Peran Neutrophil to Lymphocyte Ratio (NLR) sebagai Prognostik Kematian pada Kanker Ovarium

Roy Kristian Prasetya, dr. E.Henny Herningtyas, M.Si, Ph.D, SpPK(K.; Dr. dr. Usi Sukorini, M.Kes., SpPK(K)

2025 | Tesis | S2 Kedokteran Klinik

Latar Belakang: Kanker ovarium merupakan keganasan ginekologi dengan angka kematian tinggi. Inflamasi kronis berkontribusi terhadap perkembangan kanker ovarium. Penanda inflamasi kronis yang dapat digunakan yaitu Neutrophil to Lymphocyte Ratio (NLR). Parameter NLR sebagai penanda inflamasi yang mudah dan murah. Peran NLR pada kanker ovarium masih belum banyak diteliti.

Tujuan: Mengevaluasi peranan Neutrophil to Lymphocyte Ratio (NLR) 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 NLR ?3,24 dan nilai NLR <3>

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 NLR ?3,24 (40,6%) dan NLR <3 xss=removed>

Simpulan: Pasien kanker ovarium dengan NLR praoperasi ?3,24 memiliki prognosis kematian 2,4 kali lipat dalam 3 tahun pasca operasi, namun NLR 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 Neutrophil to Lymphocyte Ratio (NLR) serves as a simple and cost-effective marker of inflammation. Research on the role of NLR in ovarian cancer remains limited.

Objective: To evaluate the role of preoperative NLR as a prognostic factor for mortality in ovarian cancer patients during a 3-year postoperative monitoring period. 

Method: : 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 subjects were divided into two groups: those with NLR ?3.24 and those with NLR <3>

Results: The study included 93 patients, with 61 survivors and 32 deceased. Among the deceased, 29.3% were ?60 years old, while 55.6% were >60 years. Cancer staging distribution: stage I (8.8%), stage II (25%), stage III (50%), and stage IV (66.7%). Tumor characteristics: T1 (10.8%), T2 (37.5%), and T3 (55%). Lymph node involvement: N0 (22%) and N1 (55.9%). Distant metastasis: M0 (27.3%) and M1 (68.8%). The most common histopathological type was high-grade serous carcinoma (62.1%). Among the deceased, 40.6% had NLR ?3.24, while 16.7% had NLR <3 xss=removed>

Conclusion: Ovarian cancer patients with preoperative NLR ?3.24 have a 2.4-fold higher 3-year mortality prognosis after surgery, but NLR is not an independent prognostic factor due to tumor progression type.

Kata Kunci : Neutrophil to Lymphocyte Ratio (NLR), kanker ovarium, kematian