Validitas Nasoendoskopi Narrow-Band Imaging (NBI) Terhadap Biopsi Karsinoma Nasofaring Pasca Terapi

Veby Novri Yendri, Dr. dr. Camelia Herdini, M.Kes., Sp.T.H.T.K.L(K), FICS ; Dr. dr. Bambang Hariwiyanto, Sp.T.H.T.K.L(K), FICS

2018 | Tesis-Spesialis | ILMU KESEHATAN TELINGA HIDUNG TENGGOROK BEDAH KEPALA DAN LEHER

Latar belakang: Karsinoma nasofaring merupakan keganasan yang paling sering ditemukan pada kepala dan leher, memiliki keunikan karena bersifat radiosensitif sehingga menjadi modalitas terapi utama. Evaluasi pasca terapi menjadi hal penting untuk menilai prognosis, dan biopsi merupakan standar baku untuk mengetahui hasil terapi. Biopsi dapat dilakukan dengan panduan nasoendoskopi narrow-band imaging yang memiliki sinar merah dan biru yang dapat memberikan gambaran vaskularisasi mukosa dan submukosa. Tujuan: Mengetahui validitas nasoendoskopi narrow-band imaging terhadap biopsi karsinoma nasofaring pasca terapi. Metode: Penelitian ini dengan rancang potong lintang pada semua pasien KNF pasca terapi yang akan dilakukan response assessment di Poli THTKL RSUP Dr. Sardjito sebanyak 40 subyek penelitian selama periode Mei-Juni 2018 yang dilakukan secara berurutan. Pemeriksaan biopsi dilakukan dengan panduan nasoendoskopi NBI, dan hasil biopsi dilakukan pemeriksaan histopatologi. Hasil: Dari 40 subyek penelitian ini didapatkan hasil penghitungan validitas nasoendoskopi NBI terhadap biopsi kanker nasofaring pasca terapi meliputi : sensitivitas (85,7%), spesifisitas (87,8%), nilai duga positif (60%), nilai duga negatif (96,6%), rasio kecenderungan positif (7,07), rasio kecenderungan negatif (0,16), dan akurasi (87,5%). Gambaran nasoendoskopi NBI pasca terapi tampak homogen (75%), inhomogen (25%) Kesimpulan: Validitas nasoendoskopi Narrow-Band Imaging terhadap biopsi kanker nasofaring pasca terapi adalah baik (87,5%)

Background: Nasopharyngeal carcinoma is the most common malignancy found in the head and neck. It is a unique head and neck cancer because of its radiosensitivity and it becomes the main modality of therapy. Post-treatment evaluation is important to assess prognosis, and biopsy is the gold standard for evaluating the results of therapy. A biopsy can be performed with a narrow-band imaging nasoendoscopy guide that has red and blue rays that can give an overview of mucosal and submucosal vascularization. Objectives: This study aimed to determine the validity of NBI nasoendoscopic examination of nasopharyngeal carcinoma post-treatment biopsy. Methods: This study was a cross-sectional design for all post-treatment NPC patients who will be conducted a response assessment at the ENT-HNS Clinic Dr. Sardjito as many as 40 subjects during May-June 2018 period that conducted sequentially. Biopsy examination was carried out with nasoendoscopy NBI guidance, and the results of biopsy were performed histopathological examination. Result: From the 40 subjects of this study found the results of the calculation of nasoendoscopic NBI validity on nasopharyngeal cancer biopsy after treatment included : sensitivity (85.7%), specificity (87.8%), positive predictive value (60%), negative predictive value (96.6 %), positive trend ratio (7.07), negative trend ratio (0.16), and accuracy (87.5%). Postoperative NBI nasoendoscopy features appear homogeneous (75%), inhomogenous (25%). Conclusion: Nasoendoscopic validity of Narrow-Band Imaging on postoperative nasopharyngeal cancer biopsy is good (87.5%)

Kata Kunci : Validitas, nasoendoskopi, narrow-band imaging, karsinoma nasofaring pasca terapi, respon terapi