Kadar Angiostatin Urin Pada Tumor Ovarium Epitel Jinak Dan Tumor Ovarium Epitel Ganas

Abstract

BACKGROUND: Clinical examination, ultrasound and imaging and tumor marker profile performed in order to distinguish benign ovarian tumors and malignant ovarian tumors. Most of the tumor marker in ovarian cancer based on clinicopathologic (staging and tumor progression) as of difficult to detect cancer at earlier stage. Malignant tumors are considered produce angiogenesis inhibitors such as endostatin (ES), angiostatin (AS), and trombospondin. In addition, endostatin and angiostatin is found in the urine of epithelial ovarian cancer patients, so it can be used as a marker for epithelial ovarian cancer. OBJECTIVE: To determine differences between angiostatin levels in urinary patients with benign epithelial ovarian tumors and malignant epithelial ovarian tumors METHODS: This study is a comparative analysis with cross-sectional approach at Obstetrics and Gynecology Department at H.Adam Malik hospital, Pirngadi general hospital and Network Hospital in Medan. Examination of urinary angiostatin levels in Prodia Laboratory Medan. The study began in December 2013 until the sample size is met. The population is all patient with ovarian tumor and has been planned to elective surgery. In this study, the significance level (α) of 0.05 and 95 % confidence intervals of the minimum number of samples in each group is 19. Sampling is a consecutive sampling. RESULTS: The majority of patients with malignant ovarian tumors were aged 20-50 years (73 %), premenopausal (78 %), parity ≥ 1 (73 %) and the age of menarche at age < 14 years (89 %). Based on the results of the histopathologic examination, the most group type of malignant ovarian tumors are serosum Adenocarcinoma of the ovary (26.3 %). Malignant epithelial ovarian tumors have urinary angiostatin levels 202.616 ± 229.1864 higher than that of benign ovarian epithelial tumors 90.568 ± 145.362 with p value of 0.034. Based on the statistical test of independent sample test, showed a p-value of < 0.05 which showed significant difference of urinary angiostatin levels of malignant and benign epithelial ovarian tumors. CONCLUSION: There are significant differences in the urinary angiostatin level between malignant epithelial ovarian tumors and benign epithelial ovarian tumors.

LATAR BELAKANGPemeriksaan klinis, pemeriksaan ultrasonografi dan pencitraan serta profil tumor marker dilakukan agar dapat membedakan tumor ovarium jinak dengan tumor ovarium ganas. Sebagian besar penanda tumor yang ditemukan untuk kanker ovarium didasarkan kepada klinikopatologi ( penentuan stadium dan perkembangan tumor) sehingga sulit mendeteksi kanker pada stadium dini. Tumor ganas dianggapmenghasilkan inhibitor angiogenesis seperti endostatin (ES), angiostatin (AS), dan trombospondin. Selain itu, endostatin dan angiostatin ditemukan dalam urin pasien kanker ovarium epitel, sehingga dapat digunakan sebagai penanda untuk kanker ovarium epitel. TUJUAN: Untuk mengetahui perbedaan kadar angiostatin pada urin penderita tumor ovarium epitel jinak dan tumor ovarium epitel ganas METODE: Penelitian ini merupakan penelitian analisis komparatif dengan pendekatanpotong lintang. Penelitian di bagian Obstetri dan Ginekologi RSUP H.Adam Malik, RSUD.Dr.Pirngadi dan RS Jejaring FK USU di Medan. Pemeriksaan kadar angiostatin urindi Laboratorium Prodia Medan. Penelitian mulai bulanDesember 2013 sampai jumlah sampel terpenuhi. Populasi adalah seluruh pasien tumor ovarium dan telah di rencanakanuntuk operasi elektif. Pada penelitian ini digunakan tingkat kemaknaan (α) sebesar 0,05 dan interval kepercayaan 95 % maka jumlah sampel minimal masing-masing grup adalah 19 orang. Pengambilan sampel secara consecutive sampling. HASIL:Mayoritas penderita tumor ovarium ganas adalah usia 20-50 tahun(73%), belum menopause(78%), paritas ≥1(73%) dan usia menarche pada usia <14 tahun(89%). Berdasarkan hasil pemeriksaan histopatologis, kelompok tumor ovarium jenis ganas yang terbanyak adalah Adenocarcinoma Serosum Ovarii (26.3%). Tumor ovarium epitel ganas mempunyai kadar angiostatin urin 202,616 ± 229,1864 yang lebih tinggi dari tumor epitel ovarium jinak yaitu 90,568 ± 145,362. Dengan nilai p value 0,034. Berdasarkan uji statistik independent sample test didapatkan hasil nilai p<0,05 yang menunjukkan ada perbedaan yang bermakna kadar Angiostatin urin tumor ovarium epitel ganas dan jinak. KESIMPULAN: Terdapat perbedaan bermakna kadar angiostatin urin pada tumor ovarium epitel ganasdan tumor ovarium epitel jinak.