VALIDITAS GAMBARAN CT SCAN DAN ENDOSKOPI BERDASARKAN SKOR OBYEKTIF ABNORMALITAS NASOFARING UNTUK EVALUASI RESPONS PADA TUMOR PRIMER KARSINOMA NASOFARINGS PASCATERAPI

DEWI YULIANTI, dr. Bambang Hariwiyanto, Sp.T.H.T.K.L(K)., FICS ; Dr. dr. Sagung Rai Indrasari, M.Kes., Sp.T.H.T.K.L(K)., FICS

2021 | Tesis-Spesialis | ILMU KESEHATAN TELINGA HIDUNG TENGGOROK BEDAH KEPALA DAN LEHER

Latar Belakang: Karsinoma nasofarings (KNF) merupakan suatu keganasan epitelial kepala leher yang sering terjadi di Indonesia. KNF bersifat radiosensitif, sehingga menjadi modalitas terapi utama. Evaluasi pascaterapi menjadi hal penting untuk menilai prognosis, dan biopsi merupakan baku emas untuk mengetahui hasil terapi. CT scan termasuk modalitas radiologi pilihan pada kebanyakan rumah sakit. Endoskopi merupakan pemeriksaan rutin yang dilakukan pascaterapi KNF yang dapat digunakan sebagai panduan dalam melakukan biopsi. Endoskopi nasofaring berdasarkan skor obyektif abnormalitas nasofaring memiliki sensitivitas dan spesifitas yang baik dalam memprediksi kemungkinan keganasan nasofarings. Tujuan: Mendapatkan validitas gambaran CT scan dan endoskopi berdasarkan skor obyektif abnormalitas nasofaring untuk evaluasi respons pada tumor primer karsinoma nasofarings pascaterapi. Metode: Penelitian ini dengan rancang potong lintang pada semua pasien KNF pascaterapi yang akan dilakukan evaluasi respons di Poli THT-KL RSUP Dr. Sardjito sebanyak 35 subyek penelitian selama periode November 2020- Agustus 2021 yang dilakukan secara berurutan. Dilakukan pemeriksaan CT scan dilanjutkan pemeriksaan endoskopi menggunakan skor obyektif abnormalitas nasofaring. Biopsi nasofaring dengan tuntunan endoskopi dan hasil biopsi dilakukan pemeriksaan histopatologi. Hasil: Dari 35 subyek penelitian didapatkan hasil penghitungan validitas gambaran CT scan dan endoskopi berdasarkan skor obyektif abnormalitas nasofaring terhadap biopsi kanker nasofaring pascaterapi meliputi: sensitivitas (75.0%), spesifisitas (93.5%), nilai duga positif (60.0%), nilai duga negatif (96.7%), rasio kemungkinan positif (11.63), rasio kemungkinan negatif (0.27), dan akurasi (91.43%). Kesimpulan: Gambaran CT scan dan endoskopi berdasarkan skor obyektif abnormlitas nasofaring valid untuk evaluasi respons pada tumor primer karsinoma nasofarings pascaterapi.

Background: Nasopharyngeal carcinoma (NPC) is a head and neck epithelial malignancy that often occurs in Indonesia. NPC is radiosensitive 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. CT scan is chosen in most hospitals as a radiological modality for NPC. Endoscopy is a routine examination post treatment which can be used as a guide in performing a biopsy. Endoscopic based on objective score of nasopharyngeal abnormality has good sensitivity and specificity to predict the likelihood of nasopharyngeal malignancy. Objective: This study aimed to get the validity of CT scan imaging and endoscopic based on objective score of nasopharyngeal abnormality for response evaluation in primary tumor of nasopharyngeal carcinoma post therapy. Method: This study was a cross sectional design for all post treatment NPC patients who will be conducted a response evaluation at the ENT-HNS Clinic Dr. Sardjito as many as 35 subjects during November 2020- August 2021 period that conducted sequentially. CT scan was performed and followed by an endoscopic examination using an objective score of nasopharyngeal abnormality. Nasopharyngeal biopsy was carried out with endoscopic guidance and the results of biopsy were performed histopathological examination. Result: From the 35 subjects of this study found the results CT scan imaging and endoscopic based on objective score of nasopharyngeal abnormality validity on nasopharyngeal cancer biopsy after treatment included: sensitivity (75.0%), specificity (93.5%), positive predictive value (60.0%), negative predictive value (96.7%), positive likelihood ratio (11.63), negative likelihood ratio (0.27), and accuracy (91.43%). Conclusion: CT scan imaging and endoscopic based on objective score of nasopharyngeal abnormality is valid for response evaluation in primary tumor of nasopharyngeal carcinoma post therapy.

Kata Kunci : Validitas, CT scan, skor obyektif endoskopi nasofaring, karsinoma nasofarings pascaterapi, evaluasi respons