Peran Platelet to Lymphocyte Ratio (PLR) Sebagai Prognostik Kematian pada Kanker Ovarium

Roy Kristian Prasetya, dr.E.Henny Herningtyas, M.Si, Ph.D, Sp.PK, Subsp. Onk.K (K), Subsp.E.M.(K).; Dr. dr. Usi Sukorini, M.Kes, Sp.PK, Subsp.H.K. (K), Subsp.B.D.K.T. (K)

2025 | Tesis-Spesialis | S2 Ilmu Patologi Klinik

Latar Belakang: Kanker ovarium merupakan keganasan ginekologi dengan angka kematian yang tinggi. Inflamasi kronis memiliki kontribusi terhadap perkembangan kanker ovarium. Penanda inflamasi kronis yang dapat digunakan yaitu Platelet to Lymphocyte Ratio (PLR). Parameter PLR menjadi penanda inflamasi yang mudah dan murah. Platelet to Lymphocyte Ratio (PLR) pada kanker ovarium masih belum banyak diteliti.

Tujuan: Mengevaluasi peranan Platelet to Lymphocyte Ratio (PLR) praoperasi sebagai prognostik kematian pada pasien kanker ovarium dalam pemantauan 3 tahun pasca operasi.

Metode: Penelitian kohort retrospektif menggunakan data sekunder pasien terdiagnosis kanker ovarium epithelial berdasarkan histopatologi yang dioperasi pertama kali tahun 2019-2020 di RSUP Dr. Sardjito. Pemantauan dilakukan selama 3 tahun. Subjek dibagi kelompok nilai PLR ?200 dan nilai PLR <200>

Hasil: Didapatkan 93 subjek penelitian terdiri dari kelompok hidup 61 subjek dan meninggal 32 subjek. Kelompok meninggal terdiri dari proporsi usia ?60 tahun (29,3%) dan usia >60 tahun (55,6%). Proporsi stadium I (8,8%), stadium II (25%), stadium III (50%), dan stadium IV (66,7%). Ukuran tumor T1 (10,8%), T2 (37,5%), dan T3 (55%). Keterlibatan limfonodi N0 (22%) dan N1 (55,9%). Metastasis jauh M0 (27,3%) dan M1 (68,8%). Tipe progresivitas tipe I (21,9%) dan tipe II (62,1%). Diferensiasi histopatologi terbanyak pada high grade serous carcinoma (62,1%). Kelompok meninggal dengan PLR ?200 (41,8%) dan NLR <200 xss=removed>

Simpulan: Pasien kanker ovarium dengan PLR praoperasi ?200 memiliki prognosis kematian 2,7 kali lipat dalam 3 tahun pasca operasi tetapi PLR bukan faktor independen karena dipengaruhi tipe progresivitas.

Background: Ovarian cancer is a gynecological malignancy with a high mortality rate. Chronic inflammation contributes to the development of ovarian cancer. The Platelet to Lymphocyte Ratio (PLR) serves as a simple and cost-effective marker of inflammation. Research on the role of PLR in ovarian cancer remains limited. 

Objective: To evaluate the role of preoperative PLR as a prognostic factor for mortality in ovarian cancer patients over a 3-year postoperative monitoring period. Methods: A retrospective cohort study was conducted using secondary data from epithelial ovarian cancer patients based on histopathology who underwent their first surgery at Dr. Sardjito General Hospital (2019-2020). The patients were categorized into two groups based on PLR values: PLR ?200 and PLR <200>

Results: The study included 93 patients, with 61 survivors and 32 deceased. Among deceased patients, 29.3% were aged ?60 years, while 55.6% were >60 years. Cancer staging distribution included stage I (8.8%), stage II (25%), stage III (50%), and stage IV (66.7%). Tumor characteristics included T1 (10.8%), T2 (37.5%), and T3 (55%). Lymph node involvement was N0 (22%) and N1 (55.9%), while distant metastasis was M0 (27.3%) and M1 (68.8%). High-grade serous carcinoma was the most common histopathological type (62.1%). Among deceased patients, 41.8% had PLR ?200. A preoperative PLR ?200 had a hazard ratio (HR) of 2.7 (95% CI: 1.1 – 6.9; p = 0.024) during the 3-year postoperative follow-up.

Conclusion: Ovarian cancer patients with preoperative PLR ?200 have a 2.7-fold increased prognosis of mortality within 3 years after surgery, but PLR is not an independent prognostic factor due to tumor progression type.

Kata Kunci : Platelet to Lymphocyte Ratio (PLR), kanker ovarium, kematian