PERBEDAAN KADAR TSH ANTARA KARSINOMA TIROID TERDIFERENSIASI DAN PEMBESARAN TIROID JINAK

ANTON SONY WIBOWO, Dr.dr.Camelia Herdini, Sp.T.H.T.K.L., M.Kes.,FICS;Dr.dr.Bambang Udji Djoko Rianto,Sp.T.H.T.K.L.(K).,M.Kes

2018 | Tesis-Spesialis | SP ILMU PENYAKIT THT

Latar belakang: Karsinoma tiroid terdiferensiasi (Karsinoma papiler dan karsinoma folikuler tiroid) adalah keganasan kepala leher yang sering terjadi. Kanker ini masih mengekspresikan reseptor TSH dan peka terhadap TSH. TSH bersifat sebagai stimulus pertumbuhan kanker. Kadar TSH memiliki nilai diagnosis dan dapat membantu dalam pencegahan, diagnosis dan tatalaksana karsinoma tiroid. Tujuan: Penelitian ini bertujuan untuk mengetahui perbedaan kadar TSH antara karsinoma tiroid terdiferensiasi dan pembesaran tiroid jinak. Metode Penelitian : Penelitian ini adalah case control study (studi kasus-kontrol). Sampel penelitian adalah penderita pembesaran tiroid yang menjalani operasi tiroidektomi di RSUP. Dr. Sardjito Yogyakarta tahun 2015-2016 dan dilakukan pemeriksaan histopatologi. Kadar TSH diambil dari pemeriksaan darah sebelum dilakukan operasi tiroidektomi. Perbedaan kadar TSH dianalisis pada masing-masing kelompok dan antar kelompok penelitian. Hasil: Sampel penelitian berjumlah 50 pasien yang menjalani tiroidektomi, masing-masing kelompok terdiri dari 25 pasien. Terdapat perbedaan yang bermakna kadar TSH antara karsinoma tiroid terdiferensiasi dengan pembesaran tiroid jinak dengan nilai p = 0,001 dan Rasio Odds (RO) 11,15 (IK 95% 2,86-43,46) (kadar TSH<1 mIU/L dibandingkan >/=1 mIU/L). Hasil analisis regresi logistik didapatkan hasil p =0,036 pada variabel kadar TSH dan p = 0,001 pada variabel Free T4. Disamping itu, didapatkan juga perbedaan yang signifikan rerata kadar TSH antara karsinoma tiroid terdiferensiasi stadium awal (stadium I/II) dan stadium lanjut (stadium III/IV) (p = 0,048). Kesimpulan: Terdapat perbedaan yang bermakna kadar TSH antara karsinoma tiroid terdiferensiasi dan pembesaran tiroid jinak

Background: Differentiated thyroid carcinomas (Papilary and follicular carcinoma thyroid carcinoma) are common head and neck cancer. This cancer still express TSH receptor and influented by TSH. Thyroid Stimulating Hormorne has been cancer stimulus substance. This hormone has a diagnostic value. Levels of TSH has rules on preventing, diagnosing, and managing thyroid carcinoma. Objective: The objectice of our study is determining the difference TSH levels between differentiated thyroid carcinoma and benign thyroid enlargement. Methods: This case-control study recruited subjects who underwent thyroidectomies for his/her thyroid enlargement at Dr Sardjito general hospital, Yogyakarta, between 2015-2016. Histopatological examination, which determined the histopatology characteristic, from pathology department had been reported on medical record. TSH levels had been taken before the thyroidectomies. The TSH levels and histopatology will be analyzed among and between groups. Result: Study sample were 50 patients post thyroidectomy , each group consisted of 25 patients. There was statistically significant difference TSH level between differentiated thyroid carcinoma and benign thyroid enlargement with p = 0,00 and Odds Ratio (OR) 11,15 (CI 95% 2,86-43,46) (TSH level<1mIU/L compared to >/=1 mIU/L). The result of Logistic Regression Analysis is p =0,036 for TSH variable and p = 0,001 for Free T4. It was also found statistically significant difference mean TSH level between early stage differentiated thyroid carcinoma (stage I/II) and late stage (III/IV) (p = 0,048). Conclusion: There is significant difference TSH level between differentiated thyroid carcinoma and benign thyroid enlargement.

Kata Kunci : pembesaran tiroid, karsinoma tiroid terdiferensiasi, thyroid stimulating hormone (TSH), tiroidektomi, histopatologi