Tesis

Uji Diagnostik Pemeriksaan Ultrasonografi Dibandingkan Pemeriksaan Klinis Dalam Mengukur Ukuran Lesi Primer Kanker Serviks = Diagnostic performance of ultrasound compare to clinical examination in measuring the size of primary tumor of cervical cancer.

Tujuan. Penelitian ini membahas perbandingan performa diagnostik antara pemeriksaan ultrasonografi dengan pemeriksaan klinis dalam mengukur ukuran lesi primer kanker serviks. Metode. Dilakukan uji diagnostik potong-lintang secara retrospektif terhadap pasien kanker serviks stadium IB di RSUPN Dr. Ciptomangunkusumo dari tahun 2009 hingga tahun 2014. Nilai diagnostik dari kedua pemeriksaan dihitung dengan luaran: sensitivitas, spesifisitas, nilai prediksi positif, nilai prediksi negatif, dan akurasi. Uji kesesuaian dari kedua pemeriksaan juga dihitung dengan ukuran makroskopik sebagai standar baku emas. Hasil. Dari periode tahun 2009 hingga tahun 2014, didapatkan 92 subjek yang memenuhi kriteria inklusi dengan komposisi yaitu 65 kasus (70%) kanker serviks stadium IB1 dan 27 kasus (30%) kanker serviks stadium IB2. Ultrasonografi didapatkan memiliki nilai diagnostik yaitu sensitivitas 92%, spesifisitas 96%, nilai prediksi positif 92%, nilai prediksi negatif 96%, dan akurasi 95%. Sementara itu, pemeriksaan klinis didapatkan memiliki nilai diagnostik yaitu sensitivitas 51%, spesifisitas 92%, nilai prediksi positif 73%, nilai prediksi negatif 82%, dan akurasi 80%. Dari perhitungan kesesuaian antara ukuran pemeriksaan ultrasonografi dan ukuran makroskopik, didapatkan perbedaan rata-rata 0,56 cm. Sementara itu, dari perhitungan kesesuaian antara ukuran pemeriksaan klinis dan ukuran makroskopik, didapatkan perbedaan rata-rata 0,97 cm. Kesimpulan. Penelitian ini menyimpulkan bahwa pemeriksaan ultrasonografi memiliki performa diagnostik yang lebih baik dibandingkan pemeriksaan klinis dalam mengukur ukuran lesi primer kanker serviks.
Kata kunci: lesi primer kanker serviks, ultrasonografi, pemeriksaan klinis, nilai diagnostik


Objective. The purpose of this study is to compare the diagnostic value of ultrasound and clinical examination in measuring the size of primary tumor of cervical cancer. Methods. It is a retrospective cross sectional study for patients with cervical cancer stage IB in Cipto Mangunkusumo hospital from 2009 to 2014. Diagnostic value of both examinations were calculated with outcome: sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. Resemblance test of both examinations were also calculated with macroscopic size as the gold standart. Result. From period 2009 until 2014, there were 92 subject which fulfilled the inclusion criteria, consisted of 65 cases (70%) cervical cancer stage IB1 and 27 cases (30%) cervical cancer stage IB2. Ultrasonografi was found to have diagnostic values as follow: sensitivity 92%, specificity 96%, positive predictive value 92%, negative predictive value 96%, and accuracy 95%. Meanwhile, clinical examination was found to have diagnostic values as follow: sensitivity 51%, specificity 92%, positive predictive value 73%, negative predictive value 82%, and accuracy 80%. From the calculation of resemblance between ultrasound and macroscopic size, there was an average difference approximately 0.56 cm. Meanwhile, from the calculation of resemblance between clinical examination and macroscopic size, there was an average difference approximately 0.97 cm. Conclusion. It can be concluded that the ultrasound has better diagnostic value compare to clinical examaination in examining the size of primary tumor of cervical cancer.
Keyword: primary tumor of cervical cancer, ultrasound, clinical examination, diagnostic value