Perbedaan Kadar Tumor Necrosis Factor-alpha pada Penderita Sirosis Hati dan Karsinoma Hepatoselular

Yuliana Rias Mayasari, dr. Neneng Ratnasari, SpPD-KGEH; Prof.dr.Siti Nurdjanah, Mkes, SpPD-KGEH

2014 | Tesis | S2 Ilmu Penyakit Dalam

Latar belakang. Progresifitas penyakit hati dapat diketahui dari peningkatan kadar TNF-alpha karena TNF-alpha berkorelasi dengan inflamasi hati, nekrosis dan gagal hati. TNF-alpha dibentuk sebagai respon terhadap injuri jaringan, dapat bersifat karsinogenesis, dihubungkan dengan peningkatan progresi siklus sel dan stress oksidatif. Metode: Desain penelitian adalah studi potong lintang. Subyek penelitian ini adalah penderita sirosis hati dan KHS yang berobat di poliklinik rawat jalan atau menjalani rawat inap di bangsal Penyakit Dalam RSUP Dr Sardjito yang memenuhi kriteria inklusi dan eksklusi. Perbandingan kadar TNF-alpha pada kelompok sirosis hati 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. Sejumlah 42 pasien, yang terdiri dari 24 pasien sirosis hati dan 18 orang dengan KHS dianalisa. Didapatkan rerata kadar TNF-alpha penderita sirosis hati 28,5±3,3 ng/ml, sedangkan kadar TNF-alpha penderita KHS 90,2±26,9 ng/ml. Kesimpulan. Rerata Kadar TNF-alpha pada penderita KHS lebih tinggi dan bermakna secara statistik dibandingkan kadar rerata TNF-alpha pada sirosis hati.

Background. Progression of liver disease can be known from the increased levels of TNF-alpha. TNF-alpha correlated with liver inflammation, necrosis and liver failure. TNF-alpha was formed in response to tissue injury, may be carcinogenesis, associated with an increase in cell cycle progression and oxidative stress. Methods. The study design was a cross sectional study. The subjects of this study were patients with liver cirrhosis and hepatocellular carcinoma (HCC), treated as outpatient clinic or hospitalized in the Internal Medicine ward of Sardjito Hospital, who met inclusion and exclusion criteria. Comparison of the levels of TNF-alpha in the liver cirrhosis group and HCC were analyzed using t-test for normally distributed data and used Mann-Whitney U test for not normally distributed data. Analysis of the data was computerized. Differences were considered significant if the obtained p<0.05 with 95% confidence intervals. Results. Total of 42 patients, consisting of 24 patients with liver cirrhosis and 18 with HCC were analyzed. Obtained the mean levels of TNF-alpha in liver cirrhosis patients was 28.5±3.3 ng/ml, whereas levels of TNF-alpha in HCC patients 90.2±26.9 ng/ml. Conclusion. The mean levels of TNF-alpha in patients with HCC was higher and statistically significant compared to the mean levels of TNF-alpha in liver cirrhosis.

Kata Kunci : TNF-alpha, sirosis hati, KHS, hepatitis B dan C