HUBUNGAN RASIO NETROFIL TERHADAP LIMFOSIT DENGAN STADIUM KLINIS PADA KARSINOMA NASOFARINGS

IGNATIUS ADHI AKUNTANTO, dr. Sagung Rai Indrasari, M.Kes., Sp.THT-KL(K).

2015 | Tesis | SP ILMU PENYAKIT THT

Latar belakang: Respon inflamasi sistemik telah terbukti berperan sebagai faktor promotor metastasis dan progresivitas tumor melalui inhibisi apoptosis, promosi angiogenesis dan kerusakan DNA. Rasio netrofil terhadap limfosit (NLR), sebagai salah satu penanda inflamasi, berhubungan dengan progresivitas dan metastasis berbagai macam keganasan. Hubungan NLR dengan karsinoma nasofarings (KNF) masih belum jelas. Tujuan: Penelitian ini bertujuan untuk menentukan hubungan NLR dengan stadium klinis KNF. Metode: Rancang penelitian adalah kasus kontrol. Data sampel penelitian diambil dari rekam medis, yaitu pasien yang telah terdiagnosis KNF di bagian Telinga Hidung dan Tenggorok Bedah Kepala Leher (THT-KL) Rumah Sakit Umum Pusat (RSUP) Dr. Sardjito Yogyakarta, melalui pemeriksaan patologi anatomi, denga stadium klinis telah ditentukan melalui pemeriksaan CT-Scan, rontgen toraks, USG abdomen dan bone survey. Pasien KNF stadium lanjut dikategorikan sebagai kelompok kasus, sedangkan pasien KNF stadium awal dikategorisasikan sebagai kelompok kontrol. Nilai netrofil dan limfosit diambil dari hasil pemeriksaan darah rutin sebelum dilakukan terapi. Analisis statistik untuk membuktikan hipotesis menggunakan chi square. Hasil: Sampel penelitian berjumlah 48 pasien KNF, masing-masing kelompok terdiri atas 24 sampel. Terdapat hubungan yang bermakna NLR dengan stadium klinis pasien KNF, dengan nilai p = 0,03 dan Rasio Odd (OR) = 4,231 (interval kepercayaan 95% 1,107-16,167). Kesimpulan: Terdapat hubungan yang bermakna antara NLR dengan stadium klinis pada KNF.

Background: Systemic inflammatory response could promote tumor metastasis and progression by inhibition of apoptosis, promotion of angiogenesis, and damage of DNA. Neutrophyl to lymphocyte ratio, one of the inflammatory marker, has been shown to be associated with progression and metastasis of many kinds of malignancies. Whereas its role in nasopharyngeal carcinoma (NPC) remains unclear. Purpose: To determine the association between neutrophil lymphocyte ratio with clinical staging in NPC. Methods: Research design was case control study. Sample of this research which was taken from medical records, is NPC patients who had undergone anatomy pathology examination and whose clinical staging had been determined by CTscan, thorax plain photo, abdominal USG and bone survey. Late clinical staging was categorized as case group, while early clinical staging was categorized as control group. Neutrophil and lymphocyte value were taken from routine blood examination before treatment. Statistical analysis to prove the hypothesis were using chi square. Result: Study sample were 48 NPC patient, each group consisted of 24 sample. There was statistically significant association between NLR with clinical staging in NPC, with p = 0,03 and Odds Ratio (RO): 4,231 (95% confidence interval 1,107-16,167). Conclusion: There is significant association between NLR with clinical staging in NPC.

Kata Kunci : Karsinoma nasofarings, rasio netrofil limfosit, stadium klinis