2%, 31-45 years for 21.6%, 46-60 years for 37,8%, >60 years for 29,7%. Based on the histopathological classification, pleomorphic adenoma for 56.8%, Whartin's tumor for 8.1%, myoepithelioma for 2,7%, basal cell adenoma for 2.7%, oncocytoma for 2.7%, cystadenoma for 5.4%, canalicular adenoma for 2.7%, mucoepidermoid carcinoma for 10.8%, adenocarcinoma for 5.4%, and acinic cell carcinoma for 2.7%. Based on the location of the tumours’ appearance, parotid gland for 83.8%, submandibular gland for 13.5%, minor salivary glands for 2.7%. Based by the incidences annually, first year for 21.6%, second year for 32.3%, and the third year for 46.1%.Conclusion: Males are more than females, most commonly found in the age group of 51-60 years, the most commonly benign tumour found is the pleomorphic adenoma, the most commonly found malign tumour is mucoepidermoid carcinoma, the most commonly location of the tumours’ appearance is the parotid gland. The salivary glands tumours continued to increase during the last three years.Suggestion: Still necessary to do further research about salivary glands tumours.Keywords: salivary glands tumours, age, gender, histopathology, location, profileAbstrak : Tumor kelenjar liur adalah tumor yang relatif sedikit dijumpai ditemukan. Belum ditemukan data yang lengkap tentang kejadian tumor kelenjar liur di Indonesia. Tujuan utama dari penelitian ini adalah untuk mengetahui profil penderita tumor kelenjar liur di RSUP Prof. Dr. R.D. Kandou Manado periode Juli 2012-Juni 2015. Metode penelitian yang digunakan adalah deskriptif retrospektif. Hasil penelitian memperlihatkan terdapat 37 penderita tumor kelenjar liur. Laki-laki sebanyak 59,5% dan perempuan 40,5%. Kelompok usia <16 tahun sebanyak 2,7%, 16-30 tahun sebanyak 8,1%, 31-45 tahun sebanyak 21,6%, 46-60 tahun sebanyak 37,8%, >60 tahun sebanyak 29,7%. Berdasarkan klasifikasi histopatologi jenis pleomorphic adenoma sebanyak 56,8%, Whartin’s tumor sebanyak 8,2%, myoepithelioma sebanyak 2,7%, basal cell adenoma sebanyak 2,7%, oncocytoma sebanyak 2,7%, cystadenoma sebanyak 5,4%, canalicular adenoma sebanyak 2,7%, mucoepidermoid carcinoma sebanyak 10,8%, adenocarcinoma sebanyak 5,4%, acinic cell carcinoma sebanyak 2,7%. Berdasarkan lokasi munculnya tumor, kelenjar parotis sebanyak 83,8%, kelenjar submandibula sebanyak 13,5%, kelenjar liur minor sebanyak 2,7%. Berdasarkan jumlah pertahunnya, tahun pertama sebanyak 21,6%, tahun kedua sebanyak 32,3%, dan tahun ketiga sebanyak 46,1%.Kesimpulan : Penderita laki-laki lebih banyak daripada perempuan, paling banyak ditemukan pada kelompok usia 46-60 tahun, tumor jinak yang paling banyak ditemukan adalah pleomorphic adenoma, tumor ganas yang paling banyak ditemukan adalah mucoepidermoid carcinoma, lokasi tersering munculnya tumor adalah kelenjar parotis. Penderita tumor kelenjar liur terus meningkat selama tiga tahun terakhir.Saran : Perlu dilakukan penelitian lebih lanjut tentang tumor kelenjar liurKata Kunci : tumor kelenjar liur, usia, jenis kelamin, histopatologi, lokasi, profil
Analisis Hubungan Ca 15-3 dan Respon Kemoterapi Neoadjuvan pada Pasien Kanker Payudara Stadium Lanjut Lokal Rusli, Lie V.; Merung, Marselus; Pontoh†, Victor; Manginstar, Christian; Hatibie, Mendy J.; Langi, F. L. Fredrik G.
e-CliniC Vol 9, No 2 (2021): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v9i2.34659

Abstract

Abstract: Neoadjuvant chemotherapy is one of the therapeutic modalities used in the management of locally advanced breast cancer. Therapeutic response can be objectively assessed with RECIST and Ca 15-3 could be used to monitor response to breast cancer (BC) treatment. This study was aimed to prove the relationship between Ca 15-3 and response to neoadjuvant chemotherapy in locally advanced BC. The study was carried out at the Departement of Surgery Prof. Dr. R. D. Kandou Hospital Manado using a single-arm pre-post trial. Each patient would be performed Ca 15-3 test and clinical assessment (RECIST) pre and post chemotherapy for two sessions. There were 11 BC patients with invasive ductal carcinoma.  The average age was 60 years old and the majority had anemia and lymphocytopenia. There was a decrease in Ca 15-3 in each patient by a baseline of 21.8 U/mL pre-treatment and a decrease in the lesion size by 30.3 mm using RECIST. The results showed that changes in RECIST and Ca 15-3 level were correlated with each unit change in RECIST was associated with a decrease in Ca 15-3 level by 0.03 units (p=0.019). In conclusion, there was a decrease in Ca 15-3 level in response to chemotherapy, followed by a decrease in RECIST. There was a relationship between Ca 15-3 level and chemotherapy response assessed with RECIST after the second chemotherapy.Keywords: Ca 15-3, chemotherapy response, neoadjuvant chemotherapy, RECIST, breast cancer  Abstrak: Kemoterapi neoadjuvan masih merupakan pilihan utama terapi untuk kanker payudara (KPD) stadium lanjut local. Respon suatu kemoterapi dapat dinilai secara objektif dengan RECIST dan Ca 15-3 dapat digunakan untuk memantau respon terhadap pengobatan KPD. Penelitian ini bertujuan untuk membuktikan hubungan antara Ca 15-3 dengan respon kemoterapi neoadjuvan RECIST pada pasien KPD stadium lanjut lokal. Penelitian dilaksanakan di Bagian Bedah RSUP Prof. Dr. R. D. Kandou, Manado dengan menggunakan single-arm pre-post trial. Setiap individu yang terlibat akan diperiksa kadar Ca 15-3, serta penilaian RECIST sebelum dan sesudah mereka menerima kemoterapi selama dua sesi. Hasil penelitian mendapatkan 11 pasien KPD dengan karsinoma duktal invasif. Rerata usia 60 tahun, umumnya dengan anemia dan limfositopenia. Terdapat penurunan Ca 15-3 pada tiap pasien sebesar awal 21,8 U/mL pra pengobatan dan penurunan lesi 30,3 mm saat dinilai menurut RECIST. Didapatkan bahwa perubahan RECIST dan Ca 15-3 memiliki keterkaitan dengan setiap unit perubahan RECIST berhubungan dengan penurunan kadar Ca 15-3 sebesar 0,03 unit (p=0,019). Simpulan penelitian ini ialah terdapat hubungan antara kadar Ca 15-3 dengan respon kemoterapi setelah kemoterapi siklus ke dua.Kata kunci: Ca 15-3; respon kemoterapi; neoadjuvan kemoterapi; RECIST; kanker payudara
Co-Authors Ainun Aschorijanto, Ainun Asri, Rizky Hatibie, Mendy J. Manginstar, Christian Pontoh†, Victor Rusli, Lie V. Victor Pontoh, Victor Wawolumaja, Arya Wirawan Iman, Wirawan