Tesis

Faktor-Faktor Yang Mempengaruhi Keberhasilan Diagnostik (Diagnostic Yield) Endoskopik Ultrasonografi Dengan Aspirasi Jarum Halus (EUS FNA) Untuk Diagnosis Lesi Pankreas = Factors affecting the diagnostic yield of Endoscopic Ultrasound Fine Needle Aspiration (EUS FNA) in diagnosing Pancreatic Lesion.

Latar Belakang : Tingkat akurasi EUS FNA dalam diagnosis lesi pankreas diduga dipengaruhi oleh berbagai macam faktor. Penelitian mengenai faktor yang mempengaruhi keberhasilan EUS FNA belum pernah dilakukan di Indonesia. Penelitian ini dilakukan untuk mengetahui faktor-faktor yang mempengaruhi keberhasilan EUS FNA untuk diagnosis lesi pankreas pada populasi Indonesia. Metode : Penelitian ini merupakan studi potong lintang dari data rekam medis pada januari 2012 - Juli 2022 atau total seluruh subjek yang dilakukan EUS FNA karena lesi pankreas di PESC RSCM. Pasien dengan data tidak lengkap dan lesi peripankreas tidak diikutkan. Karakteristik dasar subjek penelitian ditampilkan dalam bentuk tabel. Analisis bivariat menggunakan uji chi square dilakukan dengan masing-masing variabel bebas terhadap keberhasilan diagnostik EUS FNA untuk menghitung nilai odds ratio (OR). Variabel dengan nilai p< 0,25 pada analisa bivariat dimasukkan ke analisa multivariat dengan regresi logistik. Hasil : Sebanyak 201 pasien dengan lesi pankreas yang menjalani pemeriksaan EUS FNA diikutkan dalam penelitian. Angka keberhasilan diagnostik EUS FNA pada lesi pankreas adalah sebesar 77,11%. Ukuran lesi 3 cm diasoasikan dengan peningkatan keberhasilan diagnosis EUS FNA berdasarkan analisis bivariat (OR 2,46; IK95 1,25 – 4,86; p= 0,008). Analisis multivariat menunjukan bahwa ukuran lesi 3 cm (OR 1 8,95; IK95 4,77 – 75,29; p = 0,000), lokasi lesi di korpus (OR 2.82; IK95 1.03-7.77; p= 0,04) dan ukuran jarum 22G (OR 7.49; IK95 1.87-29.97; p= 0.004) diasoasikan dengan peningkatan keberhasilan diagnosis. Kesimpulan : Ukuran lesi, lokasi lesi dan ukuran jarum, merupakan faktor yang mempengaruhi keberhasilan diagnostik EUS FNA pada lesi pankreas.
Kata Kunci : EUS FNA, Lesi pankreas, keberhasilan diagnosis, faktor-faktor yang mempengaruhi



Background: Diagnostic accuracy of EUS FNA in diagnosing pancreatic lesion are affected by several factors. Clinical study regarding these factors had not been done in Indonesia. This study aims to study factors affecting the diagnostic yield of EUS FNA in diagnosing pancreatic lesion in Indonesian population. Method: This study is a cross-sectional study of medical record data in January 2012 - July 2022 or a total of all subjects who underwent EUS FNA due to pancreatic lesions at PESC RSCM. Patient with incomplete data and peripacreatic lesion was excluded. Clinical characteristics of sample is presented in a table. Bivariat analysis was conducted with chi square test between independent factors and diagnostic success of EUS FNA to obtained the odds ratio (OR). Factors with p-value above 0,25 are included for multivariat analysis using logistic regression. Result: A total of 201 patients underwent EUS FNA was included in this study. Success rate of diagnosing pancreatic lesion using EUS FNA was 77,11%. Lesion size 3 cm increased the odds for diagnostic success based on bivariat analysis (OR 2,46; 95% CI 1,25 – 4,86; p = 0,008). Multivariate analysis showed that the lesion size  3 cm (OR 18.95; CI95 4.77 – 75.29; p = 0.000), the location of the lesion in the corpus (OR 2.82; CI95 1.03-7.77; p = 0.04) and needle size 22G (OR 7.49; CI95 1.87-29.97; p= 0.004) was associated with an increase in diagnostic yield. Conclusion: The size of the lesion, the location of the lesion and the size of the needle, are factors that influence the diagnostic yield of EUS FNA in pancreatic lesions
Keywords: EUS FNA, Pancreatic lesion, diagnostic yield, factors affecting