Objective To determine the predictive accuracy of the combined panels of serum human tissue kallikreins (hKs) and CA-125 for the detection of epithelial ovarian cancer. Methods Serum specimens collected from 5 Indonesian centers and 1 Vietnamese center were analyzed for CA-125, hK6, and hK10 levels. A total of 375 specimens from patients presenting with ovarian tumors, which include 156 benign cysts, 172 epithelial ovarian cancers (stage I/II, n=72; stage III/IV, n=100), 36 germ cell tumors and 11 borderline tumors, were included in the study analysis. Receiver operating characteristic analysis were performed to determine the cutoffs for age, CA-125, hK6, and hK10. Sensitivity, specificity, negative, and positive predictive values were determined for various combinations of the biomarkers. Results The levels of hK6 and hK10 were significantly elevated in ovarian cancer cases compared to benign cysts. Combination of 3 markers, age/CA-125/hk6 or CA-125/hk6/hk10, showed improved specificity (100%) and positive predictive value (100%) for prediction of ovarian cancer, when compared to the performance of single markers having 80-92% specificity and 74-87% positive predictive value. Four-marker combination, age/CA-125/hK6/hK10 also showed 100% specificity and 100% positive predictive value, although it demonstrated low sensitivity (11.9%) and negative predictive value (52.8%). Conclusion The combination of human tissue kallikreins and CA-125 showed potential for improving prediction of epithelial ovarian cancer in patients presenting with ovarian tumors.

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Background: Nature of the disease, side effect from treatments such as surgery, chemotherapy, and chemo radiation reduce the patient’s quality of life. Thus, the family support is substantial in cancer patient treatment. Aim of this study was comparing the quality of life of patients with cervical cancer in support of the nuclear family and extended family at Dr. Sardjito hospital Yogyakarta, Indonesia.Methods: The study population were all cervical cancer patients treated with chemotherapy in Dr. Sardjito general hospital, Yogyakarta, Indonesia from October to November 2016. Samples were collected using purposive sampling to obtain 62 respondents, 30 respondents for nuclear family group and 32 for extended family group. The study instruments were family support questionnaire, EORTC QLQ-C30 Indonesian version, and EORTC QLQ-C24 were translated to Indonesian. The quality of life was assessed during chemotherapy.Results: Quality of life for cervical cancer patient from supportive family had mean >50. The respective mean of general health status for patients from supportive nuclear and extended family were 76.28±21.434 and 67.82±22.017. Nearly all items in symptom, multi-item and single-item scales had mean <50, except item financial problem. Meanwhile, quality of life for cervical cancer patient from unsupportive family had mean >50. The respective mean of general health status for patients from unsupportive nuclear and extended family were 70.83±20.972 and 75.00±8.33. Nearly all items in symptom, multi-item and single-item scales had mean <50, except items fatigue and sore. Several items of quality of life had p<0.05, which were constipation (p=0.049), and financial problem (p=0.045).Conclusions: There was no significant difference between quality of life of cervical cancer patients with support from nuclear and extended families. However, in ‘financial problem’ item, nuclear family had better quality of life while in contrast, extended family had better quality of life in ‘constipation’ item. Family education program needed because several domains of quality of life is still low and requires family involvement in treatment.

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