Validitas gejala dan tanda utama karsinoma nasofarings

PRASETYO, Ashadi, Dr. dr. Bambang Hariwiyanto, Sp.THT-KL(K)

2010 | Tesis | S2 Ilmu Kedokteran Klinik

Latar belakang: Karsinoma nasofarings merupakan keganasan yang mempunyai insidensi yang cukup tinggi di Indonesia. Diagnosis KNF sering terlambat karena gejala dan tanda dini KNF tidak khas, letak nasofarings relatif tersembunyi serta pemeriksaan penunjang seperti nasoendoskopi, CT-Scan, patologi anatomi tidak tersedia disemua rumah sakit sehingga penderita karsinoma nasofarings seringkali datang sudah dalam stadium lanjut. Diagnosis hanya berdasar gejala dan tanda utama KNF belum pernah diteliti sebagai salah satu alat diagnosis karsinoma nasofarings yang sederhana, cepat, valid dan murah untuk meningkatkan kewaspadaan dokter terutama yang bekerja dipusat pelayanan kesehatan primer. Tujuan: Menentukan validitas 3 gejala dan tanda utama KNF sebagai alat diagnosis karsinoma nasofarings Manfaat penelitian: Penelitian ini diharapkan menjadi salah satu alat diagnosis karsinoma nasofarings yang sederhana, cepat, valid dan murah terutama untuk daerah yang belum mempunyai fasilitas pemeriksaan penunjang seperti CT Scan, nasoendoskopi dan patologi anatomi. Metodologi: Penelitian ini merupakan uji diagnostik dengan membandingkan 3 gejala dan tanda utama karsinoma nasofarings (KNF) dibandingkan dengan suatu reference standard yaitu CT Scan nasofarings sehingga didapatkan tabel 2x2. Rancang penelitian adalah potong lintang (cross-sectional). Teknik pengambilan sampel dengan cara consecutive sampling. Sampel pada penelitian ini adalah semua orang dengan keluhan benjolan leher, sumbatan hidung dan gangguan pendengaran konduktif di RS DR.Sardjito Yogyakarta yang memenuhi kriteria inklusi dan ekslusi. Analisis statistik: Dilakukan analisis data menghitung sensitifitas, spesifisitas, nilai duga positif, nilai duga negatif, rasio kecenderungan positif dan rasio kecenderungan negatif dari 3 gejala dan tanda KNF dengan tabel 2x2.

Background: Nasopharyngeal cancer (NPC) is a malignancy with a high incidence rate in Indonesia. The diagnosis of NPC is often late due to the fact that the signs and symptoms of early NPC is not specific, the location of the nasopharyngs which is quite hidden, and supporting examinations such as nasoendoscopy, CT Scan, pathology may not be avalaible in primary health care facilities. Thus patients suffering from NPC are often diagnosed during the later stages of the cancer. Diagnosing this cancer based on the main signs and symptoms of NPC has never been evaluated as a simple, quick, valid and inexpensive primary diagnostic tool to increase awareness of physicians located in primary health care facilities. Goal: Evaluate the validity of three main signs and symptoms of NPC as a diagnostic tool for NPC. Study Purpose: This study can potentially be used as as a simple, quick, valid and inexpensive primary diagnostic tool especially in primary health care facilities that do not have supporting examinations such as nasoendoscopy, CT Scan, and pathology. Methodology: This study is a diagnostic test assessing three main signs and symptoms of NPC compared to a reference standard which is nasopharyngeal CT Scan and resulting in a 2 x 2 table. This study implements a cross – sectional design. Samples for this study was done using consecutive sampling. The samples for this study are all patients complaining of neck mass, nasal obstruction and conductive hearing loss at Dr. Sardjito Hospital Yogyakarta based the inclusion and exclusion criteria. Statistical Analysis: Data analysis was done by evaluating the sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio, and unlikelihood ratio from three main signs and symptoms of NPC with a 2 x 2 table.

Kata Kunci : Karsinoma nasofarings,3 gejala dan tanda KNF,CT Scan, Nasopharyngeal cancer, signs and symptoms of NPC, CT Scan