Tesis

Proporsi dan faktor-faktor yang memengaruhi nilai kepositifan biopsi transbronkial pada pasien terduga kanker paru di RSUP Persahabatan = The proportion and the factors affecting the positive values of transbronchial biopsy results in lung cancer patients at Persahabatan Hospital.

Latar belakang : Kanker paru merupakan penyebab utama kematian di dunia. Pada dua dekade terakhir telah ditemukan beberapa terapi target yang memberikan peningkatan angka tahan hidup baik pada pasien kanker paru. Selain analisis jenis kanker paru, dibutuhkan juga pemeriksaan molekuler yang menjadi penyebab kanker paru, sehingga dibutuhkan spesimen yang adekuat. Terdapat beberapa faktor yang memengaruhi kepositifan hasil biopsi transbronkial pada lesi paru perifer, dengan mempertimbangkan faktor-faktor tersebut diharapkan dapat meningkatkan nilai kepositifan hasil biopsi dan mempercepat tata laksana pasien kanker paru. Metode : Penelitian menggunakan metode potong lintang pada 77 pasien yang menjalani biopsi transbronkial di RSUP Persahabatan pada bulan September 2024 hingga bulan Desember 2024. Melakukan analisis hubungan pada faktor-faktor yang memengaruhi nilai kepositifan biopsi transbronkial, seperti tanda brokus, ukuran tumor, lokasi lesi paru dan panduan biopsi. Hasil : Pada penelitian ini diperoleh rerata usia subjek 58 tahun (±12,73). Jenis kelamin terbanyak laki-laki 47 (61%) subjek. Proporsi kepositifan biopsi transbronkial mencapai 63,6%. Proporsi lokasi lesi terbanyak pada apeks paru yaitu 57,2%. Analisis bivariat menunjukkan tanda bronkus dan ukuran lesi paru memengaruhi nilai kepositifan biopsi transbronkial. Berdasarkan analisis multivariat, ukuran lesi paru ≥2,95 cm dengan atau tanpa tanda bronkus memengaruhi nilai kepositifan biopsi transbronkial 5,44 (1,54-19,14) ; p 0,008. Kesimpulan: Tanda bronkus dan ukuran lesi paru merupakan variabel bebas yang memengaruhi nilai kepositifan hasil biopsi transbronkial. Ukuran lesi paru ≥2,95 cm meningkatkan kemungkinan hasil positif pada biopsi transbronkial dengan atau tanpa tanda bronkus.
Kata kunci : Kanker paru, nilai kepositifan biopsi transbronkial, tanda bronkus, ukuran lesi paru.


Background : Lung cancer is the leading cause of death worldwide. In the last two decades, several target therapies have been found that improve overall survival of lung cancer patients. In addition to analyzing the type of lung cancer, molecular examinations are also needed to identify the causes of lung cancer, which necessitates adequate specimens. Several factors influence the positivity of transbronchial biopsy results in peripheral lung lesions; considering these factors is expected to improve the positivity rate of biopsy results and expedite the management of lung cancer patients. Method : This study used a cross-sectional method involving 77 patients who underwent transbronchial biopsy at Persahabatan Hospital from September 2024 to December 2024. Analysis was performed on the relationship between factors affecting the positivity of transbronchial biopsy, such as bronchial signs, tumor size, location of the lung lesion, and guidance for biopsy. Results : In this study, the average age of the subjects was 58 (±12.73) years old. The majority of the subjects were male, with 47 (61%) subjects. The proportion of positive transbronchial biopsy results reached 63,6%. The proportion of lesion locations was highest at the apex of the lung, which accounted for 57.2%. Bivariate analysis showed that bronchial signs and the size of lung lesions affected the positivity of transbronchial biopsy results. Based on multivariate analysis, lung lesion size ≥2.95 cm, with or without bronchial signs, influenced the positivity value of the transbronchial biopsy by 5.44 (1.54-19.14); p 0.008. Conclusion : Bronchial signs and the size of lung lesions are independent variables that affect the positivity of transbronchial biopsy results. A lung lesion size ≥2.95 cm increases the likelihood of a positive result in transbronchial biopsy, with or without bronchial signs.
Keywords: Lung cancer, diagnostic yield of transbronchial biopsy, bronchus sign, lung lesion size.