Tesis

Korelasi Nilai Serum Alfa Fetoprotein terhadap Gambaran Patologi Karsinoma Hepatoselular di RSCM = Correlation of Alpha-Fetoprotein level serum with pathology differentiation in hepatocellular at RSCM.

Pendahuluan: Alfa fetoprotein (AFP) merupakan penanda tumor yang mengalami peningkatan pada karsinoma hepatoselular (KHS) namun dapat juga normal pada 40% kasus. Peningkatan AFP dikatakan menghasilkan diferensiasi tumor yang buruk. Kasus KHS yang datang ke RSCM cenderung lanjut dengan karakteristik tersendiri. Penelitian ini bertujuan menilai korelasi AFP terhadap derajat diferensiasi KHS di RSCM. Metode: Data 32 kasus KHS di RSCM yang dilakukan hepatektomi dikumpulkan secara retrospektif dari 2010-2016. Data dasar karakteristik pasien dinilai berdasarkan nilai AFP dan derajat diferensiasi. Lalu dilakukan analisis untuk melihat korelasi nilai AFP dengan derajat diferensiasi KHS. Hasil: Nilai rata-rata AFP adalah 20183ng/ml, usia 51.75 tahun, 81% kasus terjadi pada laki-laki, 59.4% berdiferensiasi buruk, 50% berukuran > 5-10 cm, 50% kasus sirosis, dan 68.8% terdapat invasi pembuluh darah. Diferensiasi buruk 42% pada laki-laki, 47.4% pada HbsAg positif, 50% pada Anti HCV positif, 31.2% sirosis, dan 40.9% mengalami invasi pembuluh darah. Nilai AFP < 20 ng/ml menghasilkan diferensiasi buruk 57.9% sedangkan pada AFP > 20 ng/ml 42.1% berdiferensiasi buruk. Pada analisis orelasi didapatkan r=0.203 dengan p > 0.05. Kesimpulan: AFP tidak dapat memprediksi derajat diferensiasi karsinoma hepatoseluler pada karakteristik kasus KHS di tempat kami.
Kata Kunci. AFP, Gambaran Patologi, Karsinoma Hepatoselular


Introductions: AFP is a tumor marker which is increased in HCC, but might be found normal in 40% cases. Increased AFP implies a worsen tumor differentiation. Correlation between AFP with HCC which is characterized with large size tumor managed in RSCM remains unclear. This study aims to ind the correlation between differentiation and AFP serum level. Methods: A total of 32 of HCC cases following hepatectomy in RSCM during 2010-2016 were enrolled in a retrospective study. Subject characteristics, AFP levels and differentiation stage were the variables in this study, and subjected to statistical analysis. Significancy found if p < 0.05. Results: Subject enrolled in this study consists of male 27 (81.3%) and female 6 (18.8%). Age found in range of 20-76 years (51.75±12.34). We found 59.4% and 12.5% subjects were positive-HbsAg and positive-Anti HCV. Tumor size were 50% > 5-10 cm in diameter, 50% subjects were cirrhotic, and 68.8% subjects with microvascular invasion. AFP level found in range of 0.5-400000 ng/mL (20183+SD75580.08). Among all the subjects 12.5% were well-differentiated, 28.1% were moderate differentiated, and 59.4% were poorly differentiated. AFP level < 20ng/mL in poorly differentiated was 57.9% and those with AFP level > 20ng/mL was 42.1%. Correlation analysis revealed an r = 0.203 with p > 0.05. Conclusion: AFP level can not be held as a predictor representing the differentiation in our current study.
Keywords: AFP level, tumor differentiation, HCC