Supriadi Gandamihardja
Departemen Obstetri dan Ginekologi Fakultas Kedokteran Universitas Padjadjaran

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Pemeriksaan Tunggal Kadar Osteopontin Serum dan CA 125 untuk Prediktor Keganasan Tumor Ovarium Tipe Epitel: Inferior dibandingkan dengan Pemeriksaan Gabungan Aditiyono, Aditiyono; Harsono, Ali Budi; Winarno, Gatot N.A.; Gandamihardja, Supriadi; Kusumanto, Ardhanu; Susanto, Herman
Indonesian Journal of Obstetrics & Gynecology Science Volume 1 Nomor 1 Maret 2018
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

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AbstrakTujuan: Membandingkan penanda tumor osteopontin (OPN), cancer antigen 125 (CA125), kombinasi sebagai prediktor keganasan pada penderita tumor ovarium. Metode: Penelitian cross sectional ini dilakukan pada pasien dengan keganasan pada kista ovarium jenis epitel. Analisis data dilakukan secara univariat dan bivariat. Hasil: 47 pasien dengan hasil hitopatologi jinak dan 43 dengan hasil histopatologi ganas masuk dalam penelitian. Hasil nilai median CA125 kelompok ganas dibanding kelompok jinak (142,2 vs 61,030, p < 0,05), cut off point CA125 99,9 U/mL, sensitivitas 76,7% dan spesifisitas 61,7%. Diskusi: Kombinasi CA125 dan OPN memiliki sensitivitas lebih rendah dibandingkan CA125. Kombinasi CA125 dan OPN akan meningkatkan spesifitas, nilai duga positif dan akurasi yang lebih baik. Tumor marker OPN tidak tepat digunakan untuk proses deteksi dini, tetapi lebih tepat untuk penegakan diagnosis lebih baik dibandingkan dengan gold standard CA125.Kesimpulan: Kombinasi OPN dan CA125 memiliki nilai tingkat akurasi paling tinggi apabila dibandingkan pemeriksaan tunggal CA125, OPN.  Kata Kunci: tumor ovarium tipe epitel, OPN, CA 125, prediktor keganasanSingle Check of Serum Ostepontin and CA 125 Levels as A Predictor of Malignancy in Epitheliaal Ovarium Tumor is Inferior to Combined ExaminationAbstractObjective: To compare the sensitivity, specificity, expected value positive, expected value negative and accuracy among osteopontin (OPN), cancer antigen 125 (CA125), and combination as predictor of malignancy in ovarian tumor patients.Method: A cross sectional study was done to compare parameters OPN and CA125 in determining malignancy of ovarian cysts. Data analysis was performed by univariate and bivariate analysis. Results: A total of 47 subjects were included with benign histopathological result and 43 subjects with malignant histopathological result. The median value of CA125 in malignant group was compared to that of benign group (142.2 vs. 61.030, p value <0.05), the cut-off point of CA125 was 99.9 U/mL with sensitivity of 76.7% and specificity of 61.7%. Discussion: Combination of CA125 dan OPN has lower sensitivity compared to single tumor marker CA125. This combination will increase specificity, positive predictive value and accuracy. The OPN is inappropriate when used for early detection instead is suggested for diagnostic value risk predictor for malignancy in ovarian tumor compared to gold standard CA125.Conclusions: Combination OPN dan CA125 has higher accuracy compared to single CA125, and OPN. OPN was useful biomarker for predicting ovarian malignancy.Keywords: Epithelial ovarian tumor, OPN, CA 125, predictor for ovarian malignancy
Hubungan Kadar βHCG Praevakuasi, Gambaran Histopatologi, dan Kista Lutein dengan Performa βHCG pada Penderita Mola Hidatidosa yang Berkembang Menjadi PTG dan Kembali Normal Hidayat, Yudi Mulyana; Gandamihardja, Supriadi; Krisnadi, Sofie Rifayani
Majalah Kedokteran Bandung Vol 46, No 4 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Insidensi penyakit trofoblas di Indonesia maupun negara berkembang masih cukup tinggi dibandingkan dengan negara maju. Hal yang perlu diwaspadai adalah terjadinya penyakit trofoblast gestasional (PTG) pascaevakuasi mola hidatidosa berkisar 10-20%. Beberapa variabel klinis telah diteliti sebagai variabel faktor risiko keganasan seperti kadar β-human chorionic gonadotropin (βHCG) praevakuasi, gambaran histopatologi, dan terdapat kista lutein. Tujuan penelitian ini adalah mengetahui hubungan kadar βHCG praevakuasi, gambaran histopatologi dan kista lutein dengan performa penurunan βHCG pada penderita mola. Metode penelitian yang digunakan adalah case control study pada penderita mola hidatidosa komplet di Rumah Sakit Dr. Hasan Sadikin Bandung selama periode tahun 2007-2011. Hasil penelitian menunjukkan hubungan bermakna kadar βHCG ≥100.000 mIU/mL dengan keganasan pascamola (p<0,05), terdapat hubungan bermakna gambaran histopatologi proliferasi berlebih dengan keganasan pascamola (p<0,05), dan terdapat hubungan bermakna kista lutein positif dengan keganasan pascamola (p<0,05). Simpulan penelitian ini adalah variabel kadar βHCG praevakuasi ≥100.000 mIU/mL, gambaran histopatologi proliferasi berlebih, dan kista lutein positif memiliki korelasi dengan keganasan pascaevakuasi mola. Variabel faktor risiko tersebut  dapat digunakan untuk memilahkan penderita mola hidatidosa komplet risiko tinggi atau risiko rendah untuk kejadian keganasan dan variabel faktor risiko keganasan tersebut berpengaruh pada performa penurunan kurva regresi βHCG.Kata kunci: Gambaran histopatologi, kadar βHCG, kista lutein, mola hidatidosa komplit, PTGRelationship between Pre-Evacuation βHCG Level, Histopathologycal View, Lutein Cysts and βHCG Performance in Patients with Hydatidiform Mole which Developed into Gestational Trophoblastic Disease (GTD) and Back to NormalAbstractThe incidence of trophoblastic diseases in Indonesia and developing countries is relatively high compared to the developed countries. The incidence of gestational trophoblast tumors (GTT) after the evacuation of a hydatidiform mole ranges from 10% to 20%. Several clinical variables have been studied as the risk factors for malignancy, including the pre-evacuation level of beta human chorionic gonadotropin (βHCG), histopathological appearance, and the presence of lutein cysts. The purpose of this study was to determine the relationship between βHCG decline and pre-evacuation βHCG levels, histopathological features, and the lutein cysts status in patients with moles. This study was a case control study of patients with complete hydatidiform mole in Dr. Hasan Sadikin General Hospital during the period of 2007-2011. The results revealed that there was a significant correlation between the level of βHCG ≥100,000 mIU/mL and post-molar malignancy (p<0.05). There was also a significant relationship between the histopathologic feature of excessive post-molar cell proliferation and malignancy (p<0.05) and between the presence of lutein cyst and post-molar malignancy (p<0.05). This study concludes that the pre-evacuation βHCG level ≥100.000 mIU/mL, excessive proliferation, and the presence of lutein cysts are correlated with malignancy after molar evacuation. These risk factors are useful to differentiate whether a complete hydatidiform mole will become malignant or remain benign.Key words: Beta human chorionic gonadotropin levels, histopathologic features, lutein cysts, complete hydatidiform mole, gestational trophoblast tumors DOI: 10.15395/mkb.v46n4.345
DETERMINAN KEIKUTSERTAAN PENAPISAN KANKER SERVIKS PADA WANITA PEKERJA SEKS Kurniati, Ana; Gandamihardja, Supriadi; Sutisna, Mamun
Jurnal Kesehatan Ibu dan Anak Vol 4 No 2 (2013): November
Publisher : Poltekkes Kemenkes Yogyakarta

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Cervical cancer is the second women killer in the world includes Indonesia. The number of cases of cervical cancer increased in city of Yogyakarta. Screening programs have not rum optimally so that the screening coverage is low and often the patients come in the last stage. Female sex workers (FSW) are one of the groups who are most vulnerable and at high risk of cervical cancer as well as a reservoir of HPV. The participant of FSW in cervical cancer screening is still low. This study aimed to analyze the determinant associated with female sex workers participation in cervical cancer screening. The design of this study was an observational study using correlative analysis. The subject was FSW who practice in Komplek Pasar Kembang Yogyakarta. Univariable analysis performed with the frequency distribution, bivariable analysis with Chi-square and multivariable analysis with logistic regression with significantly p-value &lt;0.05. the result analysis using Chi-square showed that age was associated with cervical cancer screening participation (p =0,006) education was not associated with cervical cancer screening respondent had primary education, duration of work as FSW was associated with cervical cancer screening participation (p=0.000), knowledge was associated with participation in cervical cancer screening(p=0.010) and 40% of respondent knowledgeable were low, attitude was not related to participation in cervical cancer screening (p=0.164) and 47% of respondent had negative attitude. The result simultaneous analysis showed that knowledge was the most dominant determinant with the prevalence ratio was 3.67 (p&lt; 0.05). this study suggests that sociodemographic (age and duration work as FSW) and knowledge were significantly associated with the participation in cervical cancer screening.