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Majalah Patologi Indonesia
Published by Perhimpunan Ahli Patologi Indonesia
ISSN : 02157284     EISSN : 25279106     DOI : https://doi.org/10.55816/
Core Subject : Health,
Health Professions Public Health
Majalah Patologi Indonesia (MPI) digunakan sebagai wahana publikasi hasil penelitian, tinjauan pustaka, laporan kasus dan ulasan berbagai aspek di bidang patologi manusia. Tujuannya ialah menghadirkan forum bagi permakluman dan pemahaman aneka proses patologik serta evaluasi berbagai penerapan cara diagnostik sejalan dengan kemajuan perkembangan ilmu dan teknologi. Selain itu juga untuk merangsang publikasi barbagai informasi baru/mutakhir.
Arjuna Subject : Kedokteran - Patologi dan Kedokteran Kesehatan
Articles 319 Documents
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Pengaruh Pemberian Low-Level Laser Therapy pada Proses Penyembuhan Luka Bakar Derajat II . Ester Asima N.I.S., Troef Soemarno
Majalah Patologi Indonesia Vol 21 No 2 (2012): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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ABSTRAK Latar belakang Luka bakar telah menjadi penyebab kematian dan kesakitan yang sering terjadi dalam kehidupan sehari-hari. Silver sulfadiazine adalah obat antibakteri topikal yang sering diberikan sebagai pencegahan infeksi pada lesi luka bakar (konsentrasi 5-20%). Low-level laser therapy telah lama diketahui memiliki sifat merangsang aktifitas sel termasuk sel-sel inflamasi yang berperan pada proses penyembuhan luka. TGF-β adalah faktor pertumbuhan penting yang menyebabkan migrasi dan proliferasi fibroblast serta meningkatkan sintesis kolagen. Peranan laser pada penyembuhan masih merupakan suatu kontroversi. Metode Dua puluh empat ekor mencit jantan galur BALB/c dibagi secara random dalam tiga kelompok. Dibuat luka bakar pada punggung hewan coba menggunakan pangkal paku besi berdiameter satu sentimeter yang sebelumnya dicelupkan pada air mendidih. Pada kelompok pertama (P1) luka diberi salep silver sulfadiazine topikal 1%, dan pada kelompok kedua (P2) luka diberikan sinar laser kemudian diolesi dengan silver sulfadiazine topikal 1%. Pada kelompok kontrol luka hanya dibersihkan dengan natrium klorida 0,9 %. Semua luka ditutup dengan kasa steril dan ditutup dengan verband. Pada hari keempat jaringan luka dibiopsi dan dibuat sediaan histopatologi dengan pewarnaan hematoxylin-eosin dan pewarnaan imunohistokimia. Hasil Terdapat perbedaan yang signifikan antara jumlah makrofag pada kelompok perlakuan dan kelompok kontrol (p=0,031) dan antara ekspresi TGF-β oleh makrofag pada kelompok kontrol dan kelompok perlakuan (p=0,034). Kesimpulan Pemberian kombinasi low-level laser dan silver sulfadiazine dapat meningkatkan jumlah makrofag dan ekspresi TGF-β oleh makrofag sehingga penyembuhan luka terjadi lebih cepat dan lebih baik. Kata kunci : luka bakar derajat II, low-level laser therapy, silver sulfadiazine, makrofag, TGF-β ABSTRACT Backsground Burn injuries remain one of the leading causes of injury morbidity and mortality often occurs in daily living. Silver sulfadiazine is antibacterial preparations that are often given for prevention of infection in a burn lesion which is relatively narrow (5-20%). Low-level laser therapy have recently been investigated for stimulation of cell activities involved in wound healing process. TGF-β is a potent fibrogenic agent that cause fibroblast migration and increased synthesis of collagen. The role of the laser in burn healing process has been controversial. Methods Second-degree burn wound on the backside of each of 24 BALB/c mice was created with a standard burning procedure by applying a heating plate. 24 mice were divided into three groups randomly. Group control, burn lesion was treated with 0,9% NaCl solution and closed dressing, the second group (P1), burn lesion was treated with topical silver sulfadiazine 1% and closed dressing, and third group (P2), burn lesion was treated with 4 J/cm2 laser irradiation, topical silver sulfadiazine 1% and closed dressing. A biopsy was performed on the lesion on the fourth day after the burns. We studied the effect of low-level laser therapy and topical silver sulfadiazine on TGF-βs-expression macrophages in healing process of burns by making observations on Hematoxylin Eosin staining and immunohistochemistry techniques. Results There were significant differences of the number of macrophage (p=0,031) and TGF-β expression (p=0,034) on group control compared with group treated. Conclusion Low-level laser therapy and silver sulfadiazine of second degree burn wound increase the number of macrophage and expression TGF-β protein on white male BALB/c strain mice, and the wound healing process become more quick and better. Key words: second-degree burn, low-level laser therapy, silver sulfadiazine, macrophage, TGF-β
Penilaian Akurasi Diagnosis Potong Beku pada Tumor Ovarium Jenis Epitelial di Departemen Patologi Anatomik FKUI/RSCM Tahun 2009-2011 . Tantri Hellyanti, Hartono Tjahjadi
Majalah Patologi Indonesia Vol 21 No 2 (2012): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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ABSTRAK Latar belakang Tumor ovarium merupakan salah satu neoplasma penyebab kematian tertinggi akibat kanker; 90% diantaranya adalah jenis epitelial. Hingga saat ini belum ada pemeriksaan preoperatif untuk menentukan perangai biologik tumor ovarium. Akurasi diagnosis potong beku (PB) penting dalam menentukan prosedur pembedahan selanjutnya. Tujuan Memberi informasi akurasi diagnosis PB, khususnya terkait tumor ovarium jenis epitelial di Departemen Patologi Anatomik FKUI/RSCM. Cara kerja Dilakukan penilaian ulang seluruh kasus tumor ovarium jenis epitelial yang menjalani PB pada periode 2009-2011. Selanjutnya dilakukan penghitungan prevalensi akurasi diagnosis PB berdasarkan perangai biologik tumor. Hasil penelitian Akurasi diagnosis PB pada tumor ovarium jenis epitelial jinak, borderline, dan ganas masing-masing sebesar 82%, 64% dan 89%. Kesimpulan Akurasi diagnosis PB tumor ovarium jenis epitelial di institusi kami cukup tinggi; nilai terendah didapatkan pada kelompok borderline. Kata kunci : akurasi, diagnosis potong beku, tumor ovarium jenis epitelial, borderline ABSTRACT Background Ovarian tumor is one of the most common causes of cancer-related-death, and 90% are epithelial type. Until now, there is no pre-operative examination that could be used to ascertain the biological behavior of ovarian tumor, so the frozen section (FS) is important in determining the next surgical procedure. Objective To provide information of FS accuracy, especially for ovarian epithelial tumor, in Anatomical Pathology Department FMUI/CMH. Methods All ovarian epithelial tumor cases which underwent FS analysis in 2009-2011 were reviewed. FS accuracy for biological behavior was computed. Results A total of 82%, 64% and 89% cases with benign, borderline and malignant FS diagnosis were confirmed in the final diagnosis. Conclusion FS accuracy for ovarian epithelial tumor in our institution is fairly high with the lowest accuracy falls in the borderline category. Keywords : accuracy, frozen section diagnosis, ovarian epithelial tumor, borderline
Pengaruh Pemberian Ekstrak Batang Sarang Semut (Myrmecodia Pendens Merr & Perry) terhadap Ekspresi p21 dan Ekspresi ki67 pada Galur Sel Karsinoma Mammae T47D . Mudjahid1, Sarjadi1, Dyah Ratna Budiani
Majalah Patologi Indonesia Vol 21 No 2 (2012): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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ABSTRAK Latar belakang Pendekatan empiris banyak dilakukan masyarakat Indonesia dalam penggunaan herbal batang sarang semut sebagai obat anti kanker, tanpa adanya penelitian yang mendasarinya. Ekstrak batang sarang semut beberapa tahun belakangan ini banyak digunakan dalam penanganan kanker payudara tanpa pengawasan secara medik. Penelitian tentang potensi antikanker ekstrak batang sarang semut dilaksanakan antara lain dengan melihat pengaruhnya terhadap ekspresi p21 dan ki67 pada sel T47D secara in vitro. p21 suatu tumor supressor protein yang berfungsi dalam induksi cell cycle arrest dan repair DNA. Sedangkan ki67 merupakan marker proliferasi sel yang selalu hadir pada setiap aktivitas proliferasi sel Metode Jenis penelitian eksperimental dengan design post test only control group menggunakan 24 well kultur sel kanker mammae T47D pada medium RPMI 1640, masing-masing well berisi 2x105/200µl. Empat well pada perlakuan dengan fraksi etanolik ekstrak batang sarang semut pada konsentrasi 0 μgr/ml; 31,25 μgr/ml; 62,5 μgr/ml dan 125 μgr/ml. Penilaian Makna tampilan p21, ki67 dinyatakan sebagai Skor Sitologi Hasil Uji Regresi korelasi menunjukkan adanya hubungan yang positif antara kenaikan konsentrasi sarang semut dengan tingkat ekspresi p21 R2 = 0,889 Ekstrak sarang semut menunjukkan hubungan negatif antara kenaikan konsentrasi sarang semut dengan penurunan terhadap ekspresi ki67 R2 = 0,827 Kesimpulan Ekstrak sarang semut fraksi etanolik menurunkan ki67 dan meningkatkan tingkat ekspreasi p21 Kata kunci:Sarang semut(Myrmecpodia pendens, Merr & Perry), p21 dan ki67. ABSTRACT Background Empirical Approaches was done by a lot of Indonesian society on the extract of batang sarang semut as a component of herbal anti-cancer, in the absence of the underlying research. Extract of batang sarang semut in recent years is widely used in the treatment of breast cancer without clinical and laboratory supervision. Study in vitro on the anticancer potential of stem extracts of sarang semut conducted among others by looking at its effect on the expression of p21 and ki67 on T47D cell line. p21 is a tumor supressor protein that functions in the induction of cell cycle arrest and DNA repair. While ki67 is cell proliferation marker that is always present in every proliferation cell activity that is nutritious. Methods This experimental was designed as a post test only control group using 24 well culture T47D mammary cancer cells in RPMI 1640 medium, each well containing 2x105/200μl. Four well were treated with the fraction of ethanolic extract of stem until the concentration of 0 μgr/ml; 31.25 μgr /ml; 62.5 μgr/ml and 125 μgr/ml. Assessment The expressions of p21 and ki67 is declared as Cytologic Score. Results Regression test of correlation showed a positive relationship between the increasing concentration of sarang semut with the expression of p21, R2 = 0.889. Extract sarang semut showed a negative relationship between the increasing concentration of sarang semut with a decreasing expression of ki67 R2 = 0.827 Conclusion The fraction of ethanolic extract of sarang semut decreasing the level of ki67 expressions and increasing the level of p21 expressions. Keyword : sarang semut(Myrmecpodia pendens,Merr & Perry), p21 and ki67.
Karakteristik Umur dan Histopatologi pada Subtipe Karsinoma Payudara Tripel Negatif . Suly Auline Rusminan, Heni Maulani, Fifie Julianita, Zen Hafy
Majalah Patologi Indonesia Vol 21 No 3 (2012): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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ABSTRAK Latar belakang Karsinoma payudara tripel negatif (KPTN) adalah karsinoma payudara yang tidak mengekspresikan reseptor esterogen, progesteron dan HER-2. Proporsi kejadian KPTN adalah 10-17% dari seluruh karsinoma payudara. KPTN memiliki perjalanan klinis agresif, prognosis yang buruk dan karakteristik klinikohistopatologi serta molekular yang unik. Penelitian ini dirancang untuk mengetahui hal-hal yang terkait dengan karakteristik dan faktor-faktor yang diduga berhubungan dengan subtipe KPTN basal-like dan nonbasal-like berdasarkan tripanel petanda (CK14, EGFR dan 34βE12). Bahan dan cara kerja Penelitian observasi analitik ini menggunakan sampel 39 kasus KPTN dari Laboratorium Patologi Anatomik RSUP dr. Mohammad Hoesin Palembang (periode Juli 2009-Juli 2011). Pulasan imunohistokimia CK14, EGFR dan 34βE12 dilakukan untuk membedakan subtipe KPTN basal-like atau nonbasal-like, kemudian dianalisis hubungan antara karakteristik umur dan histopatologinya. Hasil KasusKPTN terbanyak didapatkan pada kelompok umur 45-49 tahun (33,3%), dengan rerata usia 55 tahun, umumnya adalah jenis karsinoma duktal invasif derajat keganasan tinggi (79,5%). Proporsi KPTN subtipe basal-like dijumpai pada 41% KPTN. Pada penelitian ini tidak dijumpai adanya hubungan statistik bermakna (p>0,05) antara umur dan karakteristik histopatologi yang meliputi ukuran tumor, pleomorfisme inti, jumlah kelenjar, jumlah mitosis, derajat keganasan, subtipe histologi, komponen DCIS, invasi limfovaskular, status limfonodus, tepi tumor dan area nekrosis dengan subtipe KPTN. Kesimpulan Berdasarkantripanel petanda imunohistokimia (CK14, EGFR dan 34βE12) didapatkan 41% kasus termasuk KPTN tipe basal-like. Tidak ada hubungan bermakna antara karakteristik umur dan histopatologi dengan subtipe karsinoma payudara tripel negatif. Kata kunci : Karsinoma payudara tripel negatif, basal-like, CK14, EGFR, 34βE12, umur, karakteristik histopatologi. ABSTRACT Background Triple negative breast cancer (TNBC) is defined as a subtype of breast cancer which is negative for estrogen receptor, progesterone receptor and HER-2. Accounts for 10-70% of all breast cancer.TNBC have aggressive behavior, poor prognosis, unique clinicohistopathologic characteristic and molecular profiles. This study designed to identified characteristics and related with TNBC subtype using tripanels CK14, EGFR and 34βE12. Methods This study was an analytical observasional study based on thirty nine cases of TNBC at the Anatomic Pathology Laboratory of Dr.Mohammad Hoesin General Hospital, Palembang since July 2009-July 2011 period, immunohistchemical staining for CK14, EGFR and 34βE12 were use to distinguish the TNBC basal-like and nonbasal-like subtype, and correlated with age and histopathologic characteristics. Results Most ofTNBC patients were 45-49 years old (33.3%), with mean 55 years old. Most of TNBC (79,5%) were high grade invasive ductal carcinoma (79,5%). Proportion of the basal-like TNBC subtype was 41%. No statistical correlation (p>0,05%) between age, and histopathologic characteristics including tumor size, nuclear pleomorphism, mitotic score, tubule formation score, histologic grade, DCIS component, lymphovascular invasion, lymph node status, margin, and necrosis area with TNBC subtype. Conclusion Based on thetripanel immunohistochemical marker (CK14, EGFR and 34βE12 determine 41% of cases as TNBC basal-like. No statistical correlation between age and histopathological characteristics with TNBC subtype. Key words: Triple negative breast cancer, basal-like, CK14, EGFR and 34βE12, age, histopathologic characteristic.
Peningkatan Ekspresi Ki67 Tidak Berhubungan dengan Para-meter Prognostik Histopatologik Karsinoma Payudara Invasif di Sumatera Barat . Loli Devianti 1, Aswiyanti Asri 1, Edison
Majalah Patologi Indonesia Vol 21 No 3 (2012): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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ABSTRAK Latar belakang Karsinoma payudara merupakan keganasan tersering pada wanita. Tahun 2010 dari 3 laboratorium Patologi Anatomik di Sumatera Barat (Sumbar), karsinoma payudara menempati peringkat pertama, dengan jumlah kasus 304. Prognosis karsinoma payudara invasif dipengaruhi oleh sejumlah faktor prognostik histopatologik diantaranya status kelenjar limfe, derajat diferensiasi histologik, tipe histologik, indeks mitosis, invasi vaskular serta penanda proliferasi (Ki67). Ki67 merupakan suatu protein nonhiston inti, diekspresikan pada seluruh fase siklus sel kecuali fase G0, sehingga merupakan penanda prognostik superior untuk menilai proliferasi sel sebagai kunci utama progresi tumor. Penelitian ini bertujuan untuk mengetahui hubungan antara ekspresi Ki67 dengan tipe histopatologik, grade histopatologik, invasi vaskular dan metastasis kelenjar limfe. Metode Jenis penelitian observasional dengan desain cross sectional menggunakan 52 sampel karsinoma payudara invasif. Dilakukan pengumpulan status kiriman, preparat HE, blok parafin dan dilanjutkan dengan pemeriksaan imunohistokimia menggunakan antibodi Ki67. Labelling index dihitung dengan persentase sel yang positif 0,05). Tidak terdapat hubungan yang signifikan antara ekspresi Ki67 dengan invasi vaskular (p>0,05). Tidak terdapat hubungan yang signifikan antara ekspresi Ki67 dengan metastasis kelenjar limfe (p>0,05). Kesimpulan Tidak terdapat hubungan peningkatan ekspresi Ki67 dengan tipe histopatologik, derajat diferensiasi, invasi vaskular dan metastasis kelenjar limfe dan hanya berupa tren. Kata kunci : Karsinoma payudara invasif, ekspresi Ki67, tipe histopatologik, derajat diferensiasi, invasi vaskular, metastasis kelenjar limfe. ABSTRACT Background Breast carcinoma is the most cancer found in women. In the year 2010, it was the most cancer in three anatomical pathology laboratories of west Sumatera with 304 total cases. The prognosis of this disease can be affected by various histopathological prognostics. They are nodal status, histologic grade, histologic type, mitotic index, vascular invasion and proliferation markers (Ki67). Ki67 is an antigen related to nonhistone nuclear proteins that is expressed in all cell-cycle phases except in G0, and proponents advocated its use as a prognostic marker more superior to cells proliferation, as key feature of the progression of tumors. This study aims to determine the correlation of Ki67 expression to histopathological type, histopathological grade, vascular invasion and nodal status. Methods This observasional cross sectional study based on 52 samples of invasive breast carcinoma. Patients’s record, HE slides and paraffin embedded tissue were collected and will observed for immunohistochemical evaluation by Ki67 antibody. Labeling Index for each tumor is presented as percentages of positive cells stained in 10% ( in 500 cells). Statistical analyses was using Chi square. It was observed on January-September 2011. Results Invasive breast carcinoma with poorly differentiated has tendency to show Ki67 expression ≥ 10%, but it can’t continued with statistical analyse. There was no correlation between Ki67 expression and histologic type (p>0,05). There was no correlation between Ki67 expression and vascular invasion (p>0,05). There was no correlation between Ki67 expression and nodal status (p>0,05). Conclusion There were no statistically significant correlation between Ki 67 expression and hystopathological type, histopathological grade, vascular invasion, and nodal status. It was only a trend. Key words : Invasive breast carscinoma, histopathological type, histopathological grade, vascular invasion, nodal status.
Kesesuaian Ekspresi E-Cadherin pada Karsinoma Duktal dan Lobular Payudara . Mona Oktarina ZD, Heni Maulani, M.Rasjid HS, M.Zulkarnain
Majalah Patologi Indonesia Vol 21 No 3 (2012): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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ABSTRAK Latar belakang Karsinoma duktal (40-70%) dan lobular (5-15%) merupakan jenis karsinoma payudara yang banyak dijumpai. Kedua jenis karsinoma ini memiliki gambaran histopatologik berbeda, namun terkadang gambaran ini dapat tumpang tindih sehingga cukup menyulitkan ahli patologi. Penelitian sebelumnya melaporkan ekspresi E-cadherin umumnya menghilang pada karsinoma lobular karena Loss Of Heterozygocity (LOH) gen CDH1 atau mutasi gen disertai hilangnya wild-type allele, sedangkan pada karsinoma duktal akan menetap karena tidak dijumpai mutasi ini.Penelitian ini bermaksud melihat kesesuaian antara gambaran histopatologik dengan ekspresiE-cadherin tersebut. Bahan dan cara kerja Sampelsejumlah 72 kasuskarsinoma payudara jenis duktal, lobular, serta kasus karsinoma invasif dengan gambaran histopatologik meragukan antara kedua jenis karsinoma tersebut (Januari 2008-Juli 2011) dari arsippreparat HE dan blok parafin ditinjau ulang, dilakukan pulasan imunohistokimia E-cadherin, diinterpretasikan oleh 2 orang ahli patologi secara independen; dilakukan uji statistik Kappa. Hasil Nilai Kappa untuk kesesuaian diagnosis antara ahli patologi = 0,380. Dari 27 kasus duktal: ekspresi E-cadherin positif 25 kasus,negatif 1 kasus, 1 kasus menunjukkan ekspresi positif dan negatif. Kasus lobular hanya 2 kasus:semua menunjukkan ekspresi negatif.Kasus meragukan: ekspresi E-cadherin positif 21 kasus, negatif 14 kasus, dan 1 kasus dijumpai ekspresi positif dan negatif dalam satu tumor (nilai kappa = 0,809). Kesimpulan Ada kesesuaian yang sangat kuat antaraekspresi E-cadherin dengan gambaran histopatologik (positif untuk karsinoma duktal; negatif untuk karsinoma lobular), dapat digunakan untuk membantu membedakan kedua jenis karsinoma tersebut terutama pada kasus yang memiliki gambaran histopatologik meragukan. Kata kunci: Karsinoma duktal, karsinoma lobular, ekspresi E-cadherin ABSTRACT Background The most common breast carcinomas are ductal (40-70%) and lobular (5-15%) types. They have distinct histopathologycal features, but the challenge for the pathologists are sometimes both features can appears on the same tumor in confusing pattern. Many research reported that lobular carcinomas commonly have lost expression of E-cadherin due to Loss of heterozygocity (LOH) or mutation of CDH1 gene with loss of wild-type allele, meanwhile ductal carcinomas have positive expression because no mutation was detected. This study want to see the conformity between the histopathologycal features with the E-cadherin expression. Methods Seventy two samples of H&E-stained slides and paraffin blocks consists of 18 ductal carcinomas, 18 lobular carcinomas and 36 invasive carcinomas showing confusing histopathologycal features of both types (Januari 2008-Juli 2011) from the pathologycal archieves being reviewed, E-cadherin immunohistochemical stains were performed, evaluated independently by two pathologists; Kappa statistical test were conducted. Results Kappa value between the 2 pathologists are 0,380. From 27 cases of ductal carcinomas, the E-cadherin expression were positive in 25 cases, negative in 1 case, and both expression was seen in 1 case. Lobular carcinoma only 2 cases; both showed negative E-cadherin expressions. In the confusing cases: positive E-cadherin expression were observed in 21 cases, negative in 14 cases, and 1 case was found with both positive and negative expression (Kappa value = 0,809). Conclusion E-cadherin expression is strongly conform with the histopathologycal features (ductal carcinomas are positive; lobular carcinomas are negative), can be used as a useful diagnostic tool to differentiate both types of carcinomas; especially for the cases with confusing histopathologycal features. Keywords: Ductal carcinomas, lobular carcinomas, E-cadherin expression
Kanker Payudara “Triple-Negative” Subtipe “Basal-Like” dan “Normal-Like”: Analisis Perbedaan Usia Penderita dan Karak-teristik Histopatologik Serta Analisis Nilai “Cut-Off” Reseptor Hormon . Vinesia L. Riddi, Primariadewi Rustamadji, Endang SR. Hardjolukito
Majalah Patologi Indonesia Vol 21 No 3 (2012): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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ABSTRAK Latar belakang Karsinoma payudara (KPD) berdasarkan profil ekspresi gen dan karakter imunofenotipe diklasifikasikan menjadi beberapa subtipe. Salah satu subtipe adalah jenis basal-like (KPDBL) yang disebutkan sebagai tumor agresif dengan prognosis yang lebih buruk dibandingkan subtipe lain pada karsinoma payudara triple-negative (KPDTN). Di Indonesia, belum ada data publikasi mengenai KPDTN. Penelitian ini bertujuan untuk mengetahui proporsi kasus KPDTN serta membedakan KPDBL dan KPD normal-like (KPDNL) menggunakan pulasan imunohistokimia (IHK) CK5. Metode Seluruh kasus KPD dari bulan Januari 2009-Oktober 2010 diambil dari arsip Departemen kami. Terdapat 42 kasus yang didiagnosa sebagai KPDTN berdasarkan ekspresi negatif reseptor estrogen (RE), reseptor progesteron (RP) dan human epidermal growth factor receptor-2 (HER2). Selanjutnya dilakukan pulasan IHK CK5 untuk membedakan KPDBL dengan KPDNL serta menghubungkannya dengan masing-masing parameter klinikopatologik KPDTN yang karakteristik. Hasil Terdapat 40 kasus yang memenuhi kriteria inklusi penelitian ini. Hanya 20 dari 40 kasus (50%) KPDTN mengekspresikan CK5 positif dan dikelompokkan sebagai KPDBL. Duapuluh kasus sisanya tidak mengekspresikan CK5 dan dikelompokkan sebagai KPDNL. Tidak terdapat perbedaan antara KPDTN dan KPDNL berdasarkan usia penderita (p = 0,519), grade histologik (p = 0,452), gambaran morfologi pushing border (p = 0,828), central/geographic necrosis (p = 1,000) dan infiltrasi limfosit peritumoral (p = 0,219). Kesimpulan Gambaraan histopatologik tidak dapat digunakan untuk membedakan KPDBL dari KPDNL pada KPDTN. Untuk itu, penambahan CK5 dalam panel antibodi untuk KPD, dapat membantu pembedaan kedua subtipe tersebut. Kata kunci : karsinoma payudara triple-negative, Karsinoma payudara jenis basal-like, CK5 ABSTRACT Background Breast cancers have been classified into distinct subtype base on gene profiling and/or immunophenotype characteristic. Basal-like phenotype is defined as an aggressive tumor which have a poor prognosis among the other phenotype in triple-negative breast cancer (TNBC). There was no published data about the TNBC in Indonesia. The aim of this study was to investigate the prevalence and clinicopathologic feature of TNBC and also differentiate basal (BL) and normal-like (NL) phenotype in TNBC by using immunohistochemical marker, cytokeratin-5 (CK5). Method All invasive breast cancers from January 2009 to October 2010 were selected from the file of our Departement. There were 42 TNBC which have been identified by the negative expression of estrogen receptor, progesterone receptor and HER2 using immunohistochemistry. We performed CK5 immunohistochemistry to determined BL and NL phenotype and correlate the CK5 positivity with age of patient and histopathological features. Results Only 40 of cases were included in our investigation. We found 20 out of 40 TNBC cases (50%) showed CK5 expression and defined as BL breast cancer (BC). The rest 20 cases were not positive for CK5 and defined as NL-BC. There were no significant statistical differences between BL and NL-BC base on age and histopathological features. Conclusions The age of patient and histopathological features cannot differentiate between BL and NL-BC. Therefore, the use of CK5 as the immunomarker of basal-like phenotype would be benefit to differentiate this aggressive tumor from the NL phenotype. Key words : triple-negative breast cancer, basal-like breast cancer, CK5
Korelasi antara Ekspresi Cyclooxygenase-2 dan Karsinoma Kolorektal . Winta Mayanti, Zulkarnain Musa, Fifie Julianita, Irsan Saleh
Majalah Patologi Indonesia Vol 21 No 3 (2012): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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ABSTRAK Latar belakang Karsinoma kolorektal merupakan salah satupenyakitutama dan frekuensi keganasan yang paling banyak terjadi pada traktus gastrointestinal. Pasien dengan stadium lanjut umumnya tidak dapat disembuhkandengan regimen pengobatanyang ada sekarang dan sedikit pengaruhnya terhadap harapan hidup 5 tahun. Oleh karena itu, pendekatan lain dilakukan untuk menurunkan morbiditas, mortalitas dan prognosis penyakit yang lebih baik dengan terapi tambahan (kemopreventif) anti Cyclooxygenase-2(COX-2) yaitu obat-obat anti-inflamasi nonsteroid, khususnya inhibitor COX-2 selektif. Cyclooxygenase-2 dijadikan terapi target karena perannya dalam tumorigenesis dan angiogenesis pada karsinoma kolorektal dari mekanisme metabolisme asam arakhidonat. Penelitian ini bertujuan untuk mengetahui korelasi antara ekspresi Cyclooxygenase-2 dan karsinoma kolorektal Bahan dan cara kerja Penelitian ini merupakan studi observasional korelatif dengan pendekatan serial kasus dan sampeldiperoleh selama periode Januari 2010 sampai Desember 2010. Tiga puluh sampel berupaarsipslaidpengecatan H&E dan blok parafin jaringan patologi dari Laboratorium Patologi Anatomik RSUP. Dr.Mohammad Hoesin Palembang, kemudian ditinjau ulang dan dipulas dengan immunohistokimiaCyclooxygenase-2, dievaluasi oleh 2 orang patolog secara independen. Hasil dianalisis untuk menilai positifitasnya dan diuji statistik korelatif nonparametrik Spearman. Hasil Didapatkan nilai positif ekspresiCyclooxygenase-2 yang sama baik menurut tipe maupun derajat (differensiasi) dari karsinoma kolorektal sebesar 86,7%(26/30), dan didapatkan korelasi yang bermakna antara ekspresi Cyclooxygenase-2 dan tipe karsinoma kolorektal dengan arah korelasi negatif dan kekuatan korelasi sedang (r= -,436 p< 0,05) namun masih perlu penelitian lebih lanjut dengan kasus yang lebih banyak. Kesimpulan Ekspresi Cyclooxygenase-2 pada sel-sel tumor karsinoma kolorektal dapat dipakai sebagai acuan para klinisi untuk membantu manajemen terapi maupun prognosis penyakit setelah tindak lanjut penderita. Kata kunci: Karsinoma kolorektal, Cyclooxygenase-2, korelasi ABSTRACT Background Colorectal carcinoma is one of the major diseases and the frequency of the most common malignancy in the gastrointestinal tract. Patients with advanced stage are generally not curable with current treatment regimens and little effects on 5 years life expectancy. Therefore another approach was taken to reduce morbidity, mortality and disease prognosis better with additional therapy (chemopreventive) anti Cyclooxygenase-2 (COX-2), these are nonsteroidal anti-inflammatory drugs, especially selective COX-2 inhibitor. Cyclooxygenase-2 used as targeted therapy because of its role in tumorigenesis and angiogenenesis in colorectal carcinoma from mechanism of arachidonic acid metabolism. This study aims to determine the correlation between expression of Cyclooxygenase-2 and colorectal carcinoma. Material and methods This study is an observational correlative study with serial cases and samples obtained during the period January, 2010 to December 2010. Thirty samples of H&E stained slides and paraffin blocks from the pathological archives of the Anatomical Pathology Laboratory of Dr.Mohammad Hoesin General Hospital Palembang being reviewed, Cyclooxygenase-2 immunohistochemical were performed, evaluated by 2 pathologist independently. The results were analyzed to asses the positifity and using nonparametric Spearman correlative statistical test we analyzed the correlation. Results The same values obtained positifity of Cyclooxygenase-2 expression both the type and grade (differentiation) of colorectal carcinoma by 86.7% (26/30) with a significant correlation between expression of Cyclooxygenase-2 and type of colorectal carcinoma with the negative direction and moderate strength of the correlation(r= -,436 p< 0,05) but further study with more cases is still needed. Conclusion The expression of Cyclooxygenase-2 in tumor cells of colorectal carcinoma that can be used as a referrence for clinicians to help therapy management and prognosis the disease after follow-up patients. Key words: Colorectal carcinoma, Cyclooxygenase-2, the correlation
Akurasi Potong Beku, Sitologi Imprint dan Scraping Intraoperatif dalam Mendiagnosis Tumor Ovarium . Elda Rusnita, Henny Sulastri, Jusuf Fantoni, Zen Hafy
Majalah Patologi Indonesia Vol 21 No 3 (2012): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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ABSTRAK Latar belakang Teknik potong beku maupun sitologi imprint dan scraping sudah digunakan sebagai konsultasi patologi intraoperatif dalam mendiagnosis tumor ovarium. Penelitian mengenai keakuratan diagnosis potong beku intraoperatif pada tumor ovarium pernah dilakukan namun terhadap sitologi imprint dan scraping belum pernah dilakukan di RSUP. Dr. Moh. Hoesin Palembang. Tujuan dari penelitian ini adalah untuk mengetahui akurasi potong beku, sitologi imprint dan scraping dalam mendiagnosis tumor ovarium dibandingkan histopatologi sebagai baku emasnya. Bahan dan cara kerja Penelitian ini merupakan uji diagnostik pada 105 sampel arsip tumor ovarium dari bulan Januari 2009 sampai Desember 2010. Hasil pemeriksaan potong beku, sitologi imprint dan scraping serta histopatologinya dibaca ulang oleh dua orang Spesialis Patologi Anatomik. Data dianalisis untuk menghitung nilai akurasi pemeriksaan potong beku serta sitologi imprint dan scraping. Hasil Didapatkan nilai akurasi potong beku sebesar 99% dan akurasi sitologi imprint dan scraping sebesar 97,14%. Kesimpulan Pemeriksaan potong beku serta sitologi imprint dan scraping merupakan pemeriksaan dengan nilai akurasi yang tinggi. Pemeriksaan sitologi imprint dan scraping dapat menjadi alternatif pemeriksaan intraoperatif untuk rumah sakit yang tidak mempunyai fasilitas potong beku. Kata kunci: Tumor ovarium, potong beku, sitologi imprint dan scraping, akurasi. ABSTRACT Background Frozen section or imprint and scrape cytology technics have been used as an intraoperative consultation measure for ovarian tumor diagnosis. Study about the accuracy of frozen section diagnosis for ovarian tumor had already been done in Dr. mohammad Hoesin General Hospital Palembang but not for imprint and scrape cytology. The aim of this study is to evaluate the accuracy of frozen section, imprint and scrape cytology in ovarian tumor diagnosis compared with histopathology as a gold standard. Methods This study was a diagnostic tes of one hundred and five samples from the archives of ovarian tumors from January 2009 to December 2010. The frozen section, imprint, scrape cytology and histopathological results were evaluated by two pathologists. The data were analized for the determination of the accuracy of frozen section and imprint and scrape cytology. Results The overall accuracy rate for frozen section, imprint and scrape cytology is 99% and 97,14% respectively. Conclusion Frozen section and imprint and scrape cytological examination revealed high accuracy, therefore imprint and scrape cytology are strongly recommended as an alternative measure for intraoperative consultation instead of frozen section mainly for hospitals that do not have facility of frozen section. Key words : Ovarian tumor, frozen section, imprint and scrape cytology, accuracy
Ekspresi Matrix Metalloproteinase-9 (MMP-9) pada Nodul Hiperplastik, Adenoma Folikuler dan Karsinoma Folikuler Tiroid . Heriyawati; Imam Susilo
Majalah Patologi Indonesia Vol 23 No 1 (2014): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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Background Differential diagnosis of thyroid nodules can be problematic for pathologists and clinicians in routine examination. Especially, in differentiating hypercellular, hyperplastic nodule from follicular adenoma, as well as follicular adenoma from follicular carcinoma, because evidence of capsular and vascular invasion is necessary. Thus, ancilliary diagnostic marker may be useful along with histopathological examination of the nodules thyroid. Methods An analytic observational study with cross sectional approach was carried out. Study samples were patients with hyperplastic nodule, follicular adenoma and follicular carcinoma which were diagnosed histopathologically at the Laboratory of Anatomical Pathology of Dr. Soetomo Hospital during 2009-2011. Immunohistochemical examination was performed by using polyclonal antibody against MMP-9, a protein which has the ability to degrade extracellular matrix. Expression of MMP-9 was assessed semi quantitatively based on the percentage of tumor cells that showed imunoreactivity. Statistical differences were analyzed by using Kruskal-Wallis and Mann-Whitney test, with significance limit of p

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