Tesis

Proporsi sindrom paraneoplastik hematologi pada pasien kanker paru kasus baru di RS Rujukan Respirasi Nasional Persahabatan = Proportion of hematologic paraneoplastic syndrome in patients with new case of lung cancer in Persahabatan National Respiratory Refferal Hospital.

Latar belakang : Kanker paru dapat memiliki gejala dan tanda yang salah satunya disebabkan sindrom paraneoplastik. Salah satu sindrom paraneoplastik melibatkan sistem hematologi yang terdiri dari anemia, leukositosis, netrofilia, hipereosinofilia, trombositosis dan hiperkoagulabilitas.Belum ada data/penelitian di Indonesia mengenai sindrom paraneoplastik hematologi pada kanker paru. Metode : Penelitian ini adalah studi potong lintang analitik yang dilakukan di poliklinik onkologi toraks RSRRN Persahabatan dalam periode September 2018 hingga Februari 2019 terhadap semua pasien kanker paru kasus baru yang sudah tegak diagnosis serta memenuhi kriteria inklusi dan eksklusi yang diambil secara total sampling. Hasil : Subjek memiliki rerata usia 56,7+11,4 tahun.Sebagian besar laki-laki, berstatus gizi normal (42,6%), memiliki riwayat merokok (75%) dan IB sedang (52%). Jenis histologi tersering KSS (39,7%) dengan stage lanjut (83,8%) dan PS < 2 (94,1%). Proporsi anemia paraneoplastik adalah 40,4% yang berhubungan dengan status gizi kurang dan tersering berjenis normositik normokromik.Proporsi leukositosis paraneoplastik adalah 39% yang berhubungan dengan jenis kelamin laki-laki dan riwayat merokok.Proporsi netrofilia paraneoplastik 51,5% yang berhubungan dengan jenis kelamin laki-laki, riwayat merokok dan jenis histologi KSS.Proporsi hipereosinofilia dan trombositosis paraneoplastik masing-masing adalah 2,9% dan 18,4%. Proporsi hiperkoagulabilitas paraneoplastik adalah 91,2% yang didominasi peningkatan kadar D-dimer. Kesimpulan : Sindrom paraneoplastik hematologi yang paling sering ditemukan pada pasien kanker paru adalah hiperkoagulabilitas, netrofilia dan anemia. Diperlukan penelitian lanjutan untuk menilai hubungan sindrom paraneoplastik hematologi dengan prognosis pasien.
Kata kunci : sindrom paraneoplastik hematologi, kanker paru


Background:Lung cancer could have signs and symptomswhich was caused by paraneoplastic syndromes. One of those paraneoplastic syndromes involves hematologic system consisting of anemia, leukocytosis, neutrophilia, hypereosinophilia, thrombocytosis and hypercoagulability. There has been no data/research in Indonesia regarding hematologic paraneoplastic syndrome in lung cancer. Methods:This study was a cross-sectional analytic study conducted at the thoracic oncology clinic in Persahabatan Hospital during September 2018 to February 2019 for all patients with new case of lung cancer whose diagnosis established and fulfilled the inclusion and exclusion criteria taken in total sampling. Results:Subjects had a mean age of 56.7+11.4 years. Most of them were male, had normal nutritional status (42.6%), had a smoking history (75%) and moderate IB (52%). The most common type of histology was SCC/squamous cell carcinoma (39.7%) with advanced stage (83.8%) and PS < 2 (94.1%). The proportion of paraneoplastic anemia was 40.4% which was associated with poor nutritional status and commonly normocytic normochromic. The proportion of paraneoplastic leukocytosis was 39%, associated with male sex and smoking history. The proportion of paraneoplastic neutrophilia was 51.5%, related to male sex, smoking history and SCC histology type. The proportions of paraneoplastic hypereosinophilia and thrombocytosis were 2.9% and 18.4%, respectively. The proportion of paraneoplastic hypercoagulability was 91.2% and dominated by the increase of D-dimer level. Conclusion:The most common hematologic paraneoplastic syndrome found in lung cancer patients were hypercoagulability, netrophilia and anemia. Further research is needed to assess the correlation of hematologicparaneoplastic syndrome and the prognosis of the patients.
Keywords:hematologic paraneoplastic syndrome, lung cancer