BAB V KESIMPULAN DAN SARAN
5.2 Saran
1. Pemeriksaan ekspresi vimentin dapat menjadi alternatif penanda pada adenokarsinoma endometrium di Departemen Obstetri dan Ginekologi FK USU sehingga kemudian hari dapat dijadikan sebagai prosedur diagnostik awal dalam mendiagnosis asal jaringan kanker endometrium di poli rawat jalan onkologi.
2. Perlu dilakukan penelitian lebih lanjut dengan hanya menggunakan sediaan blok parafin jaringan endometrium pasca pembedahan histerektomi total, sehingga dapat memperoleh hasil yang lebih presisi.
62
DAFTAR PUSTAKA
1. Sofian A.,Kanker Endometrium. In: Buku Acuan Nasional Onkologi Ginekologi. Yayasan Bina Pustaka Sarwono Prawirohardjo, Jakarta, 2006 : 456-467
2. Sankaranarayanan R., Worldwide Burden of Gynecological Cancer. Springer Science. 2010: 804-814
3. Siregar M. Angka Kejadian dan Karakteristik Penderita Kanker Ginekologi di RSUP H. Adam Malik dan RSUD dr. Pirngadi Medan. Tesis pada Bagian Obstetri dan Ginekologi FK USU/ RSup H. Adam Malik Medan. Mei 2002.
4. Sahil MF., Limfadenektomi pada Karsinoma Endometrium Stadium I Perlu atau Tidak?, Majalah Kedokteran Nusantara,2,38 (2005):189-194
5. Andrijono. Perjalanan Penyakit dan Deteksi Dini. In: Kanker Serviks. Divisi Onkologi Departemen Obstetri-Ginekologi. Fakultas Kedokteran Universitas Indonesia, 2009:1-19
6. Zaloudek C. Adenocarcinoma of the Cervix. Department of Pathology. University of California. 2010:1-16
7. Zaino RJ. The fruit of our labors: Distinguishing endometrial from endocervical adenocarcinoma. Int J Gynaecol Pathol 2002;21:1-3 8. McCluggage WG. A panel of immunohistochemical stains, including
carcinoembrionic antigen, vimentin and estrogen receptor, aids the distinction between primary endometrial and endocervical adenocarcinomas. Int J Gynecol Pathol 2002;21:11-5
63
9. Sofian A. The role of Vimentin Immunohistochemistry Examination as Tissue Origin Marker of Endometrial Cancer. Unversity of Indonesia. Maj Kedokt Indo 2006;56:46-50
10. Jones M.,Endometrial Carcinoma. In: Novaks Text Book of Gynecology. Eleventh Edition, Williams & Wilkins Baltimore, 1988: 728-757
11. Ghada E. ProExC is a novel marker for distinguishing between primary endometrial and endocervical adenocarcinomas. Journal of the Egyptian National Cancer Institute 2013;25:87-93
12. Chandrasoma P. Ringkasan Patologi Anatomi. Penerbit Buku Kedokteran EGC. Jakarta.2006:240-254
13. Lurain JR. Uterine cancer. In: Berek JS. Berek & Novak’s
Gynecology, 14th ed. Philadelphia: Lippincott Williams & Wilkins; 2007, p.1343-82
14. Schorge J. Endometrial Cancer. Dalam: Cunningham FG. Williams Gynecology. USA: McGraw-Hill. 2008
15. Djordjevic B. Selected Topics In The Molecular Pathology of Endometrial Carcinoma. Surgical Pathology. 2011:131-147
16. Bansal N. The Molecular Biology of Endometrial Cancers and the Implications for Pathogenesis, Classification, and Targeted Therapies. Cancer Control,2009;16:8-14
17. Banno K. Candidate Biomarkers for Genetic and Clinicopathological Diagnosis of Endometrial Cancer. International Journal of Molecular Sciences. 2013:12123-12137
64
18. Platz CE, Benda JA. Female genital tract cancer. Cancer 2000; 75:Suppl: 270-94.
19. Hacker NF. Uterine cancer . In: Berek JS, Hacker NF. Practical Gynecologic Oncology, 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2005, p.397-435.
20. Levine D.,The Corpus: Epithelial Tumors. In: Handbook for Principles and Practice of Gynecologic Oncology. Lippincott Williams & Wilkins,2010:159-190
21. Levy T, Golan A, Menczer J. Endometrial endometrioid carcinoma: A glimpse at the natural course. American Journal of Obstetrics and Gynecology, 2006, vol.195 , p.454 –457
22. Soekimin H. Adenocarcinoma Endometrium. Patologi Anatomi. Universitas Sumatera Utara. e-USU Repository 2005.
23. Andrijono. Panduan Pelayanan Medik Ginekologi Onkologi. Perkumpulan Obstetri Ginekologi Indonesia. Himpunan Onkologi Ginekologi Indonesia. Juni 2007:13-27
24. Cechini S. Sensitivity of the screening Program for Cervical cancer in the Florence District. Gynecol Oncol. 1999,33:182-4
25. Reid M. Immunophenotypic diversity of endometrial adeno carcinomas: implications for differential diagnosis. Mod Pathol. 2006 Aug;19(8):1091-100
26. Satelli A. Vimentin in cancer and its potential as a molecular target for cancer therapy. Cell. Mol. Life Sci.2011;68:3033-3046
65
27. Fuchs E. Intermediate filaments: structure, dynamics, function, and disease. Annu Rev Biochem. 1994. 63: pp. 345–82.
28. Chang L, Shav-Tal Y. Assembling an intermediate filament network by dynamic cotranslation. J Cell Biol 2006.172 (5): 747–58.
29. Katsumoto T. The role of the vimentin intermediate filaments in rat 3Y1 cells elucidated by immunoelectron microscopy and computer-graphic reconstruction. Biol Cell 2000.68 (2): pp. 139–46.
30. Goldman R. The function of intermediate filaments in cell shape and cytoskeletal integrity. J. Cell Biol. 1996.134 (4): 971–83.
31. Franke W. Rearrangement of the Vimentin Cytoskeleton during Adipose Conversion: Formation of an Intermediate Filament Cage around Lipid Globule. Cell. 1987(49):131-141
32. Lieber J. Disruption of the vimentin intermediate filament system during adipose conversion of 3T3-L1 cells inhibits lipid droplet accumulation. Journal of Cell Science. 1996:3047-3058
33. Green H. An established preadipose cell line and its differentiation in culture. Factors affecting the adipose conversion. Cell(1):19-27 34. Dabss DJ. Intermediate filaments in endometrial and endocervical
carcinomas. The diagnostic utility of Vimentin patterns. Am J Surg Pathol 1996;10:568-76
35. Alfred C. Assessment of Prognostic and Predictive Factors in Breast Cancer by Immunohistochemistry. Connection 9;2006:4-5
66
36. Qureshi A. Allred scoring for ER reporting and it’s impact in clearly
distinguishing ER negative from ER positive breast cancers. Journal Pathology Medical Association.2010 (60):350-353
37. Dako.ER/PR PharmDx Interpretation Manual.Nov 2007;28252: 1-23 38. Kim EH. Comparison of estrogen receptor, progesterone receptor and calponin expression in gonadotrophin-releasing hormone agonist-sensitive. Obstet Gynecol Sci. 2014;57:144-150
39. Coppola D. Prognostic Significance of p53, bcl-2, Vimentin, and S100 Protein-Positive Langerhans Cells in endometrial cancer. Human Pathology. 1998;29:455-462
40. Soslow A. Uterine Cancer: Pathology In: Uterine Cancer. Current Clinical Oncology. Humana Press Springer Science. 2009:51-78 41. Kamoi S. Immunohistochemical staining in the distinction between
primary endometrial and endocervical adenocarcinoma; another viewpoint. Int J Gynecol Pathol 2002;21:217-23
42. Castrillon DH. Distinction between endometrial and endocervical adenocarcinoma: an immunohistochemical study. Int. J Gynecol Pathol. 2002;1:4-10
43. Sastroasmoro S. Dasar-dasar metodologi penelitian klinis. Edisi Keempat. Sagung Seto. 2013.
44. Wiknjosastro H. Tumor Ganas Alat Genital In: Ilmu Kandungan. Yayasan Bina Pustaka Sarwono Prawirohardjo. 2008:380-394
67
45. Chiang S. Updates in Diagnostic Immunohistochemistry in Endometrial Cancer. Department of Pathology. Memorial Sloan Kettering Cancer Center.2010
46. Alwi H. Kamus Besar Bahasa Indonesia. Jakarta: Balai Pustaka. 2007
47. Physical activity and Health Adolescent In: Centers for Disease Control and Prevention. 2009.
48. Robbins C. Pathologic Basis of Disease. Roldusandy Published. 2005. 102-128
49. Howlader, N., et al. SEER Cancer Statistics Review, 1975-2008. 2011 [cited 2011; based on November 2010 SEER data submission].
50. Noviardi. Karakteristik dan Kelangsungan Hidup Penderita Karsinoma Korpus Uteri yang Dirawat di RS Dr. Pirngadi Medan Tahun 1981-1990. Tesis pada Bagian Obstetri dan Ginekologi FK USU/ RS Dr. Pirngadi Medan. Juni 1994.
51. Wee C. BMI and cervical cancer screening among white, African-American, and Hispanic women in the United States.Obes Res.2005:1275-80.
52. Green J. Risk Factors for Adenocarcinoma and Squamos Cell Carcinoma of the Cervix in Women Aged 20-44 years: the UK National Case-Control Study of Cervical Cancer. British Journal of Cancer. 2003;2078-86.
68
53. Cirisano F. Epidemiologic and Surgicopathologic Findings of Papillary Serous and Clear Cell Endometrial Cancers When Compared to Endometrioid Carcinoma. Gynecol Oncol. 1999;385-394.
Gambar pewarnaan vimentin positif:
Case Processing Summary
Cases
Valid Missing Total
N Percent N Percent N Percent
skorVimentin1 * skorVimentin2 60 100.0% 0 .0% 60 100.0%
skorVimentin1 * skorVimentin2 Crosstabulation
skorVimentin2 Total .00 2.00 3.00 4.00 5.00 6.00 7.00 8.00 skorVimentin1 .00 27 0 0 0 0 0 0 0 27 2.00 0 1 0 0 0 0 0 0 1 3.00 0 1 1 0 0 0 0 0 2 4.00 0 1 1 2 0 0 0 0 4 5.00 0 0 1 0 8 0 0 0 9 6.00 0 0 0 0 0 5 1 0 6 7.00 0 0 0 0 0 1 2 1 4 8.00 1 0 0 0 0 0 1 5 7 Total 28 3 3 2 8 6 4 6 60 Symmetric Measures Value Asymp. Std.
Errora Approx. Tb Approx. Sig.
Measure of Agreement Kappa .797 .058 12.900 .000
N of Valid Cases 60
a. Not assuming the null hypothesis.
Tests of Normality
Kolmogorov-Smirnova Shapiro-Wilk
Statistic df Sig. Statistic df Sig.
Derajat ,411 27 ,000 ,651 27 ,000
Skor_Vimentin ,141 27 ,181 ,927 27 ,058
a. Lilliefors Significance Correction
Correlations Diferensiasi Skor_Vimentin Spearman's rho Diferensiasi Correlation Coefficient 1,000 -,394* Sig. (2-tailed) . ,042 N 27 27 Skor_Vimentin Correlation Coefficient -,394* 1,000 Sig. (2-tailed) ,042 . N 27 27
*. Correlation is significant at the 0.05 level (2-tailed).
Correlations
IMT Skor_Vimentin Spearman's rho IMT Correlation Coefficient 1.000 .211
Sig. (2-tailed) . .291
N 27 27
Skor_Vimentin Correlation Coefficient .211 1.000
Sig. (2-tailed) .291 .