KORELASI UKURAN DAN JUMLAH NODUL DENGAN KADAR SERUM ALBUMIN PADA KARSINOMA HEPATOSELULER

PANJI DWI UTOMO, Dr.dr.Lina Choridah, Sp.Rad(K).; dr. Bambang Purwanto Utomo, Sp.Rad(K), M.Med,Ed

2019 | Tesis-Spesialis | RADIOLOGI

Latar Belakang. Karsinoma hepatoseluler (KHS) adalah tumor paling sering pada tumor hepar primer, terhitung sekitar 85-90% dari seluruh keganasan hepar primer. Insidensi KHS di seluruh dunia semakin bertambah, menjadi tumor paling sering kelima di dunia. Kadar albumin serum telah terbukti memiliki signifikansi prognostik pada KHS. Korelasi ukuran dan jumlah nodul dengan kadar serum albumin pada KHS masih kontroversi, namun beberapa penelitian telah membuktikan bahwa ada keterkaitan yang sangat erat antara kadar serum albumin dan peningkatan ukuran dan persentase multifokalitas nodul pada KHS Tujuan. Mengetahui adanya korelasi antara ukuran dan jumlah nodul dengan kadar serum albumin pada pasien KHS. Bahan dan Metode. Subyek penelitian terdiri dari 52 citra multislice computed tomography scanning (MSCT scan) abdomen 4 fase mulai Juni 2016-Februari 2018 di RSUP Dr. Sardjito Yogyakarta. Interpretasi dilakukan pada citra CT scan abdomen 4 fase yang didiagnosis dengan KHS, telah dibuktikan dengan pemeriksaan histopatologi disertai pemeriksaan kadar serum albumin. Dilakukan uji korelasi dengan Spearman antara ukuran nodul dengan kadar serum albumin dan antara jumlah nodul dengan kadar serum albumin. Jumlah nodul dikelompokan dalam tiga kategori yakni 1 nodul, 2-3 nodul, dan > 3 nodul. Untuk kadar serum albumin juga dikelompokan dalam tiga kategori yakni < 3,5 g/dL, 3,5-5 g/dL, dan >5g/dL. Hasil. Dari 52 subyek penelitian didapatkan 40 (76,9%) laki-laki dan 12 (23,1%) perempuan dengan rerata usia 56,17 tahun mulai dari usia 22 tahun hingga 83 tahun. Etiologi paling sering adalah infeksi virus hepatitis B yaitu 25 (48,1%), HCV 14 (26,9%) dan lain-lain 13 (25%). Kadar serum albumin terbanyak 29 (55,8%) < 3,5 g/dL. Tidak ada subyek yang masuk dalam ukuran < 2 cm, 1 (1,9%) berukuran 2-5 cm, dan 51 (98,1%) berukuran > 5 cm. Terdapat 22 (42,3%) soliter, 6 (11,5%) memiliki 2-3 nodul, dan 24 (46,2%) > 3 nodul. Kesimpulan. Tidak terdapat korelasi yang bermakna secara statistik antara ukuran nodul dengan kadar serum albumin pada KHS (p = 0,378), serta tidak terdapat korelasi yang bermakna secara statistik antara jumlah nodul dengan kadar serum albumin pada KHS (p = 0,251).

Background: Hepatocellular carcinoma (HCC) is the most common primary tumor, approximately 85-90% of all primary liver malignancies. The incidence of HCC is increasing, becoming the fifth most frequent tumor in the world. Diagnosis of HCC is usually with imaging modalities, biopsy or tumor markers of Alfa Fetoprotein (AFP). Serum albumin levels have been shown to have prognostic significance in HCC. The correlation of the size and number of nodules with serum albumin levels in HCC is still controversial, but several studies have proven that there is a very close relationship between serum albumin levels and an increase in the size and percentage of multifocality of nodules in HCC. Objective: Determine the correlation between size and number of nodules with serum albumin levels in KHS patients. Material and Methods: The research subjects consisted of 52 multislice computed tomography scanning (MSCT) 4-phase abdominal images from June 2016-February 2018 at Dr. Sardjito general hospital, Yogyakarta. Yogyakarta. Interpretation is performed on 4-phase abdominal CT scan images diagnosed with HCC, has been proven by histopathological examination and accompanied by examination of serum albumin levels. Spearman correlation test was performed between the size of the nodules with serum albumin levels and between the number of nodules with serum albumin levels. The number of nodules is grouped into three categories into 1 nodule, 2-3 nodules, and> 3 nodules. For serum albumin levels are also grouped into three categories into <3.5 g / dL, 3.5-5 g / dL, and> 5g / dL. Results: 52 study subjects found 40 (76.9%) men and 12 (23.1%) women with an average age of 56.17 years ranging from ages 22 years to 83 years. The most frequent etiologies were hepatitis B virus infection, 25 (48.1%), HCV 14 (26.9%) and 13 others (25%). The highest serum albumin level was 29 (55.8%) <3.5 g / dL. There were no subjects included in sizes <2 cm, 1 (1.9%) measuring 2-5 cm, and 51 (98.1%) measuring> 5 cm. There were 22 (42.3%) solitary, 6 (11.5%) had 2-3 nodules, and 24 (46.2%)> 3 nodules.

Kata Kunci : Kadar serum albumin, Karsinoma Hepatoseluler, ukuran nodul, jumlah nodul hepar.