PERBEDAAN KADAR TUMOR NECROSIS FACTOR-α PADA PENDERITA HEPATITIS KRONIS DAN KARSINOMA HEPATOSELULER

Tri Hartanto, dr. Neneng Ratnasari, SpPD-KGEH

2014 | Tesis | S2 Ilmu Penyakit Dalam

Latar belakang. Peningkatan kadar TNF-α berkorelasi dengan inflamasi hati, nekrosis dan gagal hati karena TNF-α dibentuk sebagai respon terhadap injuri jaringan serta dihubungkan dengan peningkatan progresi siklus sel dan stress oksidatif. Kadar tinggi TNF-α dihubungkan dengan karsinogenesis. Metode. Desain penelitian adalah studi potong lintang (cross sectional). Subyek penelitian ini adalah penderita Hepatitis Kronis dan Karsinoma Hepatoseluler yang berobat di klinik penyakit dalam atau menjalani rawat inap di bangsal Penyakit Dalam RSUP Dr Sardjito yang memenuhi kriteria inklusi. Perbandingan kadar TNF-α pada penderita Hepatitis kronis virus dan KHS dianalisis dengan menggunakan uji t-test untuk data yang terdistribusi normal dan untuk data yang tidak terdistribusi normal digunakan Mann-Whitney U test. Analisa data dilakukan secara komputerisasi.Perbedaan dianggap bermakna jika didapatkan P < 0.05 dengan interval kepercayaan 95%. Hasil. Didapatkan 36 pasien yang terdiri dari 18 orang pasien hepatitis kronis dan 18 orang dengan KHS. Rerata kadar TNF-α penderita hepatitis kronis 16,51± 2,55 ng/ml, sedangkan kadar TNF-α penderita KHS 90,22± 26,90 ng/ml, dan berbeda berMakna secara statistik. Kesimpulan. Rerata Kadar TNF-α pada penderita KHS bermakna secara statistik lebih tinggi dari kadar rerata TNF-α pada Hepatitis Kronis.

Background: The increased levels of TNF-α is associated with hepatic inflammation, necrosis, and liver failure because TNF-α is formed as a response to tissue injury and also associated with the increased of cell cycle progression and oxidative stress. The high level of TNF-α is associated with carcinogenesis. Methods: This is a cross sectional study. Subjects of this study were patients with Chronic Hepatitis and Hepatocellular Carcinoma who were treated either at polyclinic of Internal Medicine or at ward of Internal in Dr. Sardjito Central General Hospital and met the inclusion criteria. The comparison of TNF-α level in patients with Chronic Viral Hepatitis and Hepatocellular Carcinoma was analyzed using t-test for normal distributed data and Mann-Whitney U test for non-normal distributed data. Data analysis was performed using computerized analysis. The difference was significant if p< 0,05 with 95% confidence intervals. Results: From 18 subjects with Chronic Hepatitis and 18 subjects with Hepatocellular Carcinoma, the average of TNF-α levels in subjects with Chronic Hepatitis is 16,51±2,55 ng/ml while the average of TNF-α levels in those with Hepatocellular Carcinoma is 90,22±26,90 ng/ml. This results are statistically significant (p< 0,001). Conclusions: This study suggests that the average of TNF-α levels in subjects with Hepatocellular is significantly higher than in those with Chronic Hepatitis.

Kata Kunci : TNF-α –KHS – hepatitis B kronis – hepatitis C kronis