PERBEDAAN KARAKTERISTIK COMPUTED TOMOGRAPHY TORAKS NON SMALL CELL LUNG CARCINOMA TIPE ADENOCARCINOMA DAN NON ADENOCARCINOMA

SUWANDI, Prof. dr. Arif Faisal Sp.Rad (K), DHSM.; dr. Bambang Purwanto Utomo, Sp.Rad (K), M.Med.Ed

2018 | Tesis-Spesialis | RADIOLOGI

Latar Belakang. Kanker paru-paru adalah penyebab utama kematian terkait kanker di seluruh dunia. Sekitar 80-85% dari semua kanker paru-paru adalah Non Small Cell Lung Carcinoma (NSCLC). Sekitar 50% dari semua kanker paru-paru adalah tipe adenocarcinoma. Tidak semua pasien dapat dilakukan pemeriksaan histopatologi. Tujuan. Mengetahui adanya perbedaan antara karakteristik CT toraks tipe adenocarcinoma dan non adenocarcinoma. Bahan dan Cara. Subyek penelitian berjumlah 42 pasien adenocarcinoma dan 31 pasien non adenocarcinoma, yang telah menjalani pemeriksaan CT toraks dengan kontras dan telah dilakukan pemeriksaan patologi anatomi di RSUP Dr Sardjito. Penelitian bersifat observasional analitik dengan rancangan cross sectional dan pengambilan sampel secara retrospektif. Pengambilan sampel dengan cara consecutive sampling non random. Interpretasi CT toraks oleh seorang dokter spesialis radiologi konsultan toraks RSUP Dr. Sardjito dengan keahlian dibidang pencitraan toraks 18 tahun. Hasil patologi anatomi didapat dari status rekam medis. Dilakukan analisis deskriptif karakteristik dasar subyek penelitian, karakteristik CT scan toraks dengan kontras adenocarcinoma dan non adenocarcinoma dan hasil patologi anatomi. Dilakukan uji komparasi bivariat Chi Square antara karakteristik CT toraks adenocarcinoma dan non adenocarcinoma dengan hasil patologi anatomi. Hasil. Karakteristik CT scan toraks metastasis pleura didapatkan pada adenocarcinoma paru dan non adenocarcinoma paru tetapi signifikan pada non adenocarcinoma (p=0,035). Sedangkan karakteristik ukuran, lokasi, bentuk, tepi, atenuasi, GGO, kalsifikasi, pleural tail, rigler notch, angiogram, infiltrat, cavitas, atelektasis, metastasis nodal, infitrasi, destruksi tulang, metastasis paru, homogenitas, dan air bronchogram tidak signifikan secara statistik (p> 0,05) untuk membedakan adenocarcinoma dan non adenocarcinoma. Kesimpulan. Karakteristik CT scan toraks tidak dapat membedakantipe histopatologi adenocarcinoma paru dan non adenocarcinoma paru. Karakteristik CT scan toraks metastasis pleura cenderung terdapat pada tipe non adenocarcinoma.

Background. Lung cancer is the leading cause of cancer-related deaths worldwide. Approximately 80-85% of all lung cancers are Non Small Cell Lung Carcinoma (NSCLC). About 50% of all lung cancers are adenocarcinoma type. Not all patients can be histopathologically examined. Objective. This study was performed to recognize the differences between Chest CT characteristics of pulmonary adenocarcinoma and non adenocarcinoma types. Materials and methods. The subjects were 42 adenocarcinomas and 31 non adenocarcinomas consecutive patients, who had undergone chest CT contrast examination and had histopathologic examination. The research was analytic observational by cross sectional design and retrospectively sampling. Interpretation of chest CT by a chest radiologist consultant of Dr. Sardjito central hospital with 18 years of experience. Anatomical pathology results obtained from medical record status. Descriptive analysis of the basic characteristics of the study subjects, the contrast enhanced CT scan characteristics of adenocarcinoma and non adenocarcinoma and anatomical pathology results was performed. Bivariate analysis Chi square were performed to compare between the characteristics of chest CT adenocarcinoma and non adenocarcinoma with anatomical pathology results. Results. Characteristic CT scan of pleural metastasis was obtained in pulmonary adenocarcinoma and non-adenocarcinoma but significantly in pulmonary non adenocarcinoma (p = 0.035). While the characteristics of size, location, shape, edge, attenuation, GGO, calcification, pleural tail, rigler notch, angiogram, infiltrate, cavity, atelectasis, nodal metastasis, infitration, bone destruction, pulmonary metastases, homogeneity, and air bronchogram were not statistically significant (p> 0.05) to distinguish pulmonary adenocarcinoma and non adenocarcinoma. Conclusion. Chest CT scan characteristics can not distinguish the histopathologic type of pulmonary adenocarcinoma and non-adenocarcinoma. Characteristics of CT scan of pleural metastasis tends to be present in non adenocarcinoma type.

Kata Kunci : NSCLC, adenocarcinoma, karakteristik CT toraks, NSCLC, adenocarcinoma, chest CT characteristics.