HUBUNGAN RASIO PLATELET TERHADAP LIMFOSIT DENGAN STADIUM KLINIS KARSINOMA NASOFARINGS

LIA NATALIA, dr. Camelia Herdini, M.Kes., Sp.T.H.T.K.L., FICS ;dr. Siswanto Sastrowijoto, Sp.T.H.T.K.L.(K), MH

2016 | Tesis-Spesialis | SP ILMU PENYAKIT THT

Latar belakang: Platelet memiliki peran dalam proses angiogenesis dan metastasis hematogen dari kanker, sehingga mempengaruhi pertumbuhan dan perkembangan kanker. Sedangkan, limfosit merupakan komponen penting dari sistem imun adaptif, dan infiltrasi limfosit menunjukkan adanya respon imun seluler anti tumor yang efektif. Rasio platelet terhadap limfosit - Platelet Lymphocyte Ratio (PLR) yang dihitung dengan membagi jumlah platelet perifer dibandingkan dengan jumlah limfosit, mencerminkan pengaruh terbalik platelet dan limfosit pada progresivitas dan metastasis berbagai macam keganasan. Hubungan PLR dengan karsinoma nasofarings (KNF) masih belum jelas. Tujuan: Penelitian ini bertujuan untuk menentukan hubungan PLR dengan stadium klinis KNF. Metode: Rancang penelitian adalah kasus kontrol. Data sampel penelitian diambil dari rekam medis, yaitu pasien yang telah terdiagnosis KNF di bagian Telinga Hidung dan Tenggorok Bedah Kepala Leher (THT-KL) Rumah Sakit Umum Pusat (RSUP) Dr. Sardjito Yogyakarta, melalui pemeriksaan patologi anatomi, dengan stadium klinis telah ditentukan melalui pemeriksaan CT-Scan, rontgen toraks, USG abdomen dan bone survey. Pasien KNF stadium lanjut dikategorikan sebagai kelompok kasus, sedangkan pasien KNF stadium awal dikategorikan sebagai kelompok kontrol. Nilai platelet dan limfosit diambil dari hasil pemeriksaan darah rutin sebelum dilakukan terapi. Analisis statistik untuk membuktikan hipotesis menggunakan chi square. Hasil: Sampel penelitian berjumlah 50 pasien KNF, masing-masing kelompok terdiri atas 25 sampel. Terdapat hubungan yang bermakna PLR dengan stadium klinis pasien KNF, dengan nilai p = < 0,001 dan Rasio Odd (RO) = 16,625 (interval kepercayaan 95% 4,062 - 68,038). Kesimpulan: Terdapat hubungan yang bermakna antara PLR dengan stadium klinis pada KNF.

Background: Platelets have a role in angiogenesis and hematogenous metastasis of cancer, thus affecting the growth and development of cancer. Meanwhile, the lymphocytes are essential components of the adaptive immune system, and infiltration of lymphocytes show effective anti-tumor cellular immune response. Platelet to lymphocyte ratio (PLR) which is calculated by dividing the peripheral platelets count by lymphocytes, reflecting reverse influence of platelets and lymphocytes in the progression and metastasis of various malignancies. Whereas, its role in nasopharyngeal carcinoma (NPC) remains unclear. Purpose: To determine the association between platelet lymphocyte ratio with clinical staging in NPC. Methods: Research design was case control study. Sample of this research which was taken from medical records, is NPC patients at the Otorhinolaryngology Head and Neck Surgery (ORL-HNS) department dr. Sardjito General Hospital of Yogyakarta. who had undergone anatomic pathology examination and whose clinical staging had been determined by CTscan, thorax plain photo, abdominal USG and bone survey. Late clinical staging was categorized as case group, while early clinical staging was categorized as control group. Platelet and lymphocyte value were taken from routine blood examination before treatment. Statistical analysis to prove the hypothesis were using chi square. Result: Study sample were 50 NPC patient, each group consisted of 25 samples. There was statistically significant association between PLR with clinical staging in NPC, with p = < 0,001 dan Odds Ratio (OR) = 16,625 (95% confidence interval 4,062 - 68,038). Conclusion: There is significant association between PLR with clinical staging in NPC.

Kata Kunci : Karsinoma nasofarings, rasio platelet limfosit, stadium klinis./ Nasopharyngeal carcinoma, platelet lymphocyte ratio, clinical staging.