KARAKTERISTIK KLINIKOPATOLOGIK HIPERPLASIA PROSTAT JINAK DAN ADENOKARSINOMA PROSTAT DI RSUP DR. SARDJITO YOGYAKARTA

GEDE RADITYA WISNU WARDHANA, dr. Hanggoro Tri Rinonce, Sp.PA, Ph.D; dr. Sakti R. Brodjonegoro, Sp.U

2018 | Skripsi | S1 KEDOKTERAN

Latar Belakang: Lesi pada prostat merupakan salah satu lesi yang paling umum dijumpai pada pria. Ada 2 lesi prostat yang banyak dijumpai, yaitu hiperplasia prostat jinak (HPJ) dan adenokarsinoma prostat. HPJ merupakan lesi yang tersering dijumpai, terutama pada pasien lanjut usia. Adenokarsinoma prostat merupakan keganasan terbanyak keempat di dunia dan keganasan terbanyak kedua pada pria. Berdasarkan data riset kesehatan dasar 2013, prevalensi kanker prostat di Indonesia mencapai 0,02%, dengan Yogyakarta termasuk salah satu provinsi dengan prevalensi tertinggi. Namun, data klinikopatologik lesi-lesi prostat di Yogyakarta masih sangat terbatas. Tujuan: Mengetahui profil klinik dan patologik HPJ dan adenokarsinoma prostat di RSUP Dr. Sardjito Yogyakarta. Metode: Penelitian ini merupakan penelitian deskriptif retrospektif dengan menggunakan data sekunder dari rekam medik pasien dengan HPJ dan adenokarsinoma prostat. Data klinik dan patologik pasien dalam kurun waktu 2014-2015 diambil dari Instalasi Catatan Medik dan Instalasi Patologi Anatomik RSUP Dr. Sardjito Yogyakarta. Hasil: Jumlah kasus pada studi ini sebanyak 137 kasus HPJ dan 33 kasus adenokarsinoma prostat. Hanya 100 kasus HPJ dan 26 kasus yang memiliki catatan nilai PSAt. Kelompok usia yang terdiagnosis HPJ paling banyak pada kelompok usia 60 - 69 tahun (35,77%), sementara adenokarsinoma prostat paling banyak pada kelompok usia 70 - 79 tahun (37,50%). Gejala retensi urin merupakan gejala yang paling sering timbul pada kedua penyakit. Kasus HPJ paling banyak ditemui pada rentang PSAt 4 - 20 ng/ml (57%), sementara adenokarsinoma prostat paling banyak ditemui pada rentang > 100 ng/ml (61,54%). Prostatitis kronis merupakan lesi yang paling sering menyertai HPJ. Penilaian IPSS dilakukan pada 12 kasus HPJ. Sebanyak 8 kasus (66,67%) memiliki kriteria sedang berdasarkan IPSS. Berdasarkan skor Gleason, kelompok derajat, dan risiko rekurensinya, adenokarsinoma prostat paling banyak ditemui dengan skor Gleason 5+5 (30,3%) , kelompok derajat 5 (66,67%), dan risiko rekurensi high (55,56%). Kesimpulan: Pasien HPJ paling banyak memiliki kelompok usia 60 - 69 tahun dan adenokarsinoma paling banyak memiliki kelompok 70 - 79 tahun. Retensi urin merupakan gejala yang paling umum. Hasil kadar PSAt pasien banyak yang meningkat. HPJ umumnya memiliki lesi penyerta dengan prostatis kronis. Adenokarsinoma prostat paling banyak memiliki skor Gleason 5+5 dan kelompok derajat 5, dan risiko rekurensi high.

Background: Prostatic lesions are one of lesions commonly found in men. There are 2 commonly found prostatic lesions, which are benign prostatic hyperplasia (BPH) and prostate adenocarcinoma. BPH is the most common lesion, especially in elderly. Prostate adenocarcinoma is the fourth most common malignancy in the world and the second most common malignancy in men. Based on basic health research data in 2013, the prevalence of prostate cancer in Indonesia was 0,02%, with Yogyakarta as one of the provinces with highest prevalence. However, clinicopathological data of prostatic lesions in Yogyakarta is very limited. Aim: To know clinical and pathological profile of BPH and prostate adenocarcinoma in RSUP Dr. Sardjito Yogyakarta. Method: This study is a descriptive retrospective study with secondary data from medical record of patient with BPH and prostate adenocarcinoma. Clinical and pathological data from 2014 – 2015 were obtained from Medical Record Department and Anatomical Pathology Department at Dr. Sardjito Hospital. Results: The number of cases in this study were 137 cases of BPH and 33 cases of prostate adenocarcinoma. Only 100 cases of BPH and 26 cases of prostate adenocarcinoma had a PSAt record. The age group diagnosed with HPJ was highest in the 60 - 69 years olds (35,77%), while prostate adenocarcinoma prostate was highest in 70 - 79 years olds (37,50%). Urinary retention was the most common symptom appeared in both diseases. PSAt of BPH was commonly found in a range of 4 - 20 ng/ml (57%), while prostate adenocarcinoma was most commonly found in a range of > 100 ng/ml (61,54%). Chronic prostatitis was the most common lesion found accompanying BPH. The measurement of IPSS was done in 8 BPH cases. A total of 8 cases (66,67%) had moderate symptoms according to IPSS. Based on Gleason score, grade group and recurrence risk, prostate adenocarcinoma was commonly found Gleason 5+5 (30,3%), grade group 5 (66,67%), and high risk (55,56%). Conclusion: BPH patients mostly belong to the age group 60 - 69 years old and adenocarcinoma patients mostly belong to the age group 70 - 79 years old. Urine retention is the most common symptom. Most patients had increased PSAt results. BPH patients commonly had accompanying lesions of chronic prostatitis. Prostate adenocarcinoma mostly had a Gleason score of 5+5, grade of 5, and high recurrence risk.

Kata Kunci : Kata kunci: prostat, hiperplasia prostat jinak, adenokarsinoma, Yogyakarta, Indonesia