Tesis

Nilai Diagnostik Ultrasonografi Transvaginal dalam Menentukan Derajat Invasi ke Miometrium pada Kanker Endometrium = Diagnostic value of transvaginal ultrasonography to determined degree of Myometrium invasion in Endometrial cancer .

LATAR BELAKANG Di Indonesia kanker endometrium merupakan kanker ginekologi ketiga terbanyak. Diagnosis awal kanker endometrium penting dalam menentukan prognosis dan tatalaksana. USG transvaginal sebagai alat pencitraan yang efektif dan efisien. Akurasinya setara dengan MRI dan PET/CT-Scan. Meskipun secara rutin di Indonesia digunakan namun nilai diagnostiknya dalam menilai derajat invasi belum banyak diteliti di Indonesia. Oleh karena itu peneliti tertarik melakukan uji diagnostik usg transvaginal dalam menilai derajat invasi kanker endometrium ke miometrium. TUJUAN Mengetahui akurasi USG transvaginal dalam menilai invasi miometrium pada kanker endometrium dalam 5 tahun terakhir di RSCM. Serta karakteristik histopatologi berdasarkan tipe, invasi, dan derajat diferensiasi kanker Endometrium dalam 5 tahun terakhir di RSCM METODE Penelitian ini merupakan penelitian potong lintang dengan jumlah sampel 82 subjek pada Jan 2011 – Des 2016 di RSCM. Data dikumpulkan secara total sampling dari registrasi kanker divisi Onkologi Ginekologi FKUI RSCM dan dilakukan uji diagnostik. Penelitan ini sudah lolos kaji etik dan mendapat persetujuan pelaksanaan dari Komite Etik Penelitian Kesehatan FKUI-RSCM bulan Februari 2017. HASIL Uji diagnositik USG transvaginal dalam melihat ada tidaknya invasi memiliki sensitivitas, spesifisitas, NPP, NPN sebesar 78.79%, 50%, 86.67%, 36.36%. Sedangkan hasil uji diagnostik usg transvaginal dalam menilai derajat invasi memiliki sensitivitas, spesifisitas, NPP, NPN sebesar 81.40%, 76.92%, 79.55%, dan 78.90% SIMPULAN. USG transvaginal dalam menilai kedalaman invasi lebih baik dibanding kegunaannya dalam menentukan ada tidaknya invasi. Sensitivitas, spesifisitasnya 81.4-% dan 76.92% dibanding 79.41% dan 57.14%. Dalam hal ini USG transvaginal dapat digunakan sebagai alat bantu diganostik yang efisien dalam menentukan tatalaksana dan prognosis kanker endometrium .
KATA KUNCI : USG transvaginal, kanker endometrium, derajat invasi, uji diagnostik.


BACKGROUND Endometrial cancer is third most gynecological cancer found in Indonesia. Accurate early diagnosis is one of the prognosis factor. Transvaginal ultrasound was one of the chosen imaging which effective and efficient. From other study its diagnostic value was comparable to MRI or PET/CT-Scan. As a diganostic tool in Indonesia in Indonesia hasn’t been studied yet. We interested in study the diagnostic test for transvaginal ultrasound in determining the degree of myometrial invasion in endometrial cancer. OBJECTIVES To show transvaginal ultrasound accuracy in determining the degree of myometrial invasion of endometrial cancer within 5 years in RSCM. We also interested to know histopathology characteristic of endometrial cancer according to cell type, degree of invasion, and degree of differentiaton of endometrial cancer, within last 5 years in RSCM. METHODS This study is a cross-sectional study with the sample of 82 subjects in January 2011 – December 2016 at RSCM. The data were collected by total sampling from cancer registry oncology and gynecology division of Obstetric and gyncology FKUI-RSCM. This study had already passed the ethical clearance and permitted by Ethical Committee FKUI-RSCM in February 2017. RESULTS . Transvaginal USG diagnostic test in detection invasion has sensitivity, specificity, PPV, and NPV as 78.79%, 50%, 86.67%, 36.36% respectively. For determine degree of myometrial invasion it has sensitivity, specificity, PPV, and NPV as 81.40%, 76.92%, 79.55%, dan 78.90% respectively. CONCLUSIONS Transvaginal ultrasound has a better accuracy in determining degree of invasion compared to detecting myometrial invasion in endometrial cancer. In determine degree of invasion its sensitivity and specificity are 81.4% and 76.92%. For detecting any invasion its sensitivity and specificity was only 79.41% and 57.14%. Our study shown that transvaginal ultrasound was an efficient diagnostic tool fo determine further treatment and prognosis in endometrial cancer
KEYWORDS : Transvaginal USG, endometrial cancer, degree of invasion, accuracy test.