48 49
Premanopausal Benigne
151 95.0
51 66.2
202 76.5
74.8 33.8 95.0
Cancer 8
5.0 26
33.8 34
Total 159
100 77
100 236
Postmenopausal Benigne
112 92.6
38 26.0
150 92.3
74.7 74.9 92.6
Cancer 9
7.4 108
74.0 117
Total 121
100 146
100 267
Pada premanopause, receival of operational curve ROC pada CA125, HE4, dan ROMA
untuk membedakan massa ovarium jinak dan ganas dengan memakai perhitungan ROC-AUC masing-masing adalah 85,3, 91,4, dan 91,9 [31,41,47].
Berikut adalah perbandingan stratiikasi risiko pada premenopause dan postmenopause dengan massa pelvik berdasarkan ROMA dan RMI pada spesiisitas 75 [49,50,54].
Tabel 10. Stratiikasi Risiko Pada Premenopause dan Postmenopause Dengan Massa Pelvis Berdasarkan ROMA dan RMI pada Spesiisitas 75
N Sensitvity
PPV NPV
Over all Agreement
Benign Cancer
ROMA RMI
P ROMA
RMI ROMA
MRI ROM A
RMI Benigne vs EOC
and LMP 312 68
145 32 89.0
80.7 0.011
62.3 59.7
93.6 89.3
79.4 76.6
Benigne vs Stage I-IV EOC
312 72 123 28
94.3 84.6
0.002 59.8
56.8 97.1
92.5 80.5
77.5 Benigne vs Stage
I-II EOC 312 90
34 10 85.3
64.7 0.001
27.1 21.8
97.9 95.1
76.0 73.7
Benigne vs Satge III-IV EOC
312 78 86 22
98.8 93.0
0.039 52.1
50.3 99.6
97.5 80.2
78.6 Benigne vs Stage
I-IIIB and IIIC EOC omentum and
Lymh node + 312 88
44 12 68.2
68.2 0.003
33.3 27.5
97.9 94.3
76.7 73.9
REKOMENDASI SISTEM SKORING KANKER OVARIUM TIPE EPITELIAL DI INDONESIA
Indonesia adalah archipelago terbentang sangat luas dalam radius dengan penduduk 240 juta dimana 52.3 wanita. Jumlah penduduk meopause terus bertambah seiring dengan angka
harapan hidup wanita. Kanker ovarium tipe epitelial dapat terjadi pada semua usia; tertinggi pada usia post menopause. Sementara, jumlah SpOG sekitar 2.640 dengan distribusi tidak
merata dan beberapa daerah kurang bahkan tidak tersedia Data POGI, 2011.
Berdasarkan hal itu maka diusulkan sistem skoring kanker ovarium di Indonesia dibedakan atas Pusat, Intermdiate dan Periferi. Pusat adalah daerah yang memiliki sumber daya SpOG K
Onko-ginekologi, USG 4D, Lab Biokimia dan Biomolekuler serta kemampuan masyarakatnya memadai yang biasanya berada di Senter Pendidikan Spesialis Obstetri dan Ginekologi.
Sedangkan, periferi adalah daerah dengan sumberdaya SpOG, USG 2D, dan keterbatasan laboratorium biomedik serta kondisi masyarakat sedang-maskin yang berada di RS Kabupaten
baik sebagai RS Jejaring atau bukan. Dan, daerah intermediate adalah daerah yang memiliki kempampuan diantara pusat dan periferi.
Diagnosis dengan sistem skoring kanker ovarium tipe epitelial ini bukanlah merupakan legalitas penanganan kanker ovarium itu sendiri; namun perlu dicarikan solusi yang terbaik. Untuk
sementara, agar dipergunakan sebagai pertimbangan rujukan untuk menghindari penanganan suboptimal atau sebaliknya over treament. Dengan demikian, rekomendasi adalah:
1 Pusat adalah ROMA sebagai pilihan pertama dan RMI II sebagai pilihan ke dua.
2 Periferi adalah Indeks Keganasan Kanker Ovarium Sudarjanto 1998 dan atau RMI 2009.
3. Intermediate adalah RMI.
Ringkasan 1
Kanker ovarium, 90 tipe epitelial dengan variasi biologi dan molekuler yang lebar; tidak spesiik. dan silent killer. Sebagai baku emas diagnosisnya adalah histopatologik bahan tumor ovarium yang
didapat ketika operatif.
2 Kesulitan skrining dan diagnosis dini kanker ovarium tersebut dipecahkan melalui sistem skoring
kanker ovarium. Sistem skoring kanker ovarium tipe epitelial berdasarkan atas gejala klinis, gambaran USG, dan kadar biomarker.
3 Beberapa sistem skoring kanker ovarium tipe epitelial seperti RMI dan ROMA; akurasinya telah
teruji. Dan, indeks keganasan ovarium Sudarjanto dan Indeks Morfologi Sassone-Timor Tritsch masih pada tempatnya untuk dibenar gunakan.
Anjuran untuk Indonesia, sistem skoring kanker ovarium tipe epitelial dibedakan atas tiga yaitu sentral dengan ROMA, intermediate dengan MRI atau indeks Sasson-Timor Tritch, dan periferi dengan indeks
Sasson-Timor Tritch atau Sudarjanto. Prediksi kanker ovarium tipe epitelial pada massa pelvis dengan modalitas USG 4D Collor Doppler
juga direkomendasi dan merupakan pilihan terbatas.
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Deteksi Molekuler Toxoplasma Gondii Pada Mencit Yang Diinfeksi Inokulat Jantung Dan Otak
Ayam Buras
Ida Ayu Pasti Apsari
1
, Ida Bagus Oka Winaya
1
, Ida Bagus Ngurah Swacita
1 1
Fakultas Kedokteran Hewan, Universitas Udayana, Denpasar, Indonesia E-mail : iapapsariyahoo.co.id
Abstract
Toxoplasma gondii is the intracellular parasite that can infect all animals, including domestic poultry. Mice are highly susceptible animal model of infection T. gondii. The study of mice infected with the heart and brain
inoculant free-range chicken has done. Purpose of the study to detect molecularly T.gondii in mice infected with free-range chicken heart and brain inoculant by the Polymerase Chain Reaction PCR methods. Ten mice have
increased titers of serum from 2 weeks irst to 2 weeks second, conducted detection of T. gondii in organs by PCR. The results showed that in mice inoculated with the heart and brain inoculant free-range chicken, is not
successfully detected molecularly T. gondii.
Key word: Toxoplasma gondii, free-range chicken, mice, heart and brain inoculant.
1. Pendahuluan
