Bambang Sutrisna
Faculty of Public Health, Universitas Indonesia

Published : 41 Documents
Articles

Estimating The Annual Cost of Smoking-Related Diseases in Indonesia

MEDIA MEDIKA INDONESIANA 2009:MMI VOLUME 43 ISSUE 5 YEAR 2009
Publisher : MEDIA MEDIKA INDONESIANA

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Abstract

Background: Smoking plays a role in the development of chronic diseases and causes substantial negative economic consequences. This study was carried out to estimate the annual cost of smoking-related cardio-cerebrovascular and pulmonary  diseases in the population by taking into account the direct costs associated with such co-morbid conditions in Indonesia.Methods: Meta-analysis using the Mix-Programme Software of the data of patients from university medical centers who were active smokers for more than a year and more than 20-pack years or passive smokers for more than a year and diagnosed with Coronary Heart Disease, Myocardial Infarction, Stroke, COPD, Chronic bronchitis, or Lung Cancer had been conducted. Annual direct cost was taken into account using the Decision Analysis Tree Age Pro (=DATA) software; cost data related to health care expenditure were derived from secondary data sources in Jakarta. In addition, Population Attributable Risk (PAR) for each comorbid conditions was calculated based on published epidemiological data from local and international journals.Results: One-hundred and eighty-seven patients (96% male) satisfying the inclusion criteria, were analyzed, of whom confirmed diagnosis of Stroke was amongst 29% of the patients, CHD 16%, Myocardial Infarction 16%, Lung Cancer 15%, COPD 17%, and Chronic Bronchitis 7%. Mean direct annual cost was highest for Lung Cancer (Rp 51.6 million) followed by Myocardial infarction (Rp 38.5 million) and CHD (Rp 37.8 million); PAR for various co-morbid conditions (based on variations in relative risk and smoking prevalence estimates) were: Stroke ~16%-26%, CHD ~17%-27%, MCI ~ 22%-33%, Lung Cancer ~ 17%-26%, COPD ~ 13%-21%, Chronic Bronchitis ~ 42%-59%.Conclusions: Annual cost of smoking-related diseases in Indonesia has been estimated. The highest cost is for Lung Cancer. The highest PAR is for Chronic Bronchitis.Keywords: Smoking-related diseases, Annual cost, Indonesia. ABSTRAKEstimasi pembiayaan per tahun penyakit terkait merokok di IndonesiaLatar belakang: Merokok berkaitan dengan kejadian berbagai penyakit kronis dengan konsekuensi ekonomi berupa biaya yang sangat banyak. Penelitian ini bertujuan untuk mengestimasi biaya dampak merokok pada berbagai kondisi ko-morbid terkait penyakit jantung, otak dan paru di masyarakat Indonesia.Metode: Meta-analisis dengan Mix-Programme software pada data sekunder penderita penyakit jantung iskemik, infark miokard, stroke, COPD, bronkitis kronis atau kanker paru dari Rumah Sakit Pendidikan Jakarta dengan kriteria : perokok aktif lebih 1 tahun dan merokok lebih 20 pak/tahun atau perokok pasif lebih 1 tahun. Cost-analysis dengan Tree Age Pro (=DATA) software dilakukan untuk membandingkan pengeluaran/biaya pengobatan per tahun menurut berbagai ko-morbid. Population Attributable Risk (PAR) untuk kondisi ko-morbid merujuk perhitungan yang ada pada jurnal epidemiologi lokal maupun internasional.Hasil: Seratus delapan puluh tujuh=187 pasien (96% laki-laki) memenuhi kriteria inklusi; diantaranya 29% pasien menderita stroke, 16% penyakit jantung iskemik, 16% infark miokard, 15% kanker paru, 17% COPD, dan bronkitis kronis 7%. Rerata pengeluaran biaya per tahun tertinggi adalah kanker paru (Rp 51,6 juta), diikuti penyakit jantung iskemik (Rp 37,8 juta); dan infark miokard (Rp 38,5 juta). PAR untuk masing-masing kondisi komorbid sebagai berikut: stroke 16-26%, penyakit jantung iskemik 17-27%, infark miokard 22-33%, kanker paru 17- 26%, COPD 13-21%, dan bronkitis kronis 42-59%.Simpulan: Pengeluaran biaya per tahun tertinggi untuk penyakit terkait dampak merokok adalah kanker paru-paru dan bila PAR terbesar pada bronkitis kronis.

Expression of p16INK4a Biomarker has a Diagnostic Value in Predicting the Progressivity of Precancerous Cervical Lesion

Indonesian Journal of Obstetrics and Gynecology Vol.34. no.3. July 2010
Publisher : Indonesian Journal of Obstetrics and Gynecology

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Abstract

Objective: To evaluate clinical value of p16INK4a biomarker level, by doing p16INK4a immunocytochemistry staining, as a predictor of progressivity of precancerous cervical lesion. Method: Design of this research is case-control study which will be stratified. Research was conducted in Cytology Laboratorium, Gynecology Specialistic Division, Department of Obstetrics and Gynecology, Dr. Cipto Mangunkusumo Hospital from August 2007 to September 2008. Immunocytochemistry examination was conducted in Anatomic Pathology Department, Dr. Hasan Sadikin Hospital. We divided the sample into two categories; patients with and without cervical intraepithelial neoplasia (CIN). This research will evaluate HPV infection and p16INK4a biomarker by doing p16INK4a immunocytochemistry (ICC) staining.Results: We have done immunocytochemistry examination in 130 patients, 26 without CIN and 104 with CIN. Immunocytochemistry cut-off point level is 50, which means value < 50 means low (L) p16INK4a expression and in reverse, value ≥ 50 means high (H) p16INK4a expression. The bivariate analysis of our study were p16INK4a (H) expression has the risk of CIN 1 with OR 8.4, for CIN 2 with OR 13 and for CIN 3 with OR 21, greater than p16INK4a (L) with all p values are significant. ICC p16INK4a (H) expression, age, number of sexual partners, and education are contributory to the risk of progressivity in CIN. The multivariate analysis demonstrates, ICC expression of p16INK4a (H) has a risk (OR) of CIN 1 17.19 times greater than p16INK4a (L); p16INK4a (H) expression’s OR for CIN 2 is 25.56; and for OR CIN 3 is 37.32. The expression of p16INK4a has a significant p value and high OR, thus ICC expression of p16INK4a is suggested to be included in the algorithm of precancerous cervical lesion guidelines and scoring of probability of CIN as an alternative to HPV DNA considering less cost of the test. In this research, we found a scoring model to determine probability of progressivity in precancerous cervical lesion.Conclusion: The expression of p16INK4a has a diagnostic value in predicting the progressivity of precancerous cervical lesion.[Indones J Obstet Gynecol 2010; 34-3: 125-30]Keywords: p16INK4a expression, immunocytochemistry, predictor of progressivity, precancerous cervical lesionTujuan: Untuk mengevaluasi nilai klinis ekspresi biomarker p16INK4a dengan pemeriksaan imunositokimia (ISK) sebagai faktor prediktor progresivitas lesi prakanker serviks.Metode: Desain penelitian ini adalah studi kasus-kontrol yang akan dilakukan stratifikasi / tes dosis respon. Penelitian dilakukandi Poliklinik Kolposkopi dan Laboratorium Sitologi, Divisi Ginekologi Spesialistik, Departemen Obstetri dan Ginekologi, RSUPN Dr. Cipto Mangunkusumo, Jakarta. Penelitian berlangsung Agustus 2007 sampai September 2008. Pemeriksaan ISK dilakukan di Laboratorium Patologi Anatomi RS Dr. Hasan Sadikin, Bandung. Kami mengkategorikan pasien menjadi 2 kelompok yaitu kelompok kasus, yaitu pasien dengan NIS dan kelompok kontrol, yaitu pasien dengan NIS negatif (non NIS). Penelitian ini akan mengevaluasi biomarker p16INK4a dengan cara pemeriksaan imunositokimia p16INK4a. Hasil: Dilakukan pemeriksaan ISK pada 130 pasien, 26 tanpa NIS dan 104 dengan NIS. Nilai titik potong ekspresi ISK p16INK4a yang didapatkan adalah 50, nilai ekspresi ISK p16INK4a < 50 berarti ekspresi rendah dan sebaliknya ≥ 50, tinggi. Analisis bivariat menunjukkan hasil yang serupa dengan analisis multivariat. Di mana ekspresi ISK p16INK4a tinggi memiliki odds ratio (OR) 8,4 pada NIS 1, OR 13 pada NIS 2, dan OR 21 pada NIS 3. Analisis multivariat menunjukkan temuan serupa, ekspresi p16INK4a tinggi memiliki OR 17,19 pada NIS 1, 25,56 pada NIS 2 dan OR 37,32 pada NIS 3, dengan nilai p yang bermakna. Ekspresi ISK p16INK4a tinggi, usia, jumlah pasangan seksual, dan pendidikan memiliki kontribusi terhadap risiko progresivitas NIS, dan dibuat suatu model skoring untuk menilai probabilitas progresivitas pada lesi prakanker serviks. Pemeriksaan ISK p16INK4a disarankan masuk ke dalam triase algoritma penatalaksanaan lesi prakanker serviks (Atypical Squamous Cells of Undertemined Significance dan Lesi Intraepitelial Skuamosa Derajat Rendah) sebagai alternatif pilihan selain HPV DNA dengan pertimbangan biaya yang lebih murah. Kesimpulan: Perubahan ekspresi p16INK4a mempunyai kemampuan memprediksi progresivitas lesi prakanker serviks (NIS).[Maj Obstet Ginekol Indones 2010; 34-3: 125-30]Kata kunci: ekspresi imunositokimia p16INK4a, prediktor progresivitas, lesi prakanker serviks

Caspase 3 and Survivin Expressions as a Predictor of Response to Radiation Therapy in Advanced Stage Cervical Cancer

Indonesian Journal of Obstetrics and Gynecology Vol. 35. No 3. July 2011
Publisher : Indonesian Journal of Obstetrics and Gynecology

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Abstract

AbstractObjective: To identify prognostic factors of advanced stage cervical cancer which was treated by radiation therapy, so that they can be implemented to support treatment in order to increase the success of therapeutic response in advanced stage cancer.Methods: Observational analytic historical cohort method study was conducted in Dr. Cipto Mangunkusumo General Hospital and 38 cases of stage IIB and IIIB cervical cancers receiving a complete radiation therapy were involved. Data were retrieved from medical records and cervical biopsies examination results. Paraffin blocks of cervical biopsies were examined histopathologically using HE staining followed by IHC. The expression of caspase 3 and survivin were then assessed by IRS scoring. Case group included 5 samples with negative therapeutic response, which means the therapeutic response other than complete response. Control group included 33 samples with positive therapeutic response which have complete response to therapy. The collected data were analyzed by univariate, bivariate, and multivariate analysis.Results: Demographic and clinicohistopathologic data were not significantly related to the occurrence of negative response to radiation therapy. Negative cytoplasmic caspase 3 expression has a predictive value of 90.75% for the occurrence of a negative response to radiation therapy (RR=9.81, CI 95%=1.231-78.286, p=0.019). Positive cytoplasmic survivin has a predictive value of 86.75% for the occurrence of a negative response to radiation therapy (RR=6.55, CI 95%=2.659-16.119, p=0.000). Nuclear caspase 3 and survivin expressions have no significant relation to the occurrence of a negative response to radiation therapy. Clinical response to radiation is influenced by clinicohistopathologic factors, caspase 3, and survivin expression altogether.Conclusion: Negative cytoplasmic caspase 3 expression and positive cytoplasmic survivin have predictive value for the risk of a negative response to radiation therapy to occur.[Indones J Obstet Gynecol 2011; 35-3: 139-45]Keywords: advanced stage cervical cancer, clinicohistopathology, caspase 3, survivin, response to radiation therapy.

Clinicopathologic Factor, Endostatin Serum Level, and Vascular Endothelial Growth Factor-C (VEGF-C) Serum Level as Predictors of Lymph Nodes Metastasis in Early Stage Cervical Cancer Patients

Indonesian Journal of Obstetrics and Gynecology Vol. 35. No 4. October 2011
Publisher : Indonesian Journal of Obstetrics and Gynecology

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Abstract

AbstractObjective: To analyze endostatin serum level and VEGF-C serum level as predictors of lymph nodes metastasis and lymph nodes metastasis in early stadium of cervical cancers.Method: This research was done in Oncology Division, Department of Obstetrics and Gynecology Faculty of Medicine University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta. The design of this research was nested case control and consecutive sampling. The subjects were all of the early stadium cervical cancer patientsin Oncology clinic, Dr. Cipto Mangunkusumo hospital that had qualified according to inclusion criteria and exclusion criteria. The bloods were taken, the serums were separated, VEGF-C serums were examined by ELISA method, and endostatin serums were examined by Immunoassay method. Patients went through radical hysterectomy surgeries, and then pathology anatomy examinations.Result: The samples were 47 patient, consisted of 33 patients (70.21%) without lymph nodes metastasis and 14 patients (29.79%) with lymph nodes metastasis. By using ROC cut off point method, the obtained cut off point of VEGF-C level was 10,066.9 pg/ml,with sensitivity 78.57%, and specificity 96.97%. It was obtained the increasingrisk of lymph nodes metastasis in patients with VEGF-C level > 10,066.9 pg/ml compare to patients with VEGF-C level ≤ 10,066.9 pg/ml, with OR 80, 95% CI (7.99; 800.71), and p < 0.001. Based on cut off point, 184.5ng/ml, with sensitivity 64.3%, and specificity 63.4%, the endostatin level was divided into two groups, which were the < 184.5ng/ml group and the ≥ 184.5ng/ml group. Patients in ≥ 184.5 ng/ml group had the risk of lymph nodes metastasis 3.15 times more compare to patients in <184.5 ng/ml group, but not statistically significant (p=0.075, 95% CI (0.856;11.595)).Conclusion: VEGF-C serum levels can be used as prognosis factor or predictor of lymph node metastasis in early stage cervical cancer patients. Endostatin serum levels as the predictor of lymph node metastasis still need further research by adding sample quantity.[Indones J Obstet Gynecol 2011; 35-4:225-9]Keywords: endostatin, VEGF-C, lymph node metastasis, cervical cancer

Acute Toxicity and Outcomes of Radiation Alone Versus Concurrent Chemoradiation for Locoregional Advanced Stage Cervical Cancer

Indonesian Journal of Obstetrics and Gynecology Vol. 36. No 1. January 2012
Publisher : Indonesian Journal of Obstetrics and Gynecology

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Abstract

AbstractObjective: To evaluate and determine the toxicity and outcomes in patient receiving radiation (RT) alone versus concurrent chemoradiation (CRT) using cisplatin for locoregional advanced cervical cancer in Dr. Cipto Mangunkusumo Hospital (RSCM). Methods: Simple randomized single-blind clinical study, done during the period of November 2010-April 2011, in 32 patients with locoregional advanced cervical cancer (16 were treated RT alone and the rest is treated with CRT). Teletherapy was administrated using 60Co Gamma Rays 1.3 MV and photon beam linear accelerator 4-10 MV. The radiation was administered as much as 2.0 Gy per fraction daily for 5 days/week, for the total of 25 fractions. Brachytherapy was performed using HDR after-loading method, with Microselectron plane radiation source 129I, as much as 3x7 Gy doses to point A. CRT using cisplatin 30 mg/m2 were given for 5 series during the radiotherapy course. The toxicity assessments were carried out each week, up until 3 months after the therapy was deemed completed based on the RTOG and ECOG criteria.Results: We acquired 100% complete response in both the CRT and RT groups. In the CRT group, we found acute gastrointestinal toxicity grade 3 (18.75%) and grade 2 (43.75%); acute genitourinary toxicity grade 3 (25%), grade 2 (31.25%); and acute hematological toxicity grade 3 (12.50%) and grade 2 (25%). It is contrasted with the RT group, in which we did not found any cases of acute gastrointestinal toxicity, genitourinary or acute hematologic toxicity. The overall time treatment (OTT) of 56-58 days in CRT and RT group were 25% vs. 81.25% respectively, and the OTT of 59-70 days in CRT and RT group were 75% vs. 18.75%, respectively.Conclusion:The response to CRT and RT for locoregional advanced cervical cancer was not different in 3 month evaluation. Acute gastrointestinal, genitourinary, and hematologic toxicities found in CRT were higher than in RT (p=0.000; p=0.000; p=0.002).[Indones J Obstet Gynecol 2012; 36-1:37-42]Keywords: acute toxicity, concurrent chemoradiation, locoregional advanced stage cervical cancer, response therapy

Mother and Child as Factors in Defining the Severity of Defect of Deciduous Teeth Email in Small for Gestational Age Babies

Journal of the Indonesian Medical Association Vol. 60 No. 9 September 2010
Publisher : Journal of the Indonesian Medical Association

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Abstract

The aim of the study was to find out the moternal factor during pregnancy and infant’s at birth in defining the severity of deciduous teeth email in small for gestational age (SGA) babies. SGA means that a baby has a birth weight of less than -2SD of normal value which is caused by Intra Uterine Growth Restriction (IUGR) and might result in anomalies of organ developments including deciduous teeth. Using the Cohort designed study, and given sample size technique 153 SGA babies aged 9-48 months consisted of 94 asymmetric and 59 symmetric, control group 390 babies, 4-48 months age, normal birth weight were enrolled in this study. The type of email defect included hypoplasia and hypocalcification according to the Development Defect of Enamel (DDE) scoring FDI modification. The indicator was pregnant mother’s characteristics (disease during pregnancy, age on delivery), baby’s characteristics at birth (gestational age, type of pregnancy, birth weight & length), and enamel defect. The samples were prospectively studied during six months with 3-month intervals. Using the Multinomial Regression Logistic Analysis we found out that mother’s disease during pregnancy, birth weight, type of SGA, are factors that define the severity of deciduous teeth email defects in SGA babies.Keywords: Deciduous teeth‘s email defect, small for gestational age, intra uterine growth restriction (IUGR)

Cut-off Levels of High Sensitive C-Reactive Protein in Coronary Acute Syndrome

Journal of the Indonesian Medical Association Vol. 60 No. 12 December 2010
Publisher : Journal of the Indonesian Medical Association

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Abstract

Acute coronary syndrome (ACS) is the gravity of cardiac inflammatory response characterized by activation of macrophages and T lymphocytes that release various cytokines. These cytokines will induce the formation of acute phase reactants, C-reactive protein (CRP) in the liver. Research on population indicates that high sensitive C-reactive protein (hs-CRP) level is an independent risk factor for coronary heart disease (CHD) in both men and women. The purpose of this study was to determine the cut-off levels of hs-CRP in acute state (ACS) with stable condition (CHD). A cross sectional observational study was conducted comparatively with consecutive sample selection to ACS or CHD patients. Levels of hs-CRP were analyzed by unpaired t test followed by sensitivity and specificity test. It was showed that average concentration of hsCRP in ACS group (mean 82.96 mg/L, SB 79.70, 95% CI 65.67-100.26) was significantly higher than the CHD group (mean 5.12 mg/L, SB 8.44, 95% CI 2.97-7.26). Levels of hs-CRP with cut-off point >8.23 mg/L have sensitivity of 88.10%, specificity 88.71%, with ROC 0.94. In conclusion, levels of hs-CRP with cut-off point >8.23 mg/L, could distinguish ACS and CHD with the highest sensitivity and specificity (sensitivity 88.10%, specificity 88.71%, ROC 0.94).Keywords: ACS, cut-off, hsCRP

The Correlation of Decreased E-Cadherin and β1-Integrin Expression with the Depth of Myometrial Invasion and Pelvic Lymph Node Metastasis in Resectable Endometrial Cancer

Indonesian Journal of Obstetrics and Gynecology Vol.34. no.3. July 2010
Publisher : Indonesian Journal of Obstetrics and Gynecology

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Abstract

Objective: The purpose of this study was to determine the correlation between decreased E-Cadherin and ß1-integrin expression in resectable endometrial cancer with the depth of myometrial invasion and pelvic lymph node metastasis.Method: This was a cross sectional study, we used immunohistochemistry examination on E-Cadherin and ß1-integrin expression in resectable endometrial cancer patients who had surgery in 1997 to 2006 in Dr. Cipto Mangunkusumo Hospital and searched the correlation with the depth of myometrial invasion and pelvic lymph node metastasis. Result: The prevalence of endometrial cancer from 1997 to 2006 in Dr. Cipto Mangunkusumo Hospital was 7.0 in a year. Out of 64 patients with endometrial cancer only 36 paraffin block could be found and immunostaining on E-Cadherin and ß1-integrin was done in 30 samples. Decreased E-Cadherin and ß1-integrin expression was associated with the depth of myometrial invasion, pelvic lymph node metastasis, lymph ovascular space involvement and degree of differentiation in resectable endometrial cancer patients. Conclusion: Decreased E-Cadherin and ß1-integrin expression was associated with the depth of myometrial invasion and pelvic lymph nodes metastasis.[Indones J Obstet Gynecol 2010; 34-3: 136-42] Keywords: E-Cadherin, ß1-integrin, the depth of myometrial invasion, pelvic lymph node metastasisTujuan: Penelitian ini dibuat untuk membuktikan apakah penurunan ekspresi E-Cadherin dan ß1-integrin pada penderita kanker endometrium berhubungan dengan kejadian kedalaman invasi miometrium dan metastasis kelenjar getah bening pelvis. Metode: Ini adalah penelitian retrospektif. Dilakukan pemeriksaan ekspresi E-Cadherin dan ß1-integrin secara imunohistokimia pada penderita kanker endometrium yang telah dioperasi tahun 1997 - 2006 di Rumah Sakit Dr. Cipto Mangunkusumo dan mencari hubungan dengan kejadian invasi miometrium dan metastasis kelenjar getah bening. Hasil: Kejadian kanker endometrium tahun 1997 - 2006 di Rumah Sakit Dr. Cipto Mangunkusumo adalah 7,0 pertahun. Dari 64 penderita kanker endometrium hanya 36 yang ditemukan blok parafinnya dan hanya 30 sampel yang dapat diperiksa ekspresi ECadherin dan ß1-integrin secara imunohistokimia. Diperoleh hasil bahwa penurunan ekspresi E-Cadherin dan ß1-integrin berhubungan dengan kejadian invasi miometrium, metastasis KGB pelvis, LVSI dan derajat diferensiasi sel penderita kanker endometrium.Kesimpulan: Ekspresi E-Cadherin dan ß1-integrin yang menurun berhubungan dengan kedalaman invasi miometrium dan metastasis kelenjar getah bening pelvis.[Maj Obstet Ginekol Indones 2010; 34-3: 136-42]Kata kunci: E-Cadherin, ß1-integrin, invasi miometrium, metastasis kelenjar getah bening pelvis

Expression of Fas Ligand is Higher in Early Stage Cervical Cancer with Lymph Nodes Metastasis

Indonesian Journal of Obstetrics and Gynecology Vol. 36. No 4 Oktober 2012
Publisher : Indonesian Journal of Obstetrics and Gynecology

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Abstract

AbstractObjective: To know whether the expression of Fas Ligand has correlation with incidene of metastasis of pelvic lymph node and lymph-vascular stromal invasion (LVSI).Methods: All patients diagnosed of cervical cancer stage IB or IIA who underwent radical hysterectomy in Dr. Cipto Mangunkusumo Central General Hospital from January 2008 until December 2009 were included in analytic cross sectional study. We tested expression of Fas Ligand in cervical cancer specimen by immunohystochemistry with monoclonal antibody. The expression of Fas Ligand was compared between the group of patients with a positive and negative pelvic lymph node and between LVSI positive and negative. The difference of expression in both group were statistically analized with Chi-square test and the correlation Spearman test.Result: Ninety one patients underwent radical hysterectomy for twoyears and 43 patients were included in these study. The expression of Fas Ligand in 7 patients (16.3%) were negative and the others were positive, with weak, moderate and strong expression were 4 (9.3%), 27 (62.8%), and 5 (11.6%) respectively. The expression of Fas Ligand was significantly higher in the group of patients with positive pelvic lymph node compared to the group of the patients with negative pelvic lymph node (p=0.007) but there was no significant difference between group of the patients with LVSI positive and negative. With Spearman test, we found that the expression of Fas Ligand had a strong correlation with pelvic lymph nodes metastasis (coeff. correlation=0.519 and p=0.00) and have no correlation with LVSI (coef. corellation=0.112 and p=0.474).Conclusion: These finding suggested that expression of Fas Ligand in cervical cancer patients has a strong correlation with the incidence of pelvic lymph node metastasis and none with LVSI. [Indones J Obstet Gynecol 2012; 36-4: 194-9]Keywords: cervical cancer, fas ligand, immunohystochemistry, LVSI, pelvic lymph node metastasis

KRAS and BRAF Mutation in Borderline Epithelial Type Ovarian Tumor

Indonesian Journal of Obstetrics and Gynecology Vol. 37. No. 2 April 2013
Publisher : Indonesian Journal of Obstetrics and Gynecology

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Abstract

Objective: To understand the molecular profile by identifying the mutation of KRAS and BRAF in borderline type ovarian tumor. Method: In the study, we examined paraffin tissue sample from Department of Pathology Anatomy, University of Indonesia/Dr. Cipto Mangunkususmo Hospital, Jakarta, that was diagnosed as borderline epithelial ovarian tumor. Seventeen samples were taken to Sandya Laboratory in Bandung for examination of PCR BRAF exon 15 codon 600, and KRAS in exon 2 codon 12 and 13, as well as exon 3 codon 61.Result: Mutation of KRAS occurred in 94% of subjects (serous borderline 62.5%, mucinous bordeline 37.5%), of which 70.6% mutation happened in exon 2 codon 12 (serous borderline 33.3%, mucinous borderline 66.7%), 52.9% mutation in exon 2 codon 13 (serous borderline 33.3%, mucinous borderline 66.7%), and 76.5% mutation in exon 3 codon 61 (serous borderline 30.8%, mucinous borderline 69.2%). Mutation of BRAF occurred only in 47% of subjects, but the results of Exact Fisher test showed that mutation in BRAF gave significant result, while other variables did not give significant result (p=0.009).Conclusion: Molecular pathology in borderline ovarian tumor related with BRAF mutation is more likely to occur in serous borderline type, while KRAS mutation is more likely to occur in mucinous borderline type.Keywords: borderline ovarian tumor, BRAF, KRAS

Co-Authors Abas Basuni Jahari Abdul B. Saifuddin Achmad Tjarta Ahmad Hudoyo Alida Harahap Alida R Harahap, Alida R Andi Friadi Andriansyah Andriansyah Andrijono Andrijono Anwar Jusuf Bethy Suryawati Bismarck J Laihad Budhi Setianto Budiningsih Siregar Chaidar Masulili, Chaidar Dede Kusmana Dewi Wulandari Dharmeizar Dharmeizar Dodi Suardi Ediwibowo Ambari Emil Taufik Endang L Achadi Endang Purwaningsih Ferry Sandra Fitriyadi Kusuma Gatot Purwoto Harahap, Alida Roswita Harapan Parlindungan Ringoringo, Harapan Parlindungan Hariyono Winarto Hasanuddin Hasanuddin Herdiman T Pohan Ichramsjah A. Rachman, Ichramsjah A. Idrus Alwi Imam Rasjidi Irawan Yusuf Irawati Ismail, Irawati Iskandar Wahidiyat, Iskandar Johnson Hutapea Junita Indarti Kartiwa H. Nuryanto Khonsa, Oni Laila Nuranna Linda Kusdhany, Linda Linda Lison, Linda Lujna Surtidewi Lukman H Makmun M. F. Aziz Markus, Unedo H Markus, Unedo H Mohamad F Aziz Mohammad F. Aziz Mohammad Farid Aziz Mpu Kanoko Mpu Kanoko Sastrosuwignyo, Mpu Kanoko Nana Supriana Nugroho Kampono Nuryanto, Kartiwa H Nuryati C. Siregar Nuryati Siregar Ong Tjandra Pelupessy, Nugraha Utama Peter Kabo Pradana Soewondo Primaria D. Rustamadji Primariadewi Rutamadji Purwanegara, Miesje Karmiati Rahayuningsih Setiabudy, Rahayuningsih Rahma Prastasari Ratna Djuwita Rianto Setiabudy Rinaldy, Dino Rizal Sanif Rochani Rochani Roosje R Oewen Roosje R. Oewen, Roosje R. Rudy Gunawan Rukmini T. Mangunkusumo Rulina Suradi, Rulina Rustamadji Primaria Santoso Cornain Sapatawati Bardososono, Sapatawati Saptawati Bardososono, Saptawati Sarwono Waspadji Sigit Purbadi Siti B. Kresno Siti Boedina Kresno Siti Setiati Sjarif H Effendi Sjarif H. Effendi, Sjarif H. Slamet Suyono Suhendro Suwarto, Suhendro Surury, Isti’anah Sylvia D Elvira Teguh Santoso Ummi Kalsum Vitantri, Fara Wiguno Prodjosudjadi Williyanti S Sjarif Willyanti S Syarif, Willyanti S Yahya Irwanto