Background: Today, pathology services are more developed for quantitative diagnostic evaluation. The quantitative diagnostic evaluation requires detailed accuracy and can be done using digital image analysis (DIA). Assessment of the Ki67 labelling index (LI) in breast carcinoma needs to be done quantitatively. A visual evaluation of Ki67 LI using light microscopy has high inter-observer variability. The evaluation of Ki67 LI could be done digitally with the DIA technique to overcome the inter-observer variability. The DIA technique is carried out by counting the Ki67 LI manually or automatically with bioimage analysis software. QuPath is one of the bioimage analysis software, has characteristics of cross-platform, intended for bioimage analysis and digital pathology. Objective: This study aims to compare the manual and automatic calculation of Ki67 LI digitally. Methods: This study was a cross-sectional study; a total of 240 digital Ki67 images from 30 slides were analyzed by counting manually and automatically using QuPath. Results: Statistical analysis using the T-test showed no significant difference between the manual and automatic counting of Ki67 LI (p = 0,801, α = 0,05). Conclusion: Digital image analysis using QuPath can be used to calculate the Ki67 LI automatically.
Background: Breast cancer (BC) and thyroid cancer (TC) are the types of cancer mostly treated at the Surgical Oncology Department with 24.1% and 6.8%, respectively, of all malignancies at Dr. Hasan Sadikin General Hospital. The delay in managing patients for both types of cancer will increase the risk of cancer stage progression. This study was conducted to determine the Covid-19 pandemic’s impact on delayed surgery due to longer waiting times in BC and TC patients.Methods: This research is a descriptive study. The data were collected from BC and TC patients who received surgery in the Surgical Oncology Department from April to June 2020 at Dr. Hasan Sadikin General Hospital. These data include the time of surgery, gender, age, stage of the disease, chemotherapy history, management, time from diagnosis until surgery, last time receiving neoadjuvant chemotherapy until surgery, and time of surgery on schedule.Results: Thirty-seven patients had undergone surgery; the stages of BC and TC patients were IIIB (66.6%) and II (50.0%), respectively. There were 31 BC patients (93.9%) who received neoadjuvant chemotherapy and underwent surgery, and total thyroidectomy with dissection was performed in 75% of TC patients. Operative procedures that were performed earlier than the schedule have been done in 20 (60.6%) and three patients (75.0%) for BC and TC patients, respectively, while 2 (0.6%) of BC patients were delayed in their management and no patient experienced a delay in management on TC.Conclusions: The management of BC and TC patients with various stages has received operation procedures faster than the previously determined schedule in the period from April to June 2020. These results also suggest a possible advantage for cancer patients requiring surgery, particularly patients with advanced BC who have received neoadjuvant chemotherapy. In certain conditions, it turns out that a pandemic may positively impact, especially in the management surgery of breast and thyroid cancer patients. However, limited time at the early start of the pandemic may change these conclusions.
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