5 research outputs found
HUBUNGAN KADAR CA-125 PRAOPERATIF TERHADAP PROGNOSIS SURVIVAL PENDERITA KANKER OVARIUM EPITELIAL DI RSUP DR. SARDJITO
Background: CA-125 level increases in 50% of patients with stage I, 90% of patients with stage
II, 92% of patients with stage III and 94% of patients with stage IV ovarian cancer. CA-125 level
were not a diagnostic tool to detect ovarian cancer, however it was useful to monitor the
progressive of disease and as a prognostic marker.
Objectives: The aim of this study is to prove whether CA-125 level before surgery in ovarian
cancer patients at Dr. Sardjito Hospital as well as a factor that correlates to the survival prognosis
of those patients.
Method: This research used cohort retrospective study at Dr. Sardjito Hospital Yogyakarta.
Results: As much as 71 ovarian cancer patients which had been included in this research with
inclusion and exclusion criteria. Subjects were divided into two groups. One group was for
patients with low CA-125 level (�35 U/ml) as much as 18 subjects and another group was for
patients with high CA-125 level (>35 U/ml) as much as 53 subjects. The result of a bivariate
analysis with an independent survival analysis (Cox�s Regression) was the stage of disease
(p=0.005, HR 4.827, CI 95% 1.623 � 14.355) and residual tumour (p=0.029, HR 2.605, CI 95%
1.101 � 6.161) were a survival prognosis factor. Multivariate analysis with a survival analysis
(Cox�s Regression) shows CA-125 level (p=0.031, HR 4.131, CI 95% 1.143 � 14.933) and
menarche (p=0.003, HR 4.989, CI 95% 1.736 � 14.342) were significantly related with survival
prognosis in EOC (Epithelial Ovarian Cancer) patients at Dr. Sardjito Hospital.
Conclusion: CA-125 level affects the survival rate of epithelial ovarian cancer patients in Dr.
Sardjito Hospital. Besides the level of CA-125, there are other factors that affect the survival rate
of epithelial ovarian cancer patients which is the stage of cancer, residual operation and age of
menarche.
Keywords: CA-125 level, EOC, prognosis, surviva
PERBANDINGAN KUALITAS HIDUP PENDERITA KANKER SERVIKS YANG DIBERIKAN KEMORADIASI BERBASIS CISPLATIN DENGAN CISPLATIN TUNGGAL DI RSUP DR SARDJITO YOGYAKARTA
Objective: Comparing the quality of life in patients with cervical cancer given
Cisplatin-based versus single Cisplatin chemoradiation and risk factors that
influencing.
Material dan Method: A retrospective cohort study design in 146 patients
with cervical cancer. Seventy three patients in each group have completed 1
series of weekly Cisplatin + 5-FU or 3 weekly Cisplatin chemoradiation at
Sardjito Hospital Yogyakarta. For assessing the quality of life, the author used
EORTC QLQ-C30 and QLQ-CX24. Data distribution was analytically tested
by Kolmogorov-Smirnov. Categorical data were tested with Chi-Square, while
continous data with Mann-Whitney test. Multivariable analysis used logistic
regression.
Result: The results of Mann-Whitney test found significant mean difference
almost in all items, except for item of diarrhea in QlQ-C30 and sexual/vaginal
function item in QLQ-CX24. The mean value of quality of life in Cisplatin + 5-
FU is higher than single Cisplatin (72.60 + 16.98 vs 62.22 + 16.73). We
found relationship of high quality of life in Cisplatin + 5-FU chemoradiation
1.73 times than single Cisplatin (RR 1.7
STATUS METILASI GEN BRCA1 GEN BRCA2 EKSPRESI PROTEIN BRCA1 PROTEIN BRCA2 HUBUNGANNYA DENGAN TERJADINYA TUMOR EPITELIAL OVARIUM DERAJAD DIFERENSIASI JENIS HISTOPATOLOGI STADIUM DAN SURVIVAL PENDERITA KANKER EPITELIAL OVARIUM
Cancer initiation and progression are controlled by genetic and epigenetic events.
Cancer develops through multistep process in which the genomes of cancer cells mutate in
several groups of genes such as proto-oncogen, tumor suppresor genes and other genes which
directly or indirectly control the cell proliferation. Cancer cells also retain genetic instability
that allows the cells to change all the time. The epigenetic process which is widely known is
DNA methylation. Methylation is adding four atoms in cytosine one of four DNA nucleotides.
This additional atom blocks proteins which transcribe the genes. Several study reported that
BRCA1 methylation was beetwen 10 % to 65 % and the study of the BRCA2 methylation in
ovarian cancer was rare and it was said that methylation was very low up to 4 %.
The study design was a prospective-cohort study. The study was conducted at Sardjito
Hospital. Methylation status of BRCA1 and BRCA2 genes was examined using MS-PCR
methode, and expression of BRCA1 and BRCA2 protein was examined using
immunohistochemistry staining to the tumor tissue.
The aim of study are: 1) Identifying the methylation status of BRCA1 and BRCA2 genes
in patients with epithelial ovarian cancer. 2) Identifying the methylation status of BRCA1 and
tumor suppresor genes in the epithelial ovarian cancer tissue cells is compared with the
methylation status of BRCA1 and BRCA2 genes fragment of the DNA in the patient�s blood
serum. 3) Identifying whether the proportion of BRCA1 and BRCA2 methylation status would
affect the stage, the degree of differentiation and the histopathology type of epithelial ovarian
cancer. 4) Identifying whether the BRCA1 and BRCA2 gene methylation and protein expression
of BRCA1 and BRCA2 were associated with the survival of epithelial ovarian cancer patients.
The study result gathering 99 cases which consisted of 30 cases of benign ovarian
epithelial tumors and 69 cases of malignant epithelial ovarian tumors was analyzed in this
study. The result showed that the methylation status of BRCA1 were 62/68 cases (89.9%) in the
benign tumor were 26/30 cases (86,7%). The methylation status of BRCA2 68/69 cases (98,6
%), in the benign ovarian tumor methylation status of BRCA2 were 29/30 cases (96,7 %).
Statisticaly no significance different p = 0,643 and p = 0,540 respectively. Seem that these
result were very hight, then internal and external validation was done, the result is same.
BRCA1 and BRCA2 of the serum that were isoloted was examined the methylation status. The
proportion of methylation is not significantly different p =0,528 and 0,626 respectively.
However, the Kappa statistic between methylation status in the tissue and serum of BRCA1 and
BRCA2 were � 0,035 and � 0,062 respectively. Its mean that methylation status in serum
cannot be used to predict methylation status of BRCA1 and BRCA2 in the tissue. It was
probably due to the primer that was used to detect DNA fragment in serum was to long same as
that was used in the tissue. Multinomial logistic regression analysis found that BRCA1
methylation status, BRCA1 protein expression and BRCA2 protein expression clinically
significant influenced to histopathology type espescially endometrioid adenocarcinoma and
clear cell adenocarcinoma OR= 3,90 (CI: 0,27 � 54,67), OR = 0,27 (CI: 0,03 � 2,18), OR =
6,95 (CI: 0,83 � 57,99) respectively. BRCA1 methylation status and BRCA2 protein
expression clinically significant influenced to the grading of the tumor especially to moderate
and poorly differentiated OR = 3,57 (CI: 0,50 � 25,37), OR = 2,16 (CI: 0,47 � 9,90). BRCA1
methylathion status, BRCA1 protein expression and BRCA2 protein expression clinically
significant influenced to the stage of diseases especially to late stage OR = 2,59 (CI: 0,33 �
20,15), OR = 2,92 (CI: 0,47 � 18, 08), OR = 2,71(0,48 � 15,08). Factors that clinically
influeced to patients survival were BRCA2 protein expression HR = 2,04 (CI: 0,61 � 0,677),
stage of diseases HR 0,42 (CI: 0,11 � 1,62). Factors that statistically significant influenced
patient survival were the age of menarche and CA 125 conccentration.
Conclusions: (1) Methylation status of BRCA1 and BRCA2 genes in the epithelial
ovarian cancer were 89,9 % and q 98,6 % respectively, (2) Methylation status of DNA
fragmen in the serum patients was not able to use for predicting methylation status of BRCA1
and BRCA2 genes in the ovarian tumor tissue, (3) BRCA1 methylation status, BRCA1 protein
expression and BRCA2 protein expression clinically significant influenced to histopathology.
BRCA1 methylation status and BRCA2 protein expression clinically significant influenced to
the grading of the tumor, (4) BRCA1, BRCA2 genes methylation and BRCA1 protein
expression were not as the prognostic factors of the survival of epithelial ovarian cancer
patients. However, BRCA2 protein expression clinically influenced to survival of the patients