21 research outputs found
Laporan hasil kegiatan pengabdian masyarakat "Aksi Solidaritas Memerangi Covid-19 Fakultas Kedokteran & Keluarga Alimni Medis Universitas Tarumanagara Tahun 2020
No full textHistopathological diagnostic criteria of barrett esophagus and its association with endoscopy findings
Get PDFBackground : In the last decades, the incidence of esophageal adenocarcinoma has significantly increased. Barrett Esophagus (BE) is widely known as a precursor lession of esophageal adenocarcinoma, and it could increase the risk of adenocarcinoma to 30-120 times higher than non-BE patient. The controversy about BE definition is still a problem amongst pathologist. BE is defined as the transition of normal esophageal squamous epithellium into metaplastic columnar epithellium that can be seen through endoscopy at the upper region of gastroesophagus transitional area, and confirmed with hystological examination.
Objective : To re-evaluate hystopathological presentation of BE and the classification of dysplasia as well as its association with clinical finding in the form of endoscopy results.
Methods : Clinical and hystopathological datas of 71 cases of BE was collected and re-evaluated based on British Society of Gastroenterology Guidelines 2005 criteria, as well as re-evaluating the grade of dysplasia based on WHO Classification of tumours of the digestive system 2010.
Results : 51 cases of BE were obtained with male:female ratio 33:18 patients. BE cases were predominated by 51-60 years old age group, in which the mean of patients age was 55 years old. The results of dysplasia grade re-evaluation showed 72,55% non-dysplasia BE case, 3,9% was BE indefinite; 23,53% was BE with low grade dysplasia; and 1,97% was BE with hard grade dysplasia. There were 15 cases (21,12%) that were changed in diagnosis, from BE to non-BE cases.
Conclusion : The diagnosis of BE could be made if there are compatibility between endoscopy examination and hystopathological examination, in which BE presentations was found, either in category 1, 2 or 3based on British Society of Gastroenterology Guidelines 2005 and endoscopy indicated supicion of BE. Changes in diagnosis of BE cases into non-BE cases could happen not because there are incompatibilities of the results of these examinations. This might happen due to nescience regarding the importance of the results of endoscopy examination and its compatibility with the results of hystopathological examination
Histopathological diagnostic criteria of barrett esophagus and its association with endoscopy findings
Get PDFBackground : In the last decades, the incidence of esophageal adenocarcinoma has significantly increased. Barrett Esophagus (BE) is widely known as a precursor lession of esophageal adenocarcinoma, and it could increase the risk of adenocarcinoma to 30-120 times higher than non-BE patient. The controversy about BE definition is still a problem amongst pathologist. BE is defined as the transition of normal esophageal squamous epithellium into metaplastic columnar epithellium that can be seen through endoscopy at the upper region of gastroesophagus transitional area, and confirmed with hystological examination. Objective : To re-evaluate hystopathological presentation of BE and the classification of dysplasia as well as its association with clinical finding in the form of endoscopy results. Methods : Clinical and hystopathological datas of 71 cases of BE was collected and re-evaluated based on British Society of Gastroenterology Guidelines 2005 criteria, as well as re-evaluating the grade of dysplasia based on WHO Classification of tumours of the digestive system 2010. Results : 51 cases of BE were obtained with male:female ratio 33:18 patients. BE cases were predominated by 51-60 years old age group, in which the mean of patients age was 55 years old. The results of dysplasia grade re-evaluation showed 72,55% non-dysplasia BE case, 3,9% was BE indefinite; 23,53% was BE with low grade dysplasia; and 1,97% was BE with hard grade dysplasia. There were 15 cases (21,12%) that were changed in diagnosis, from BE to non-BE cases. Conclusion : The diagnosis of BE could be made if there are compatibility between endoscopy examination and hystopathological examination, in which BE presentations was found, either in category 1, 2 or 3based on British Society of Gastroenterology Guidelines 2005 and endoscopy indicated supicion of BE. Changes in diagnosis of BE cases into non-BE cases could happen not because there are incompatibilities of the results of these examinations. This might happen due to nescience regarding the importance of the results of endoscopy examination and its compatibility with the results of hystopathological examination
Gastric Mucous Atrophy and Metaplasia in Patient with Helicobacter pylori Infection
No full textBackground: Helicobacter pylori (H. pylori) is one of the most common bacteria found in human and cause chronic infection. Recent study conducted in one of private hospitals in Jakarta shows that there is a trend of declining prevalance of H. pylori from 12.5% in 1998 to 2.9% in 2005. The aim of this study is to obtain` the prevalance of gastric atrophy and metaplasia in patients with H. pylori infection based on histopathology.Method: This was a case control study between June to August 2014 with 69 cases and 71 controls using medical records datas and histopathology results. Control sample was taken consecutively from patient undergone esophagogastroduodenoscopy procedure in 2013.Results: The average age for patient with H. pylori was 51 years slightly higher than patient with negative H. pylori (p > 0.05). Generally, the prevalence rate among males was slightly lower than females (p > 0.05). From Histopathology findings, active chronic gastritis was found in 62.3% patients with positive H. pylori than only 12.7% in patient with negative H. pylori (95% CI = 4.86-26.7; OR = 11.31). Mild and moderate atrophy was higher among H. pylori positive (p = 0.09). gastric mucous metaplasia was also higher (10% vs. 1.4%) among positive H. pylori patient (p = 0.03).Conclusion: H. pylori infection can cause atrophy and metaplasia in gastric mucosa. Prevalence of gastric metaplasia caused by H. pylori infection is lower in this study compared to the same study abroad
Ileal Endometriosis
No full textEndometriosis at the ileum site is a rare case and among the difficult cases of endometriosis. Intestinal endometriosis may cause obstructing symptoms, which is difficult to be distinguished from malignant or inflammatory disease. We report a case of 33-year-old woman, who admitted to the hospital because of sub-ileus intestinal obstruction. She underwent one session laparoscopy and laparatomy operation. Her ileum showed obstruction because of stenosis and adhesion with an ovarian brown cyst. She experienced terminal ileal resection, ileocaecostomy anastomosis, followed by laparatomy ovarial cystectomy and appendectomy. Microscopic evaluation of the intestine revealed vascular congestion, lymph nodes inflammation, and typical endometrial glands in the muscle layer of ileum. There was no sign of malignancy. These findings led to the diagnosis of ileal endometriosis. The ovarian cyst was actually the endometrial cyst of the ovary. Keywords: sub-ileus obstructive, ileal endometriosis, endometrial cys
Gastric Mucous Atrophy and Metaplasia in Patient with Helicobacter pylori Infection
No full textBackground: Helicobacter pylori (H. pylori) is one of the most common bacteria found in human and cause chronic infection. Recent study conducted in one of private hospitals in Jakarta shows that there is a trend of declining prevalance of H. pylori from 12.5% in 1998 to 2.9% in 2005. The aim of this study is to obtain` the prevalance of gastric atrophy and metaplasia in patients with H. pylori infection based on histopathology.Method: This was a case control study between June to August 2014 with 69 cases and 71 controls using medical records datas and histopathology results. Control sample was taken consecutively from patient undergone esophagogastroduodenoscopy procedure in 2013.Results: The average age for patient with H. pylori was 51 years slightly higher than patient with negative H. pylori (p 0.05). Generally, the prevalence rate among males was slightly lower than females (p 0.05). From Histopathology findings, active chronic gastritis was found in 62.3% patients with positive H. pylori than only 12.7% in patient with negative H. pylori (95% CI = 4.86-26.7; OR = 11.31). Mild and moderate atrophy was higher among H. pylori positive (p = 0.09). gastric mucous metaplasia was also higher (10% vs. 1.4%) among positive H. pylori patient (p = 0.03).Conclusion: H. pylori infection can cause atrophy and metaplasia in gastric mucosa. Prevalence of gastric metaplasia caused by H. pylori infection is lower in this study compared to the same study abroad.</jats:p
Alteration of Subcellular Beta Catenin Expression in Normal Mucosa Adenoma and Carcinoma in Relation to Colorectal Carcinogenesis
Get PDFBackground: Adenomatous polyposis coli (APC) gene mutation was found in up to 80% of cases of sporadic colorectal cancers and adenomas. Loss of APC protein function has been known as one of the early process in colorectal carcinogenesis. This event leads to the accumulation of beta catenin in the cytoplasm and nucleus and subsequently activates target genes that regulate cell proliferation and apoptosis. The aim of this study was to investigate the alteration of subcellular beta catenin expression in the progression of colorectal cancer. Method: This cross-sectional study was conducted with 30 paraffin-embedded tissue sections each of normal colorectal mucosa, adenomas and carcinomas. Alteration of beta catenin expression in membranous, cytoplasmic, and nuclear compartments were evaluated by immunohistochemical staining. Results: Beta catenin immunoreactivity was detected in all cases, of which 87 (96.7%) cases showed membranous expression, 78 (86.7%) cases had cytoplasmic and 51 cases (56.7%) had nuclear expression. Such results were statistically significant (p < 0.000). All normal colorectal epithelium showed membranous beta catenin expression with 18 (60.0%) cases showed cytoplasmic and no nuclear beta catenin expression was found. Strong cytoplasmic expression was found in 17 (56.7%) adenomas and 25 (83.3%) carcinomas; while strong nuclear expression was found in 12 (40.0%) adenomas and 17 (56.7%) carcinomas. There was no statistical significant association between beta catenin expression in the membranous, cytoplasmic and nuclear compartment with the degree of dysplasia or differentiation of tumor (p > 0.05). Conclusion: Altered subcellular expression of beta catenin occurs as the oncogenic process develops from adenoma into carcinoma. Such finding reflects the importance of beta-catenin in colorectal carcinogenesis
Estimated projection of oral squamous cell carcinoma annual incidence from twenty years registry data: a retrospective cross-sectional study in Indonesia
No full textBackground The incidence of oral squamous cell carcinoma (OSCC) has not been well documented in Indonesia. Thus, we aimed to analyze trends and clinicopathological profiles of OSCC cases in Indonesia, focusing on differences between age and sex groups. Methods A cross-sectional study was conducted in Indonesia’s main referral hospital, analyzing 1,093 registered OSCC cases from 2001 to 2020. Trend analysis was performed using Joinpoint regression analysis to determine the annual percentage change (APC) for overall cases and each case group based on age, sex, and anatomical subsites. APC significance was assessed using a Monte Carlo permutation test. The projection of case numbers for the following 5 years (2021–2025) was estimated using linear/non-linear regression analysis and presented as a mathematical function. The significance of the trend slope was measured using an ANOVA test. Demographic and clinicopathological characteristics of OSCC were analyzed according to age and sex, and their comparative analysis was assessed using Chi-square and its alternatives. Results The incidence of OSCC in female patients and in the tongue and buccal mucosa showed a positive trend (APC 2.06%; 3.48%; 8.62%, respectively). Moreover, the incidence of OSCC overall, and in women with OSCC, is projected to increase significantly in the next 5 years following the quadratic model. The mean age of patients was 51.09 ± 14.36 years, with male patients being younger than female patients. The male-to-female ratio was 1.15, and 36.5% of these patients were categorized as young (≤45 years old). The tongue was the predominantly affected site. Prominent pathologic characteristics included well-differentiation, keratinization, and grade I of Bryne’s (1992) cellular differentiation stage. Most patients presented with advanced staging, lymphovascular invasion, and uninvaded margins. Tumor sites and staging varied according to age, while age and tumor sites differed between sexes. Conclusion The rising incidence trends of OSCC among Indonesian patients, both in the past and projected future, are concerning and warrant attention. Further research into risk factors should be conducted as preventive measures
The Cyclooxygenase-2 and Nuclear Factor-kappa B Expressions in Colorectal Polyps
No full textBackground: Cyclooxygenase-2 (COX-2) is the rate-limiting enzyme in prostaglandin synthesis, while nuclear factor kappa B (NF-kB) is a family of transcription factors. Both play an important role in tumorigenesis. In the present study, we examined NF-kB and COX-2 expressions pattern, and their association in neoplastic and non-neoplastic colorectal polyps (CP). Method: Formalin-fixed and paraffin embedded tissue blocks from 77 patients with CP were immunostained with anti-NF-kB (p 65) and anti-COX-2. Expressions of NF-kB, and COX-2 were detected immunohistochemically. The relationship between these expressions and the two types of CP, and other clinicopathological findings were evaluated Results: The expressions of NF-kB and COX-2 in patients with neoplastic and non-neoplastic CP were high. The results of this study indicated that generally in CP, NF-kB was associated with COX-2 and the association was also seen in neoplastic and non-neoplastic polyps. There was no significant difference of NF-kB and COX-2 expressions in terms of patient’s age, sex, histologic type, and location of the CP. Neoplastic CPs were more common in the distal colon, female patients and older patients (> 60 years) compared with non-neoplastic CPs. Neoplastic CP were located more at the distal colon, more in female, and more in older (> 60 years) patients as compared with the non-neoplastic CP. Further studies are needed to elaborate the role of inflammation in sporadic colorectal carcinogenesis. Conclusion: The expressions of NF-kB and COX-2 in patients with CP were high, and strong correlated each other. There were no significant differences between expression of NF-kB and COX-2 in neoplastic and non-neoplastic polyps. Keywords: colorectal polyps (CP), NF- B, COX-2, inflammatio
Analysing 11 years of incidence trends, clinicopathological characteristics, and forecasts of colorectal cancer in young and old patients: a retrospective cross-sectional study in an Indonesian national referral hospital
No full textOBJECTIVE: To obtain annual incidence trends, understand clinicopathological characteristics, and forecast the future burden of colorectal cancer (CRC) in Indonesia. DESIGN: 11-year retrospective cross-sectional study. SETTING: A national referral hospital in Jakarta, Indonesia. PARTICIPANTS: Data from 1584 eligible cases were recorded for trends and forecasting analyses; 433 samples were analysed to determine clinicopathological differences between young (<50 years) and old (≥50 years) patients. METHODS: Trend analyses were done using Joinpoint software, expressed in annual percentage change (APC), and a regression analysis was executed to generate a forecasting model. Patients’ characteristics were compared using χ(2) or non-parametric tests. MAIN OUTCOMES: Analysis of trends, forecasting model, and clinicopathological features between the age groups. RESULTS: A significant increase in APC was observed among old patients (+2.38%) for CRC cases. Colon cancer increased remarkably (+9.24%) among young patients; rectal cancer trends were either stable or declining. The trend for right-sided CRC increased in the general population (+6.52%) and old patients (+6.57%), while the trend for left-sided CRC was stable. These cases are expected to be a significant health burden within the next 10 years. Patients had a mean age of 53.17±13.94, 38.1% were young, and the sex ratio was 1.21. Prominent characteristics were left-sided CRC, tumour size ≥5 cm, exophytic growth, adenocarcinoma, histologically low grade, pT3, pN0, inadequately dissected lymph nodes (LNs), LN ratio <0.05, no distant metastasis, early-stage cancer, no lymphovascular invasion, and no perineural invasion (PNI). Distinct features between young and old patients were found in the histological subtype, number of dissected LN, and PNI of the tumour. CONCLUSIONS: Epidemiological trends and forecasting analyses of CRC cases in Indonesian patients showed an enormous increase in colon cancer in young patients, a particularly concerning trend. Additionally, young patients exhibited particular clinicopathological characteristics that contributed to disease severity
