The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy
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Correlation of Carcinoma Percentage (CP) in Colorectal Adenocarcinoma with Several Clinical Pathological Aspects in Anatomical Pathology Department Faculty of Medicine Universitas Indonesia/Cipto Mangunkusumo Hospital Jakarta in Year 2012-2013
Get PDFBackground: Colorectal carcinoma is malignant tumour of the large intestinal epithelial, where more than 90% of colorectal carcinoma is adenocarcinoma. Desmoplastic stroma in primary tumour holds an important role in tumour development process. Mesker et al described carcinoma percentage (CP) evaluation in routine preparations with Haematoxylin-eosin (HE) staining as one of the prognostic factors.Method: This retrospective study was performed by collecting forms and slides of colorectal carcinoma resection cases from the archives of Anatomical Pathology Department FMUI-CMGNH in 2 years period (2012-2013). Collection of clinical data and re-evaluation of HE slides by 2 people which were the writer and supervisor were performed to determine CP value by observing the comparison between tumour percentage and desmoplastic stroma.Results: We included 92 cases of colorectal adenocarcinoma within those 2 years period (2012-2013). Comparison of total cases between male and female was 3:2, age > 40 years old were the most commonly found; in regard to location in the colon, most were found in the left side compared to the right side of the colon with the ratio of 3:7. Tumour histological grading with good differentiation were the most commonly found and most pT value being found were pT3; most lymph node involvement was N1. The most CP value attained in every parameter was CP-Low.Conclusion: Carcinoma percentage (CP) which was divided as CP-High and CP-Low could be used as a prognostic factor. In this study, we found more cases of CP-Low compared to CP-High, either based on sex, age, location, degree of differentiation, pT value, or even lymph node involvement. CP-Low which showed worse prognosis could also be used as a marker of patients who were at higher risk of colorectal carcinoma
Screening and Management of Colon Polyp as Colorectal Cancer Prevention
Get PDFColon polyp is a term used for abnormality from bulging tissue above surrounding colonic mucosal layer. Adenoma polyp was the commonly found polyp that progress to colorectal cancer. Most of those patients was asymptomatic. Undetected and unmanaged polyp was a risk factors of colorectal cancer event.
The Role of Fecal M2-Pyruvate Kinase (M2-PK) in Colorectal Cancer Screening
No full textColorectal cancer is a malignancy with high incidence and mortality rate. The long carsinogenesis sequence from adenoma unto carsinoma enable early detection and screening as part of the management but until recently the commercialy available test has low sensitivity and specificity. M2-pyruvate kinase (M2-PK), an isomer of glycolisis enzyme involved in aerobic metabolism, is found in high amount in cancerous cell and is shed unto luminal mucosa in colorectal cancer. Quantification of this protein in feces is a promising method to detect malignant lesion of colon. Several studies until recently demonstrate moderate sensitivity and specificity but clearly with better performance than commonly-used gFOBT
Biliary Drainage and Inflammatory Environment in Patients with Malignant Obstructive Jaundice
No full textMultiple Primary Malignancy of Esophageal and Gastric Synchronous and Colon Metachronous
Get PDFMultiple primary cancer is an incidence when a patient has multiple malignancy in two or more organs without possibility of metastatic lesion. There have been many reports on mutiple primary cancer since Billroth reported it for the first time in 1879. Patients who have been diagnosed with a cancer have higher risk for developing another cancer, thereby physician and the patients should raise more awareness toward possibility of developing a new metachronous or synchronous cancer. We report a patient who has three histologically distinct cancers. Resected primary colon adenocarcinoma and 3 years after came with hematemesis and diagnosed to have a metachronous squamous cell carcinoma of the oesophagus synchronous with gastric adenocarcinoma. This case is interesting due to the clustering of three primary cancers (synchronous and metachronous) which is a rare occurrence in a single patient.
Detection of Helicobacter pylori CagA gene and Its Association with Endoscopic Appearance in Balinese Dyspepsia Patients
Get PDFBackground: Helicobacter pylori (H. pylori) infection causes various abnormalities in the stomach. Only particular strain can cause severe problems in the stomach. CagA is a microbial virulent factor which is associated with more severe stomach problems, such as: peptic ulcer and stomach cancer. We would like to know the prevalence of CagA in Balinese population, and the association of H. Pylori CagA status with the severity of endoscopic appearance in dyspepsia patients.Method: Study design being used was analytic cross sectional study, involving 71 dyspepsia patients who underwent upper gastrointestinal endoscopic examination in Surya Husada Hospital and Balimed Hospital in June-December 2013. Sample was chosen in consecutive manner. Later, polymerase chain reaction (PCR) examinations of the stomach mucous biopsy tissue to determine H. pylori infection status and CagA status were performed. Further, Chi square test was used to identify the difference in proportion of H. pylori and CagA between mild and severe endoscopic appearance.Results: In this study, we found that the prevalence of H. pylori infection was 22.5% using PCR examination. Prevalence of CagA positive in H. pylori positive was 62.5%. There was significant association between status of H. Pylori infection and severity of endoscopic appearance (p = 0.038; OR= 2.67; 95% CI = 1.18-6.05). Status of CagA in H. pylori infected patients was not associated with the severity of endoscopic appearance. Additionally, there was significant association between patients’ age and severity of endoscopic appearance.Conclusion: The prevalence of CagA in H. pylori positive was 62.5%. H. pylori infection was associated with severity of endoscopic appearance and CagA status in H. pylori infected patients was not associated with severity of endoscopic appearance
Inducing and Aggravating Factors of Gastroesophageal Reflux Symptoms
Get PDFGastroesophageal reflux disease (subsequently abbreviated as GERD) is a disease commonly found in the community. Several factors have been recognized as inducing and aggravating factors of GERD symptoms such as older age, female gender, obesity, smoking habit, alcohol consumption, certain diet and poor eating habit like eating fatty, spicy, and acid food
Recurrent Acute Pancreatitis as A Manifestation of Sphincter of Oddi Dysfunction
Get PDFRecurrent acute pancreatitis (RAP) is defined as two or more occurance of acute pancreatitis with no evidence of underlying chronic pancreatitis. Prevalence of RAP varied from 10-30%. One of the postulated mechanism of this condition is sphincter of Oddi dysfunction (SOD) which is a clinical biliary pain syndrome or acute pancreatitis (AP) due to pancreatobiliary obstruction at the level of sphincter of Oddi. We reported a 29-year-old female patient who came to Cipto Mangunkusomo Hospital regarding upper quadrant abdominal pain with previously well documented history of AP in the last six months before admission. Laboratory findings showed elevated pancreatic enzyme level which was consistent with AP. The patient underwent magnetic resonance cholangio-pancreatography (MRCP) and endoscopic ultrasound (EUS) examination and both of the results showed dilatation of pancreatic duct which suggested SOD. Due to the lack of further diagnostic modality, manometry was not performed on this patient. However, after excluding other possible etiology of SOD, the patient underwent endoscopic retrograde cholangio-pamcreatograhy (ERCP) and sphincterotomy was performed. The signs and symptoms of AP was relieved after sphincterotomy and not yet recurred
Surgery in Liver Diseases: Perioperative Evaluation & Management
Get PDFMany patients with liver disease would have to undergo surgery. Surgery and anesthesia in patients with liver disease are associated with extremely high perioperative complications and mortality. Identification of the type of liver disease, stratification of risk factors, and management of preoperative, intraoperative, and postoperative complications are essential to reduce the morbidity and mortality. Surgical risk is increased in patients with liver cirrhosis. Child turchote pugh (CTP) and the model for end stage liver disease (MELD) are two scoring systems which are often used nowadays to stratify risk factors in patients with liver cirrhosis who will undergo surgery. Elective surgery is well tolerated in cirrhosis patients with CTP class A and permissible in patient with CTP class B with preoperative preparation, except for extensive liver resection surgery and cardiac surgery. Elective surgery is contraindicated in patients with CTP class C, acute viral hepatitis, alcoholic hepatitis, fulminant liver failure, and liver disease with severe extrahepatic complication such as hypoxemia, cardiomyopathy, and acute renal failure. Intensive monitoring in the postoperative period and early intervention of complications are also essential to reduce the morbidity and mortality
