Tesis

Hubungan kadar carcinoembryonic antigen (CEA) dan microsatellite instability (MSI) terhadap mortalitas pasien early onset colorectal cancer (EOCRC) tipe musinosum = Association of carcinoembryonic antigen (CEA) levels and microsatellite instability (MSI) with mortality among patients with early-onset mucinous colorectal cancer (EOCRC).

Kanker kolorektal (KKR) merupakan salah satu kanker insidens dan mortalitas tertinggi di dunia, dengan peningkatan insidens pada usia muda yang dikenal sebagai early onset colorectal cancer (EOCRC). Carcinoembryonic antigen (CEA) dan microsatellite instability (MSI) berperan sebagai biomarker prognostik. Data mengenai hubungan kadar CEA dan status MSI terhadap mortalitas pasien EOCRC di Indonesia masih terbatas sehingga diperlukan penelitian pada populasi ini. Desain penelitian kohort retrospektif yang menginklusi pasien EOCRC tipe musinosum dengan data MSI dan CEA di RS Siloam Kebon Jeruk, RSUPN Dr. Cipto Mangunkusumo, dan RSUP Fatmawati. Analisis dilakukan menggunakan regresi logistik untuk menilai hubungan kadar CEA dan status MSI dengan mortalitas, uji Kaplan-Meier untuk menilai three-year survival rate, dan uji korelasi Spearman untuk menilai korelasi kadar CEA dan status MSI. Sebanyak 30 subjek dengan EOCRC diinklusi. Analisis multivariat menunjukkan stadium IV (HR 10,763; IK95% 1,318– 87,887; p = 0,027) berhubungan signifikan dengan mortalitas. Tidak ditemukan hubungan bermakna antara kadar CEA dan status MSI dengan mortalitas, kesintasan, dan korelasi kadar CEA dan status MSI. Mayoritas pasien EOCRC memiliki status MSI-L dan kadar CEA >5 ng/ml. Tidak ditemukan korelasi yang signifikan secara statistik antara kadar CEA dan status MSI dengan mortalitas pasien EOCRC tipe musinosum.
Kata kunci: Early-onset colorectal cancer tipe musinosum, Carcinoembryonic antigen, Microsatellite instability, Mortalitas, Faktor prognostik


Colorectal cancer (CRC) is one of the leading causes of cancer incidence and mortality worldwide, with a rising incidence among younger individuals, referred to as early-onset colorectal cancer (EOCRC). Carcinoembryonic antigen (CEA) and microsatellite instability (MSI) are established prognostic biomarkers. However, data regarding the association between CEA levels, MSI status, and mortality in EOCRC patients in Indonesia remain limited. A retrospective cohort study was conducted including patients with mucinous-type EOCRC with available CEA and MSI data from Siloam Kebon Jeruk Hospital, Dr. Cipto Mangunkusumo National General Hospital, and Fatmawati General Hospital. Logistic regression analysis was performed to assess the association between CEA levels and MSI status with mortality. Kaplan–Meier analysis was used to evaluate three-year survival rates, and Spearman correlation was applied to assess the correlation between CEA levels and MSI status. A total of 30 EOCRC patients were included. Multivariate analysis demonstrated that stage IV disease (HR 10.763; 95% CI 1.318–87.887; p = 0.027) was significantly associated with mortality. No significant associations were observed between CEA levels and MSI status with mortality, survival outcomes, or their correlation. Most EOCRC patients had MSI-L status and CEA levels >5 ng/mL. No statistically significant association was found between CEA levels, MSI status, and mortality in patients with mucinous-type EOCRC.
Keywords: Early-onset colorectal cancer mucinous type, Carcinoembryonic antigen, Microsatellite instability, Mortality, Prognostic factors.