HUBUNGAN TROMBUS VENA PORTA PADA KARSINOMA HEPATOSELULER DENGAN NILAI INTERNATIONAL NORMALIZED RATIO ( INR)

IKA SAFITRI, Dr. dr. Bagaswoto Poedjomartono, Sp.Rad(K)RI, Sp.KN, MKes, FICA.; dr. Wigati Dhamiyati, Sp.Rad (K)Onk)

2020 | Tesis | MAGISTER ILMU KEDOKTERAN KLINIS

Latar belakang:Karsinoma hepatoseluler adalah penyakit keganasan yang sering, dan merupakan kanker tersering ketiga penyebab kematian di dunia. Adanya trombus vena porta pada karsinoma hepatoseluler berhubungan dengan penurunan survival rate pada pasien, sehingga memepengaruhi prognosis pasien. Pada pasien dengan trombus vena porta didapatkan nilai INR yang tinggi. Maka perlu dilakukan penelitian mengenai hubungan trombus vena porta dengan nilai INR. Tujuan penelitian: Mengetahui hubungan antara tumor trombus vena porta pada karsinoma hepatoseluler dengan nilai INR. Bahan dan Cara: Penelitian ini adalah studi observasional analitik uji korelasi cross-sectional dengan subjek retrospektif dengan non random consecutive sampling. Penelitian dilakukan di RSUP Dr. Sardjito Yogyakarta dengan sampel penelitian CT scan abdomen dari bulan Januari 2017 - Januari 2020. Subjek penelitian adalah pasien dengan karsinoma hepatoseluler yang telah menjalani pemeriksaan CT scan abdomen 4 fase baik yang disertai trombus vena porta maupun tidak. Dilakukan analisis dengan uji Mann Whitney untuk mengetahui hubungan antara tumor trombus vena porta pada karsinoma hepatoseluler dengan nilai INR. Penilaian ada/tidaknya trombus vena porta dilakukan pada fase vena CT Scan abdomen dengan kontras. Nilai INR didapatkan dari hasil laboratorium di Instalasi Patologi Klinik RSUP Dr.Sardjito Yogyakarta. Hasil: Didapatkan 63 subjek, 77,8 % laki-laki dan 22,2 % perempuan. Rentang usia dari 22 hingga 79 tahun.Didapatkan trombus vena porta pada 34 subyek (54 %) dan tanpa trombus pada 29 subyek (46%), diidapatkan hasil pasien karsinoma hepatoseluler tanpa trombus mean INR = 1,17 dan yang disertai trombus mean INR =1,38, dengan p = 0,039. Jadi Rerata INR pada trombus 1,38 lebih tinggi dibandingkan non trombus 1,17. Kesimpulan: Didapatkan hasil hubungan yang bermakna secara statistik antara trombus vena porta pada karsinoma hepatoseluler dengan nilai INR, dengan p= 0,039

Background: Hepatocellular carcinoma is a common malignancy, and is the third most common cancer cause of death in the world. The presence of portal venous thrombus in hepatocellular carcinoma is associated with a decrease in the patients survival rate, thereby affecting the patients prognosis. Patients with portal vein thrombus have a high INR value. So it is necessary to do research on the relationship of portal vein thrombus in hapatocellular carcinoma with INR values . Objective: To determine the relationship of portal vein thrombus in hepatocellular carcinoma with INR values . Materials and Methods: This study was an observational analytic cross-sectional correlation test with a retrospective subject with non-random consecutive sampling. The study was conducted at the Dr. Sardjito Yogyakarta with a sample of studies from January 2017 - January 2020. Subjects were patients with hepatocellular carcinoma who had undergone 4-phase abdominal CT scan, either accompanied by portal vein thrombus or not. Analyzes were performed using the Mann Witney test to determine the relationship between portal vein thrombus with INR values. Assessment of the presence/absence of portal venous thrombus was carried out in the venous phase abdominal CT scan. The INR value was obtained from laboratory results at the Clinical Pathology Installation of Dr.Sardjito Hospital Yogyakarta. Results: 63 subjects were found, 77,8 % were male and 22,2 % were female. Age ranges from 22 to 79 years. There was portal venous thrombus in 34 subjects (54%) and without thrombus in 29 subjects (46%). The result werw patients with hepatocelullar carcinoma without thrombus mean INR = 1,17 and those with thrombus mean INR = 1,38, with p = 0.039. So the mean INR in thrombus 1,38 was higher than in non thrombus mean INR =1,17. Conclusion: The results show that there is a significant relationship between portal vein thrombus in hepatocellular carcinoma with INR values, with p= 0,039..

Kata Kunci : karsinoma hepatoseluler, tumor trombus vena porta, International Normalized Ratio (INR), hepatocellular carcinoma, portal venous thrombus tumor