Perbedaan Ekspresi Foxp3+ dan Cd8+ Tumor Infiltrating Lymphocytes Karsinoma Payudara pada Berbagai Stadium T

Pendahuluan: Karsinoma payudara adalah keganasan terbanyak wanita dan sering didapatkan adanya tumor infiltrating lymphocytes (TIL) dengan relevansi klinis yang masih kontroversial. TIL sering dianggap mencerminkan respon imun inang terhadap tumor ganas. FOXP3, biomarker spesifik Treg, merupakan faktor transkripsi yang penting dalam perkembangan dan berfungsi dalam pemeliharaan self tolerance, termasuk penghambatan fungsi sel T sitotoksik CD8+. Metode: Penelitian observasional analitik terhadap 44 sampel blok parafin karsinoma payudara berbagai stadium T (AJCC edisi ketujuh) di instalasi Patologi Anatomi RSUD Dr. Soetomo Surabaya menggunakan antibodi FOXP3 dan CD8, dihitung pada area stroma tumor, kemudian dilakukan uji statistik periode 1 Januari 2014 – 31 Desember 2016. Hasil: Terdapat perbedaan bermakna ekspresi FOXP3+ antara T1 dan T4, T2 dan T3, T2 dan T4, T3 dan T4. Terdapat perbedaan bermakna ekspresi CD8+ antara T2 dan T3, T2 dan T4. Terdapat korelasi antara tingginya ekspresi FOXP3+ dengan tinginya ekspresi CD8+ pada T1 dan semua T (p < 0,05). Kesimpulan: Terdapat perbedaan bermakna ekspresi FOXP3+ dan CD8+ TIL karsinoma payudara dengan meningkatnya stadium T. Terdapat korelasi antara ekspresi FOXP3+ dan CD8+ TIL karsinoma payudara pada semua stadium T dan T1

Hubungan Antara Status Invasi Miometrium Dengan Ekspresi Claudin-4 dan Matrix Metalloproteinase-2 Pada Karsinoma Endometrioid Endometrium

AbstrakKarsinoma endometrium merupakan keganasan terbanyak kelima pada organ reproduksi wanitadenganjenis subtipe terbanyak adalah tipe endometrioid. Salah satu parameter penentuan stadium adalah kedalaman invasi miometrium yang menentukan peningkatan agresifitas dan progresifitas tumoryang berhubungan dengan luas tindakan operasi.Protein claudin-4 dan matrix metalloproteinase-2(MMP-2)adalah protein penentu dalam invasi karsinoma.Penelitian ini bertujuanmengungkap peran claudin-4 dan MMP-2 dalam invasi myometrium karsinoma endometrioid endometrium. Penelitianini merupakan penelitian analitik observasional dengan pendekatan cross sectionalmenggunakan sampel 44 blok parafin sampel karsinoma endometrioid endometrium di RSUD Dr. Soetomo periode 1 Januari-31 Desember 2017. Sampel dibagi menjadi kelompok status invasi kurang dan lebih dari separuh tebal miometrium. Pulasan imununohistokimia menggunakan antibodi monoklonal claudin-4dan MMP-2, ekspresi dinilai berdasarkan nilai scoringsemikuantitatif. Hubungan berbagai variabel dianalisis menggunakan tes korelasi Spearmanrho.Hasil penelitian menunjukkan hubungan yang bermakna antara status invasi miometrium dengan ekspresi claudin-4 (p=0,005). Tidak didapatkan hubungan yang bermakna antara status invasi miometrium dengan ekspresi MMP-2 (p=0,549). Didapatkan hubungan yang bermakna antara ekspresi claudin-4 dengan ekspresi MMP-2 (p=0,001).Kesimpulan dari penelitian ini adalahekspresi claudin-4 berhubungan dengan status invasi miometrium karsinoma endometrioid endometrium, ekspresi MMP-2 tidakberhubungan dengan status invasi miometrium karsinoma endometrioid endometrium serta terdapat hubunganbermaknaantara ekspresi claudin-4 dan MMP-2 pada karsinoma endometrioid endometriu

Diagnostic Value Of Ultrasound Parameter In Neonatal Biliary Atresia Based On Histopathological Results (Ultrasound Study Of Triangular Cord Sign And Gallbladder Abnormality)

Abstract Objective: Biliary atresia is an obliterative progressive disease that forms fibrotic tissue in the biliary tract in the neonatal phase. In some European countries, the reported incidence of biliary atresia varies between 1/14,000 and 1/20,000 live births. Ultrasound examination is the modality used to diagnose Biliary Atresia. Ultrasound assessed the sensitivity, specificity, and accuracy of the Triangular Cord Sign and gallbladder abnormality consisting of gallbladder contractility and wall echogenicity. We evaluated the diagnostic test results of Triangular Cord Sign and gallbladder contractility and wall echogenicity with ultrasound examination based on histopathological results of neonatal biliary atresia Material and Methods:This diagnostic test was performed retrospectively between January 2019 and December 2020 with consecutive sampling techniques. A total of 61 pediatric patients clinically diagnosed with biliary atresia underwent ultrasound examination of triangular cord sign and gall bladder abnormality examined by a pediatric radiologist. Histopathological results of liver biopsy specimens confirming biliary atresia were available for all those patients. Data were analysed to assess accuracy, sensitivity, specificity, PPV, and NPV of ultrasound compared with histopathology result Result: The Triangular Cord Sign sensitivity was found to be 70%, specificity 18.2%, PPV 79.5%, NPV 11.8%, and accuracy 60.7%. There was a significant relationship between Triangular Cord signs and histopathology. Gallbladder contractility parameter sensitivity was 76. %, specificity 18.2%, PPV 80.9%, NPV 14.3%, and accuracy 65.6%. However, there was no significant relationship between the histopathology results and the gallbladder wall's echogenicity, with a sensitivity of 70%, specificity of 18.2%, PPV of 79.5%, NPV of 11.8%, and accuracy of 60.7%. Conclusion:The appearance of the triangular cord sign on ultrasonography has a significant relationship with the results of histopathology in biliary atresi

PROFIL PEMERIKSAAN HISTOPATOLOGI KARSINOMA PAYUDARA DI DEPARTEMEN/SMF PATOLOGI ANATOMI RSUD DR SOETOMO SURABAYA PERIODE 2010-2013

Kanker payudara adalah kanker yang paling umum pada wanita, dan juga merupakan penyebab kematian akibat kanker secara keseluruhan. Di Indonesia, dari sudut angka kematian penyakit kanker payudara menduduki urutan pertama diikuti kanker mulut rahim.Tujuan penelitian ini adalah untuk mengetahui profil pemeriksaan karsinoma payudara dari segi data jenis kelamin, usia, jenis histopatologi, derajat histopatologi, status kelenjar getah bening, dan ukuran tumor di departemen/SMF PA RSUD Dr. Soetomo, Surabaya, selama periode Januari 2010- Desember 2013. Penelitian ini merupakan penelitian deskriptif dengan memperhatikan variabel-variabel yang menjadi fokus untuk diteliti dengan menggunakan semua kasus hasil pemeriksaan histopatologi karsinoma payudara yang tercatat di departemen/SMF PA RSUD Dr. Soetomo, Surabaya selama periode Januari 2010- Desember 2013. Dari penelitian ini didapatkan total hasil pemeriksaan histopatologi karsinoma payudara adalah 1405 dengan peningkatan dari tahun 2010-2012. Hasil pemeriksaan ini menunjukkan informasi bahwa 13 (1%) penderita berjenis kelamin laki-laki dan 1392 (99%) penderita berjenis kelamin perempuan. Kelompok usia 41 – 50 tahun merupakan kelompok terbanyak penderita karsinoma payudara. Jenis histopatologi karsinoma payudara yang paling sering ditemukan adalah jenis invasive carcinoma of no special type (78% ). Berdasarkan hasil pembacaan derajat histopatologi didapatkan 787 spesimen (58.7%) termasuk dalam karsinoma payudara derajat 3 atau diferensiasi buruk. Distribusi status kelenjar getah bening menunjukkan bahwa mayoritas 225 spesimen (35.4%) tercatat tidak ada metastasis ke kelenjar getah bening(N0). Ukuran tumor yang paling banyak terjadi adalah ukuran 2-≤5 cm (T2) dengan jumlah 227 spesimen (39.27%)

Ekspresi Epidermal Growth Factor Receptor pada Karsinoma Duktal Invasif Payudara Triple Negative Hubungannya dengan Ekspresi Ki-67, Besar Tumor, dan Derajat Histologik

Karsinoma duktal invasif payudara (KDIP) dengan fenotip triple negative (ekspresi reseptor hormon dan HER2/neu negatif) memiliki perilaku klinis yang lebih agresif dan pilihan terapi yang lebih terbatas dibandingkan tipe non triple-negative. Epidermal growth factor receptor (EGFR) merupakan famili reseptor ErbB dengan aktivitas tirosin kinase yang meningkat ekspresinya pada beberapa neoplasma. Aktivasi EGFR berlebihan menyebabkan peningkatan aktivitas proliferasi sel tumor

The Effects Of Turmeric Extract (Curcuma Longa) Loaded Hidrogels In Accelerating Wound Closure

Abstract Background: Disruption to healing process results on longer healing duration from the timeline. Povidone iodine and tulle are common management in wound care. The advance of industry in health sector and the availability of natural ingredients in Indonesia provide opportunities for developing alternatives for wound care. Turmeric (Curcuma longa) contains curcumin which is anti-inflammatory, antibacterial, and antioxidant; it is good for wound healing. Hydrogel nanocomplexes of carboxymethyl chitosan can maintain moisture in wound area and protect curcumin from hydrolysis. Objective: To analyze the potential of turmeric extract loaded hidrogels in accelerating wound closur. Method: experimental research with “post-test only control group design”. The sample consisted of 30 mice which were assigned into 5 groups. Result: All experimental groups experienced a gradual decrease in wound length. The statistical test results for groups II and III showed significant advantages compared to group IV (p<0.05). Meanwhile, group I did not have significant differences in wound closure compared to group IV on day 1 and 3 (p>0.05), but it had significant results (p<0.05) on day 5. Conclusion: Turmeric extract loaded hidrogels can accelerate the reduction of wound length

CHARACTERISTIC AND HISTOPATHOLOGICAL FEATURES OF PATIENTS WITH PERFORATED PEPTIC ULCER WHO UNDERWENT OPEN SURGERY THERAPY AT DR.SOETOMO GENERAL ACADEMIC HOSPITAL, SURABAYA, INDONESIA

Background: Perforated peptic ulcer is a form of complications from peptic ulcer and one of the most common emergency conditions in medicine. Objective: To describe the characteristic and histopathological features of patients with perforated peptic ulcer who underwent open surgery therapy in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Materials and Methods: This study was a descriptive study by observing patients’ data from medical records (secondary data) at Medical Record Center of Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, in 2016. Data obtained were analyzed descriptively. Results: Forty-six patients were identified (34 male, 12 female), most of them were between 56-65 years old for male and ≥66 years old for female. Majority of the subjects had a history of herbal medicine consumption (54%) as risk factors for developing perforated peptic ulcer and the most frequent comorbid diseases were diabetes and hypertension. The histopathological features found mostly were inflammation (100%), necrosis (44%), fibrosis (36%), granulation (17%) and  positive Helicobacter pylori (6%). Conclusion: Majority of the subjects were male, mostly between 56-65 years old for male and ≥66 years old for female. The histopathological features showed that all subjects had inflammations

Human Pappilomavirus Genotype in Cervical Tissue of Patients with Cervical Intraepithelial Neoplasia (CIN) 1, CIN 2, and CIN 3

Objectives: to determine the genotype of HPV in patients with precancerous lesions of cervical tissue.Materials and Methods: An observational study with cross sectional study of patients paraffin block CIN1, CIN2, CIN3 was conducted in Dr Soetomo Hospital. HPV DNA was extracted from paraffin blocks, then performed PCR and genotyping of HPV. The sample consisted of 28 patients with cervical tissue paraffin blocks CIN1, CIN2 and CIN3. Patients aged between 26-74 years (standard deviation 10,12).Results: HPV genotypes that infect patients with CIN1 were HPV16 and 18, CIN2 were HPV16 and 52 and CIN3 were HPV16, 67, and combined infection HPV16/67 and HPV52/67. HPV genotypes in a single infection were 26/28 (HPV16, HPV18, HPV52 and HPV67), and multiple infections were 2/28 (HPV16/67 and HPV52/67).Conclusion: The most dominant HPV genotypes infect patients with precancerous lesions of the cervix were HPV16, HPV67, HPV52, and HPV18

Mature Teratoma of The Lung : A Case Report

Background:  Mature teratoma is a germinal cell tumor that is commonly found in ovaries and testis. Mature teratoma in the lung region is a rare case. According to the literature there are only 67 cases worldwide starting from 1939 to 2007. There were one cases in Dr. Soetomo general hospital during January 2013 – December 2017. Objective: Mature teratoma in the lung region is a rare case. Presenting in a case report would be beneficial for pathology database Case Presentation: A 19 years old man came to hospital with shortness of breath within 3 months ago. It was followed with hemoptysis, trichoptysis and coughing out tooth. CT Scan examination showed an irregular walled cavity with semisolid component and calcification along with a description of "air cresent sign". In thoracotomy tumor excision obtained multilobulated mass size 8.5x6,8x5,6 cm, yellowish-gray white color, and firm consistency. There were also hair and tooth components. The microscopic representation shows pieces of lung tissue with tumor growth coated with squamous epithel with a stroma containing adnexal skin glands, fatty tissue, cartilage tissue, and serous glands (asinar). Discussion: Mature teratoma of the lung is one of the rare tumors, with symptoms of chest pain, hemoptysis, and trichoptysis. Mature teratoma of the lung is generally cystic and multiloculated, but can also be solid, encapsulated. On microscopic examination, shows a picture of various components of ectoderm, mesoderm and endoderm. Conclusion: Mature teratoma of the lung is a rare tumor. Diagnosis was based from clinical findings, radiologic examination, and confirmed with histopathology and immunohistochemistry

The Genotype of Human Papilloma Virus on Male Patients with Anogenital Warts

Human papillomavirus (HPV) infection is one of the most common sexually transmitted infections. HPV high risk (HPVHR) were HPV16,18 related with invasive penile carcinomas, and HPV low risk (HPVLR) were HPV6,11 related to anogenital warts. Male infection is usually asymptomatic that it would be explain increasing the incidence of HPV associated cancers. Identification HPV genotype is very important for predicting the development of the diseases, to be benign or malignant cancer. The objective of this study was to identify the genotype of HPV that infect men with anogential warts. This research used 12 biopsy specimens from men patient with anogenital warts at Outpatient clinic of Department Dermatology and Venereology, Dr. Soetomo General Hospital period 2016-2017. The specimens were diagnozed by pathologist and HPV gentoyping was done to detect 40 HPV genotype including HPVHR and HPVLR. The result showed that 58% (7/12) were positive for HPVLR and 42% (5/12) were positive for HPV LR/HR. The genotype HPV that infected men patient with anogenital warts is HPVLR (HPV6,11) and HPVHR (HPV18,51,52,82) with single infection of HPVLR or mutiple infection HPVLR/LR or HPVLR/HR. The infection of HPVHR would be develops to be malignant transformation. It suggested that HPV genotype needs to be checked the for the anogenital warts cases for predicting the development of the diseases