Tesis

Batasan Prostate Specific Antigen (PSA) Pada Pasien Kanker Prostat Untuk Memprediksi Metastasis ke Tulang di Rumah Sakit Sardjito, Yogyakarta = Predicting Bone Metastasis in Prostate Cancer Patients: Value of Prostate Specific Antigen at Sardjito Hospital,Yogyakarta

Tujuan: Mengetahui batasan nilai PSA untuk memprediksi adanya metastasis
tulang pada pasien kanker prostat di RS Sardjito.
Metode: Penelitian retrospektif, dengan mengumpulkan rekam medis pasien
kanker prostat telah dilakukan bone scintigraphy di RS Sardjito tahun 2006 -
2011.
Hasil: Dari 83 pasien kanker prostat yang telah dilakukan bone scintigraphy,
terdapat 55 pasien (66%) mengalami metastasis tulang dan terdapat 28 pasien (34
%) yang tidak mengalami metastasis tulang. Dari 55 pasien yang mengalami
metastasis tulang, terdapat 11 pasien (20 %) dengan PSA kurang dari 20 ng/ml
dan terdapat 44 pasien (80 %) yang memiliki PSA lebih dari 20 ng/ml. Cut-off
point PSA 17.65 ng/ml memiliki sensitivitas terbesar yaitu 85.5% dan spesifisitas
53.6%.
Kesimpulan: Pemeriksaan bone scintigraphy dianjurkan pada pasien dengan PSA
> 17.65 ng/ml, sedangkan pada pasien dengan PSA < 17.65 dianjurkan pada
pasien dengan gejala klinis nyeri tulang.


Objective: Prostate cancer shows a strong predilection to spread to the bones,
with bone metastases identified at autopsy in up to 90 % of patients dying from
prostate cancer. Serum prostate specific antigen (PSA) concentration has been
widely applied as a biomarker to diagnose and monitor prostate cancer.
Technetium-99m methylene diphosphate (Tc—99m MDP) whole body bone
scintigraphy is currently a well-accepted diagnostic procedure for bone metastasis
in malignancy. The aim of this study was to establish a useful serum PSA cut-off
value to predict the presence of bone metastasis in men with prostate cancer.
Material and Methods: Consecutive male patients diagnosed with prostate
cancer were retrospectively analyzed. All of the subjects had received Tc-99m
MDP whole body bone scintigraphy and had their serum PSA concentration
measured at Sardjito Hospital, Yogyakarta. The proper cut-off value was
established based on statistical analysis in order to predict the possibility of bone
metastasis among prostate cancer patients.
Results: In total, 83 consecutive male patients with prostate cancer were enrolled,
and 55 patients (66 %) were confirmed by scintigraphic findings to have bone
metastases. A serum PSA concentration of 17,65 ng/ml gave the best sensitivity
(78,33 %) and specificity (65,21 %). The positive predictive value, negative
predictive value were 85,45 % and 53,57 %, respectively (p