Background: Cervical cancer caused by human papilloma virus (HPV), is the second most common cancer for women. This cancer is distributed worldwide, with ~80% of cases are found in the developing countries. In Indonesia, data of HPV genotypes are still limited and do not represent all regions of the country. Thus, here we report genotyping of HPV samples collected from the Dr. Soetomo Hospital Surabaya Indonesia patients, in 2013. Materials and Method: A cross sectional study was performed using 68 paraffin blocks of low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), and squamous cell carcinoma (SCC) cervix.

Approximately 20-30% of all cervical cancer cases are adenocarcinoma and adenosquamous carcinoma. Around 70% of all of these types of cancer are related to infection of Human Papillomavirus (HPV). This study evaluated the distribution of HPV genotype in cervical adenocarcinoma and adenosquamous carcinoma. A cross-sectional study was conducted at the Department of Anatomic Pathology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, from January to December 2015. The sample were 22 formalin-fixed paraffin-embedded (FFPE) of cervical adenocarcinoma tissues and adenosquamous carcinoma tissues. FFPE was used for DNA extraction and followed with HPV genotyping to detect 40 genotypes of HPV, including low risk (LR) and high risk (HR) HPV. The histopathological types of adenocarcinomas were adenocarcinoma NOS and mucinous adenocarcinoma, while the adenosquamous carcinoma types were adenosquamous carcinoma and adenosquamous carcinoma glassy. All of the specimens were infected by HPV. In cervical adenocarcinoma, the infection was by HPV 6, 11, 16, 18, 31, 45, 68B, and 72, and in adenosquamous carcinoma by HPV 6, 16, 18, 45, and 59. HPV 18 was predominant, which was found in 13/22 (59.1%) in adenocarcinoma and 19/22 (86.4%) in adenosquamous carcinoma. Single infection and multiple infections in adenocarcinoma were 13/22 (59.1%) and 9/22 (40.9%), while in adenosquamous carcinoma were 21/22 (95.5%) and 1/22 (4.5%) respectively. The most common HR HPVs found in this study were HPV 18, HPV 45, HPV 16 and LR HPV are HPV 11, HPV 6.

Tujuan: Penelitian ini bertujuan untuk mengetahui prevalensi lesi prekanker serviks dengan cara melakukan skrining kanker serviks menggunakan pemeriksaan Pap smear.Bahan dan Metode: Penelitian ini merupakan penelitian observasional deskriptif dengan metode pendekatan cross sectional yang dilakukan pada 140 wanita, terdiri dari 90 orang dari Puskes-mas Tanah Kali Kedinding Surabaya, dan 50 orang dari Rumah Sakit Mawadah Mojokerto, dengan usia 20-70 tahun. Pemeriksaan spesimen sitologi serviks dengan pengecatan Papaniculaou dan klasifikasi hasil pemeriksaaan sitologi berdasar-kan klasifikasi Papaniculaou dan sistim Bethesda. Pemeriksaan inspeksi visual asam asetat (IVA) adalah metode lain untuk skrining kanker serviks dilakukan dengan mengoleskan asam asetat 5% pada area serviks dan melakukan pengamatan satu menit kemudian.Hasil: Hasil pemeriksaaan Pap smear menunjukkan Papaniculaou kelas I (sama dengan normal pada klasifikasi sistim Bethesda) yaitu 12.1%, kelas II (sama dengan NILM pada klasifikasi sistim Bethesda) yaitu 86, 4%, dan kelas III (sama dengan LSIL pada klasifikasi sistim Bethesda) yaitu 1,4%. Hasil pemeriksaan IVA menunjukkan 6,43% positif dan 93,57% negatif. Hasil pemeriksa-an IVA positif terdapat pada 9/140 orang yang merupakan proses keradangan dan infeksi, bukan merupakan lesi prekanker.Simpulan: Prevalensi lesi prekanker yaitu 1,4%. Pemeriksaan IVA menunjukkan hasil positif semu yang disebabkan oleh proses radang atau infeksi pada serviks.

Introduction: Breast cancer and cervical cancer are common cancers in females. Both of these cancers can be detected early. Early detect vion can reduce cancer morbidity and mortality. The community outreach activities are required to increase knowledge about breast cancer and cervical cancer, in addition to screening as preventive efforts for these two cancers.Methods: The activity of raising knowledge about the prevention and early detection of breast cancer and cervical cancer was carried out through community counseling to 94 females who were members of the PKK and young females in the Kecamatan Proppo, Kabupaten Pamekasan. Pre and post tests were given before and after the community counseling. After the community counseling, 86 participants were screened for breast cancer by clinical palpation and 46 participants were screened for cervical cancer using the pap smear method.Results: The result of the post test showed a 27.53% increase in knowledge. The results of the pap smear examination on participants showed 96% concluded as Papanicolau Class II, 2% Class I, and 2% Class IV. The patient with class IV results was referred to an obstetrician.Conclusion: Community counseling about breast self examination (BSE) and Pap smear can increase people's knowledge about early detection of breast cancer and cervical cancer.

Patient: Female, 23-year-old Final Diagnosis: Giant fibroepithelial polyps of the vulva in women with uterine myoma and primary infertility Symptoms: Irregular bleeding and mass on the vulva Medication:— Clinical Procedure: — Specialty: Obstetrics and Gynecolog Objective: Rare disease Background: Reproductive health is closely related to long-term quality of life and maternal well-being in obstetrics. The overall incidence of fibro-epithelial polyps in the general population is about 46%, but a location on the vulva is quite rare, and is very rare when the size is more than 5 cm. Case Report: A 23-year-old woman reported irregular bleeding and a mass on the vulva. After anamnesis, physical examination, biopsy, and radiology imaging, the patient was diagnosed with uterine myoma, primary infertility, and a large solid and benign mass on the vulva. The mass found on the vulva was apparently unrelated to intra-abdominal organs and urogynecology. After performing an excision accompanied by a laparoscopic myomectomy, the histopathological results showed that the mass on the vulva was a 16×11×6 cm fibroepithelial polyp weighing 700 g. After 7 months of therapy, the submucosal uterine myoma recurred. Submucosal uterine myomas were found rooted into the vaginal canal, so the surgeon performed an extirpation operation. Eight months later, the patient succeeded in having a pregnancy that ended in delivery by cesarean section. Conclusions: Giant fibroepithelial polyps are very rare. Management is by excision accompanied by a laparoscopic myomectomy. They affect reproductive health and require appropriate management and diagnosis.

Cholestatic infants are associated with congenital abnormalities or viral infections, such as cytomegalovirus (CMV) infection. CMV can be detected by polymerase chain reaction (PCR) in body fluids, including urine which can be obtained easily and is non-invasive. The objective was to detect CMV in urine specimens of cholestasis infants and to analyze its correlation with serological status. This was a descriptive observational study with the cross-sectional approach, used urine from 39 cholestatic infants who meet the inclusion and exclusion criteria and have been approved by Ethics Committee. The nested-PCR was performed from extracted urine and unextracted direct urine. Serological data of immunoglobulin (Ig) M and IgG data were collected. Data were analyzed by Chi-square. Detection of CMV from extracted urine by PCR showed positive in 87.2% patients and from unextracted urine was positive in 48.7% patients. Serological status showed that IgM was positive in 41.0% patients and IgG was positive in 89.7% patients. The acute infection (IgM+ IgG+) was found in 41.0% patients, past infection (IgM-IgG+) was 48.7% patients, and not infected (IgM-IgG-) was in 10.3% patients. The acute infection (IgM+ IgG+), past infection (IgM-IgG+) and not infected (IgM-IgG-) was found in 41.0%, 48.7%, and 10.3% patients, respectively. The correlation between PCR CMV from extracted urine with serological CMV was moderate, while the unextracted urine was low. It indicates that to detect the infection of CMV, PCR technique is more accurate than serological testing, and the extracted urine is more appropriate specimen as PCR template than direct urine.

The objective of this study is to analyze the expression of E6 Humanpapilloma virus (HPV), p53, and p16INK4A in cervical adenocarcinoma grade well differentiated (WD), moderately differentiated (MD), and poorly differentiated (PD). A cross sectional study conducted at Department of Anatomic Pathology, Dr. Soetomo General Academic Hospital Surabaya Indonesia using formalin fix paraffin embedded (FFPE) from cervical normal and cervical adenocarcioma grade WD, MD, and PD. The expression of E6 HPV, p53, and p16INK4A was performed by immunohistochemistry (IHC) staining. Data were analyzed with Kruskal-Wallis and continued with Mann-Withney test. The expression of E6 HPV in the cervical adenocarcinoma showed 35.9% specimens represented negative and 64.1% specimens represented positive. There was no significant difference in the expression of E6 HPV and p53 in cervical adenocarcinoma between grade WD, MD, and PD. The p16INK4A was overexpressed, shown as diffuse appearance in 89.7% of the specimens. There was a significant difference in the expression of p16INK4A between grade WD and MD with PD. In conclusion, some of cervical adecarcinoma were not caused by infection of HPV type 16 or 18 and the expression of p16INK4A might take a role in the developing of malignancy that caused by infection of HPV.

BACKGROUND: Bladder cancer is the tenth-most common cancer in worldwide and the majority are urothelial carcinomas. The depth of invasion plays important role in the prognostic and therapeutic factor in urothelial carcinomas. The expression of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) may associated with the progression of bladder carcinoma, such as depth of invasion. In this study, the correlation between these two markers in urothelial bladder carcinoma invasion will be analyzed.METHODS: An analytical observational research with cross-sectional were conducted on 54 formalin fixed paraffin-embedded tissue from radical cystectomy (RC) which were diagnosed as bladder urothelial carcinoma at the Anatomical Pathology Laboratory of Dr. Soetomo Academic Hospital, Surabaya and divided based on the T stage were immunostained using VEGF and MMP-9 monoclonal antibodies. The difference of VEGF and MMP-9 expression in T stage of bladder urothelial carcinoma were analyzed using Kruskal-Wallis and Anova test, the correlation between VEGF and MMP-9 expression in various T stage of bladder urothelial carcinoma were analyzed using Spearman test. RESULTS: This study showed no significant difference of VEGF expression among T stage of bladder urothelial carcinoma (p>0.05) but there was significant difference of MMP-9 expression in T stage of bladder urothelial carcinoma (p=0.043). There was a correlation between VEGF and MMP-9 in various T stage of bladder urothelial carcinoma (rs= 0.50, p=0.001).CONCLUSION: The significant correlation of VEGF and MMP-9 expression in bladder urothelial carcinoma may prove the synergistically role of both proteins in tumor invasion by MMP-9 degradation extracellular matrix.KEYWORDS: urothelial carcinoma, VEGF, MMP-9, T stage