Kesesuaian hasil pemeriksaan histopatologi potong beku dengan blok parafin pada tumor ovarium

PRAMUKTINI, Sadina, Dr. H. Buham Warsito, SpOG(K)

2005 | Tesis | PPDS I Obstetri dan Ginekologi

Latar belakang: Potong beku telah lama digunakan sebagai alat bantu diagnosis histopatologi intraoperatif dalam menentukan tumor-tumor ovarium. Kesesuaian yang tinggi dari pemeriksaan potong beku sangat penting untuk menentukan terapi yang adekuat. Tujuan: Penelitian ini bertujuan untuk mengetahui kesesuaian hasil potong beku dengan blok parafin dalam menentukan keganasan ovarium . Rancangan penelitian: Penelitian ini merupakan tes diagnostik Bahan dan cara: Data diambil dari catatan rekam medik RS Dr Sardjito Jogjakarta dalam periode Januari 2002 sampai Desember 2004. Seluruh penderita yang menjalani laparotomi dan pemeriksaan potong beku yang disebabkan oleh karena tumor ovarium diikutkan pada penelitian ini. Pemeriksaan potong beku dan blok parafin dikerjakan di bagian patologi Fakultas Kedokteran Universitas Gadjah Mada, Jogjakarta. Hasil: Sensitivitas potong beku untuk pemeriksaan tumor ganas, borderline dan jinak berturut-turut adalah 96,6% (95% CI 93,3-99,8); 94,7% (95% CI 80,4-100) dan 99,6% (95% CI 98,5-100). Spesifisitas tumor ganas, borderline dan jinak berturutturut adalah 99,6% (95% CI 98,5-100); 97,8 % (95% CI 95,3-100); 96,6% (95% CI 93,3-99,8).Nilai prediksi positif tumor ganas, borderline dan jinak berturut-turut adalah 99,6% (95% CI 96,4-100); 75% (95% CI 50,5 -99,5); 97,1% (95% CI 94,3- 99,8). Nilai prediksi negatif tumor ganas, borderline dan jinak berturut-turut adalah 97,1% (95% CI 94,3-99,9); 99,6% (95% CI 98,5-100); 99,6% (95% CI 98,4-100). Akurasi tumor ganas, borderline dan jinak berturut-turut adalah 98,2% (95% CI 96,6- 99,8); 97,6% (95% CI 95,1-100); 98,2% (95% CI 96,6-99,8). Kesimpulan: Potong beku merupakan pemeriksaan yang memberikan hasil sensitivitas, spesifisitas dan kesesuaian, yang tinggi. Bagaimanapun, hasil positif mempunyai spesifisitas lebih tinggi dari hasil negatif.

Background: Frozen section has been widely used as a diagnostic tool for intraoperative histopathologic determination of ovarian tumors. High accuracy of this examination is important to determine the adequate treatment. Objective: To evaluate the accuracy of frozen section compared to paraffin block in the determination of ovarian tumor malignancy. Design: A diagnostic test. Material and method: Data were collected from Dr Sardjito Hospital medical record, Jogjakarta, from January 2002 to December 2004. All patients undergoing laparotomy and frozen section examination due to ovarian tumor were enrolled to this study. Both frozen section and paraffin block examination were done in the Department of Pathology Faculty of Medicine, Gadjah Mada University. Result: The sensitivity of frozen section for the diagnosis of malignant, borderline and benign tumors was 96.6% (95% CI 93.3-99.8); 94.7% (95% CI 80.4-100) and 99.6% (95% CI 98.5-100) respectively. The specificity for malignant, borderline, and benign tumors was 99.6% (95% CI 98.5-100); 97.8 % (95% CI 95.3-100), and 96.6% (95% CI 93.3-99.8) respectively. The positive predictive value for malignant tumor was 99.6% (95% CI 96.4-100); for borderline tumor was 75% (95% CI 50/5 -99.5), and for benign tumor was 97.1% (95% CI 94.3-99.8) .The negative predictive value for malignant tumor was 97.1% (95% CI 94.3-99.9), for borderline tumor was 99.6% (95% CI 98.5-100), and for benign tumor was 99.6% (95% CI 98.4-100). The accuracy for malignant, borderline and benign tumors was 98.2% (95% CI 96.6- 99.8); 97.6% (95% CI 95.1-100), and 98.2% (95% CI 96.6-99.8) respectively. Conclusion: The study concluded that frozen section examination showed high sensitivity, specificity, and accuracy. Positive result, however, had a higher specificity than the negative one.

Kata Kunci : Tumor Ovarium, Potong Beku, accuracy, frozen section, ovarian tumor