Tesis

Perbandingan kadar soluble platelet-selectin pada berbagai stadium karsinoma nasofaring dan korelasinya dengan hitung trombosit = The comparison of soluble platelet-selectin levels between various stage of nasopharyngeal carcinoma and its correlation with platelet count.

Pendahuluan Karsinoma nasofaring (KNF) merupakan jenis keganasan yang unik dengan distribusi geografis dan etnis tertentu. Daerah Cina Selatan dan Asia Tenggara memiliki insidens kejadian yang tinggi. Indonesia memiliki insidens 5,66 kasus per 100.000 penduduk per tahun. Salah satu penyebab kematian pada pasien dengan keganasan adalah trombosis. Kadar soluble Platelet-selectin (sP-selectin) yang tinggi dalam plasma, hasil dari aktivasi sel-sel endotel dan trombosit, adalah salah satu predictor kejadian thrombosis. Tujuan Mengetahui kadar sP-selectin pada berbagai stadium karsinoma nasofaring dan korelasinya dengan hitung trombosit. Metode Dilakukan studi potong lintang pada 60 kasus karsinoma nasofaring yang baru terdiagnosis di Rumah Sakit Cipto Mangunkusumo pada periode Maret hingga November 2012. Kadar sP-selectin pada berbagai stadium yang diukur dengan teknik Enzyme Linked Immunosorbent Assay akan dibandingkan dan dikorelasikan dengan hitung trombosit. Hasil Dari 60 pasien KNF didapatkan rerata usia 43,9 tahun. Rasio laki-laki dengan perempuan 3:1 dan jenis patologi terbanyak adalah karsinoma tidak berdiferensiasi (83,3%). Sepuluh persen pasien mengalami trombositosis. Median kadar sP-selectin adalah 45,73 ng/mL dengan rentang interkuartil: 42,02-57,66 ng/mL. Secara statistik terdapat perbedaan kadar sP-selectin diantara stadium IVC dengan stadium lainnya (stadium IVB, p = 0,001 dan kelompok stadium I-IVA, p < 0,001). Hitung trombosit tidak berkorelasi dengan sP-selectin (r: 0,185; p = 0,158) pada karsinoma nasofaring. Simpulan Terdapat perbedaan kadar sP-selectin pada berbagai stadium karsinoma nasofaring. Hitung trombosit tidak berkorelasi dengan kadar sP-selectin.
Kata Kunci Karsinoma nasofaring, sP-selectin, hitung trombosit


Background Nasopharyngeal carcinoma (NPC) is an unique malignancy because of its geographical and ethnic patterns. South China and South East Asia have the highest incidence, while in Indonesia is about 5.66 cases per 100,000 populations per year. Thrombosis is one of the complications of malignancy. High plasma levels of soluble Platelet-Selectin (sP-selectin) produced by activated endothelial cells and platelets, are predictive of thrombosis. Objective To measure sP-selectin levels in various stages of nasopharyngeal carcinoma and its correlation with platelet count. Methods This was a cross sectional study including 60 patients with newly diagnosed nasopharyngeal carcinoma at Cipto Mangunkusumo Hospital, Jakarta, Indonesia in period of April to November 2012. Soluble P-selectin levels in various stages of NPC measured with Enzyme Linked Immunosorbent Assay was compared and correlated with platelets count. Results From 60 patients of NPC, the mean age was 43.9 years with ratio of men to women was 3:1. The most prevalence histopathology was undifferentiated carcinoma (83.3%). Ten percent of the patients had thrombocytosis. The median level of sP-selectin was 45.73 ng/mL (inter quartile range: 42.02-57.66). Soluble P-selectin levels were statistically significantly higher among patients with stage IVC than other stages (with stage IVB, p = 0.001 and with group of stage I-IVA, p < 0.001). There was no correlation between platelet count and sP-selectin levels (r = 0.185; p = 0.158). Conclusion There were different levels of sP-selectin between various stages of nasopharyngeal carcinoma. There was no correlation between platelets count and sP-selectin levels.
Key Words Nasopharyngeal carcinoma, sP-selectin, platelet count.