Hubungan Sistem Skor ACR-TIRADS Pada Ultrasonografi dan Bethesda pada FNAB terhadap Hasil Histopatologi Pascaoperatif pada Nodul Tiroid di RSUP dr Sardjito

Lukluk Purbaningrum, Prof. Dr. dr. Teguh Aryandono, Sp.B, Subsp.Onk(K), Dr. dr. R. Artanto Wahyono, Sp.B, Subsp.Onk(K)

2024 | Tesis-Spesialis | S2 Ilmu Bedah

Latar Belakang: Kanker tiroid dengan 3.3% kasus dan 0.95% kematian menempati urutan ke 12 kanker paling banyak di Indonesia pada tahun 2020. Deteksi dan intervensi kanker lebih awal menurunkan mortalitas dan morbiditas dengan ultrasonografi dan ultrasound-guided fine needle aspiration biopsy.

Tujuan: Mengetahui hubungan sistem skor ACR-TIRADS terhadap hasil histopatologi pascaoperatif, hubungan sistem skor Bethesda terhadap hasil histopatologi pascaoperatif, hubungan sistem skor ACR-TIRADS terhadap skor Bethesda, hubungan sistem skor ACR-TIRADS dan Bethesda terhadap hasil histopatologi pascaoperatif. Mengetahui sensitifitas, spesifisitas, NPV, PPV dan tes akurasi ACR-TIRADS terhadap histopatologi pascaoperatif, skor Bethesda terhadap histopatologi pascaoperatif, ACR-TIRADS dan Bethesda terhadap histopatologi pascaoperatif pada nodul tiroid

Metode: Penelitian analitik dengan cross-sectional untuk mengetahui hubungan antara sistem skor ACR-TIRADS dan Bethesda terhadap histopatologi pascaoperatif pada nodul tiroid di RSUP DR Sardjito dari Januari 2018 sampai 31 Desember 2023. Penelitian ini menggunakan SPSS ststistik 25.0 dengan analisis uji chi-square dan uji diagnostik untuk mendapatkan sensitifitas, spesifisitas, NPV, PPV dan tes akurasi

Hasil: Hubungan sistem skor ACR-TIRADS terhadap hasil histopatologi, skor Bethesda terhadap histopatologi, skor ACR-TIRADS terhadap Bethesda, skor ACR-TIRADS dan Bethesda terhadap histopatologi pascaoperatif pada nodul tiroid di RSUP dr. Sardjito dengan nilai p=0.00. Sensitifitas, spesifisitas, NPV, PPV dan tes akurasi ACR-TIRADS terhadap hasil histopatologi pascaoperatif sebesar 93.51%, 17.48%, 37.89%, 86.21%, dan 44.09%. Sensitifitas, spesifisitas, NPV, PPV dan tes akurasi skor Bethesda terhadap histopatologi pascaoperatif sebesar 73,08%, 73.73%, 83.20 %, 59.38%, dan 72.85%. Sensitifitas, spesifisitas, NPV, PPV, tes akurasi ACR-TIRADS dan Bethesda terhadap histopatologi pascaoperatif sebesar 98.18%, 36.54%, 95%, 62.07%, dan 68.22%.

Simpulan: Terdapat hubungan skor ACR-TIRADS terhadap histopatologi pascaoperatif, skor Bethesda terhadap histopatologi pascaoperatif, skor ACR-TIRADS terhadap skor Bethesda, skor ACR-TIRADS dan Bethesda terhadap histopatologi pascaoperatif. Sensitifitas ACR-TIRADS dan Bethesda terhadap histopatologi paling tinggi dibandingkan ACR-TIRADS saja dan Bethesda saja. Spesifisitas dan akurasi Bethesda lebih tinggi dibandingkan ACR-TIRADS

Background: Thyroid cancer in 3.3?ses and 0.95% mortality ranks as the 12th most prevalent cancer in Indonesia at 2020. Early cancer detection and intervention reduces mortality and morbidity with ultrasonography and ultrasound-guided fine needle aspiration biopsy.

Objective: To know the relationship of ACR-TIRADS score to postoperative histopathology, Bethesda score to postoperative histopathology, ACR-TIRADS to Bethesda score, ACR-TIRADS and Bethesda score to postoperative histopathology. To determine the sensitivity, specificity, NPV, PPV and accuracy tests of ACR-TIRADS on postoperative histopathology, Bethesda score on postoperative histopathology, ACR-TIRADS and Bethesda on postoperative histopathology in thyroid nodules.

Method: Analytical study cross-sectional to determine the relationship between ACR-TIRADS and Bethesda scoring systems on postoperative histopathology in thyroid nodules at DR Sardjito Hospital from January 2018 to December 31, 2023. This study used SPSS statistics 25.0 with chi-square test analysis and diagnostic tests to obtain sensitivity, specificity, NPV, PPV and accuracy tests.

Results: The relationship of the ACR-TIRADS score to histopathology, Bethesda score to histopathology, ACR-TIRADS to Bethesda score, ACR-TIRADS and Bethesda scores to postoperative histopathology in thyroid nodules have a value of p=0.00. The sensitivity, specificity, NPV, PPV and accuracy tests of ACR-TIRADS on postoperative histopathology were 93.51%, 17.48%, 37.89%, 86.21%, and 44.09%. The sensitivity, specificity, NPV, PPV and accuracy tests of Bethesda score on postoperative histopathology were 73.08%, 73.73%, 83.20%, 59.38%, and 72.85%. The sensitivity, specificity, NPV, PPV, accuracy tests of ACR-TIRADS and Bethesda on postoperative histopathology were 98.18%, 36.54%, 95%, 62.07%, and 68.22%.

Conclusion: There was a relationship of ACR-TIRADS score to postoperative histopathology, Bethesda score to postoperative histopathology, ACR-TIRADS to Bethesda score, ACR-TIRADS and Bethesda score to postoperative histopathology. The sensitivity of ACR-TIRADS and Bethesda to histopathology was highest compared to ACR-TIRADS alone and Bethesda alone. The specificity and accuracy of Bethesda was higher than ACR-TIRADS

Kata Kunci : ACR-TIRADS, Bethesda, histopatologi, karsinoma, tiroid