Perbedaan Kadar CEA Menurut Derajat Histopatologi Adenokarsinoma Rektum di RSUP Haji Adam Malik Medan

Abstract

Introduction: Colorectal cancer is the third most common malignancy of all cancer patients and the fourth leading cause of death in all cancer patients in the world. In a previous study at H. Adam Malik Central General Hospital, it was found that the rectum was the highest site of colorectal cancer. To diagnozed the rectal cancer, it is necessary to provide non-invasive markers to detect early rectal cancer, such as Carcinoembryonic antigen (CEA). This study aimed to examine the difference in CEA levels according to the degree of histopathology of rectal adenocarcinoma, so that the CEA level can be used as a predictor of histopathologic degree in patients with rectal adenocarcinoma. Methods: This study is andescriptive-analytic study. The data were taken from the patient's medical records. Samples of this study were taken in a total sampling of patients who had been treated at Digestive Surgery Clinic in H. Adam Malik Central General Hospital Medan from January 2011 to December 2015 with rectal adenocarcinoma that met the inclusion and exclusion criterias. The data obtained then analyzed by SPSS statistical software ver .20. Results: During the period January 2011 to December 2015 we found 36 rectal cancer patients who met the inclusion criteria and became the study samples. A total of 19 (52.8%) patients had well differentiated histopathologic result, 15 (41.7%) others was moderately differentiated and 2 (5.6%) remaining was poorly differentiated. Kruskal Wallis test obtained p value = 0.048, so it can be concluded that there is a relationship between CEA levels before treatment with tumor histopathology in patients with rectal cancer. Conclusion: This study obtained differences in CEA levels according to histopathology degree of rectal adenocarcinoma.

Pendahuluan: Kanker kolorektal merupakan keganasan ketiga terbanyak dari seluruh penderita kanker dan penyebab kematian keempat dari seluruh kematian pada pasien kanker di dunia. Dalam penelitian sebelumnya di RSUP H. Adam Malik ditemukan bahwa rektum merupakan lokasi terbanyak terjadinya kanker kolorektal.Untuk membantu diagnosis kanker rektum diperlukan pemantuan petanda atau marker yang tidak invasif untuk mendeteksi kanker rektum lebih awal, sepeti Carcinoembryonic antigen (CEA). Penelitian ini bertujuan untuk menguji perbedaan kadar CEA menurut derajat histopatologi adenokarsinomarektum sehingga kadar CEA dapat dipakai sebagai prediktor derajat histopatologipada pasien dengan adenokarsinoma rektum. Metode: Penelitian ini merupakan penelitian deskriptif analitik. Data diambil dari rekam medis pasien.Sampel penelitian ini diambil secara total sampling yaitu pasien yang pernah berobat di Poliklinik Bedah Digestif RSUP Haji Adam Malik Medanmulai Januari 2011 hingga Desember 2015dengan diagnosa adenokarsinomarektum yang memenuhi kriteria inklusi dan eksklusi.. Data yang di peroleh kemudian dianalisis dengan perangkat statistik SPSS ver.20. Hasil: Selama periode Januari 2011 sampai dengan Desember 2015 didapatkan 36 pasien kankerrektum yang memenuhi kriteria inklusi dan menjadi sampel penelitian. Sebanyak 19 pasien (52.8%) memiliki hasil histopatologi well differentiated, 15 lainnya (41.7%) moderately differentiated dan 2 sisanya (5.6%) poorly differentiated. Hasil uji Kruskal Wallis didapatkan nilai p= 0,048 sehingga dapat disimpulkan bahwa terdapat hubungan antara kadarCEAsebelum terapidengan histopatologi tumor pada pasien kanker rektum. Simpulan: Darihasil analisis pada penelitian ini didapat perbedaan kadar CEA menurut derajat histopatologi adenokarsinoma tumor rektum.