Uji Diagnostik Sitologi Imprint Dan Frozen Section Intraoperatif Pada Tumor Ovarium

NORMAN AJI TRIANTORO, Prof. Dr. dr. Heru Pradjatmo, Sp. OG. Subsp. Onk, M.Kes.; Dr.dr. Nuring Pangastuti, Sp. OG. Subsp. Urogin RE

2023 | Tesis-Spesialis | OBSTETRI DAN GINEKOLOGI

Latar Belakang: Kanker ovarium menjadi penyebab utama kematian akibat kanker ginekologi pada wanita di seluruh dunia. Diagnosis intraoperatif yang benar sangatlah penting. Sitologi imprint adalah salah satu metode pemeriksaan yang murah dan cepat. Penerapan sitologi imprint sangat berguna dimana fasilitas frozen section tidak tersedia. Tujuan: Mengetahui nilai diagnostik (sensitivitas dan spesifisitas) sitologi imprint dan frozen section dalam mendiagnosa tumor ovarium. Metode: Penelitian Cross Sectional Study dan bersifat deskriptif pada wanita dengan tumor ovarium yang dilakukan pemeriksaan intraoperatif sitologi imprint dan frozen section serta pemeriksaan histopatologi blok parafin pasca bedah. Dilakukan uji diagnostik dengan skala dikotom jinak dan ganas untuk menentukan sensitivitas, spesifisitas, nilai prediksi positif, dan nilai prediksi negatif. Hasil: Dibandingkan dengan sitologi imprint, frozen section memiliki kekuatan yang tinggi terhadap histopatologi tumor ovarium, dengan sensitivitas (97,14% dan 87,14%), spesifisitas (97,56% dan 97,56%), nilai prediksi positif (98,55% dan 98,38%) dan nilai prediksi negatif (95,23% dan 81,63%) serta akurasi (97,29% dan 90,99%). Meskipun frozen section memiliki sensitivitas dan spesifisitas yang lebih baik dibanding sitologi imprint, tingkat akurasi dari sitologi imprint cukup memuaskan dengan 90% kasus berkorelasi dengan diagnosis akhir (p=0,000). Kesimpulan: Sitologi imprint dapat digunakan sebagai alternatif pemeriksaan intraoperatif tumor ovarium pada rumah sakit yang belum memiliki fasilitas frozen section.

Background: Ovarian cancer is the leading cause of death from gynecological cancer in women around the world. Correct intraoperative diagnosis is very important. Imprint cytology is one of the cheap and fast methods of examination. The application of imprint cytology is very useful where frozen section facilities are not available. Purpose: The purpose is to determine the diagnostic value (sensitivity and specificity) of imprint cytology and frozen section in diagnosing ovarian tumors. Method: Descriptive Cross Sectional Study in women with ovarian tumors who underwent intraoperative cytologic imprint and frozen section examinations and histopathological examination of postoperative paraffin blocks. Diagnostic tests were carried out with benign and malignant dichotomous scales to determine sensitivity, specificity, positive prediction value, and negative prediction value. Results: : The intraoperative diagnostic value of frozen section is better than that of imprint cytology for ovarian tumors. Compared with imprint cytology, frozen section has high strength for ovarian tumor histopathology, with sensitivity (97.14% and 87.14%), specificity (97.56% and 97.56%), positive predictive value (98.55% and 98.38%) and negative predictive value (95.23% and 81.63%) and accuracy (97.29% and 90.99%). Although frozen section had better sensitivity and specificity than imprint cytology, the diagnostic accuracy of imprint cytology has been satisfactory, with those of 90% of the cases correlating with the final diagnoses (p=0,000). Conclusion: Imprint cytology can be used as an alternative for intraoperative examination of ovarian tumors in hospitals that do not yet have frozen section facilities.

Kata Kunci : tumor ovarium, sitologi imprint, ovarian tumor, frozen section, imprint cytology