Tesis

Gambaran CT Scan Toraks Adenokarsinoma Paru Berdasarkan Status Mutasi Epidermal Growth Factor Receptor Di Rumah Sakit Cipto Mangunkusumo = CT Characteristics of Lung Adenocarcinoma Based on Epidermal Growth Factor Receptor Mutation Status at Ciptomangunkusumo Hospital.

Latar belakang dan tujuan: Penemuan terapi target Epidermal growth factor receptor-tyrosine inhibitor kinase (EGFR-TKI) peroral pada pasien adenokarsinoma paru dengan status mutasi EGFR positif terbukti dapat memperbaiki gejala klinis, meningkatkan kualitas hidup dan survival rate secara signifikan. Pemeriksaan CT scan toraks dikombinasikan dengan data demografis jenis kelamin, status merokok dan ras dapat membantu klinisi memprediksi status mutasi EGFR pasien adenokarsinoma paru sebelum pemberian terapi target. Penelitian ini bertujuan untuk mengetahui gambaran CT scan toraks adenokarsinoma paru berdasarkan status mutasi EGFR. Metode: Penelitan deskriptif analitik dengan komparasi internal menggunakan desain potong lintang menggunakan data sekunder hasil pemeriksaan CT scan toraks dan pemeriksaan status mutasi EGFR secara molekular menggunakan teknik PCR dari Departemen Patologi Anatomi RSCM pada 73 subyek adenokarsinoma paru yang belum diterapi. Hasil: Gambaran CT scan toraks adenokarsinoma paru dengan status mutasi EGFR positif di RSCM terbanyak berupa retraksi dan nodul pleura, densitas solid, efusi pleura, serta tidak ditemukan gambaran air bronkogram, nekrosis, nodul kontralateral, invasi pada struktur di sekitar tumor, spikula kasar maupun limfadenopati. Gambaran CT scan toraks adenokarsinoma paru dengan status mutasi EGFR negatif di RSCM terbanyak berupa retraksi dan nodul pleura, limfadenopati N3, densitas solid, efusi pleura serta tidak ditemukan gambaran air bronkogram, nekrosis, nodul kontralateral maupun invasi pada struktur di sekitar tumor. Simpulan: Berdasarkan status mutasi EGFR, gambaran CT scan berupa retraksi dan nodul pleura cenderung lebih sering ditemukan pada adenokarsinoma paru dengan status mutasi EGFR positif walaupun tidak terdapat perbedaan bermakna diantara kedua kelompok.
Kata kunci: CT scan toraks, mutasi Epidermal growth factor receptor, adenokarsinoma paru


Background and purpose: The discovery of epidermal growth factor receptor-tyrosine inhibitor kinase, orally targeted therapy for positive EGFR mutation status lung adenocarcinoma patient has significantly improves patient’s clinical symptoms, quality of live and survival rate. Chest CT scan with demography data such as sex, smoking status and race could help clinician in predicting the EGFR mutation status of lung adenocarcinoma patient before EGFR-TKI targeted therapy. This study aims to describe chest CT characteristics of lung adenocarcinoma based on epidermal growth factor receptor mutation status at ciptomangunkusumo hospital. Methods: Descriptive analytic study with cross sectional design using secondary data from chest CT scan and EGFR mutation analysis using PCR from Ciptomangunkusumo Hospital Patology Anatomy Departement of the lung adenocarcinoma patient before any treatment given. Results: CT characteristics of the lung adenocarcinoma with positive EGFR mutation status most commonly found in this study are pleural retraction and pleural nodule, solid density, pleural effusion, there is no air bronchogram, necrosis, contralateral nodule, invasion to the surrounding structure, coarse speculation or lymphadenopathy. CT characteristics of the lung adenocarcinoma with negative EGFR mutation status most commonly found in this study were pleural retraction and pleural nodule, N3 lymphadenopathy, solid density, pleural effusion and there was no air bronchogram, necrosis, contralateral nodule or invasion to the surrounding structure. Conclusion: Based on EGFR mutation status, pleural retraction and pleural nodule tend to be found more common in the lung adenocarcinoma patient with positive EGFR mutation status even though in this study there was no significant difference of chest CT characteristics of lung adenocarcinoma between two groups.
Keywords: Chest CT, Epidermal growth factor recepto mutation, lung adenocarcinoma