Nilai AgNOR pada Respon Kemoradiasi Kanker Serviks Sel Skuamosa Stadium Lanjut

Abstract

Aim: To determine AgNOR score and chemoradiation response in advanced stage squamous cervical cancer. Methods: This is a descriptive study with case series in Obstetrics and Gynecology Departemen, Adam Malik General Hospital from September to November 2014. Fifty patient with squamous cervical can@r stage llA2- lllB that have received chemotherapy cisplatin 5 times followed by external radiation 25x and brachytherapy or with box system were included in this study. ldentity of patients were collected and also the chemoradiation therapy based on RECIST. AgNOR was analyzed microscopically from previous paraffin block that collected before chemoradiation in Pathological Anatomy Laboratorium Facilty of Medicine USU. Data were collected and Results: AgNOR mean level in stage llB (5,13t0,89) was higher compared to stage lllB (5,01t0,87), in non keratinizing subhistopathology was higher (5,17 t 0,78) than keratinizing (4,76 *1,03). There is a significant correlation and difference between AgNOR score and chemoradiation response, (p=0,032; p=0,000). Complete and partial response patients showed a significant dffierence of its AgNOR mean leveland also complete and progressive response patients (p<0,05) Conclusion: There is a significant correlation and difference between AgNOR score and chemoradiation response in advanced stage squamous cervical cancer

Tujuan: Mengetahui nilaiAgNOR pada respon kemoradiasi kanker serviks sel skuamosa.stadium lanjut Metode: Penelitian ini adalah penelitian deskriptif dengan desain penelitian case sen'es, dilakukan di Departemen Obstetri dan Ginekologi RSUP H.Adam Malik Medan bulan September-November 2014. Sebanyak 50 pasien kanker serviks sel skuamosa stadium llA2-lllB yang sudah mendapat kemoterapi cisplatin sebanyak 5x disertai radiasi eksternal sebanyak 25 x dan brakhiterapi sebanya( 2 x ataupun radiasi tambahan dengan box sysfem, dikumpulkan identitasnya dan dilihat respon kemoradiasinya berdasarkan RECIST, kemudian diambil blok parafinnya sebelum kemoradiasi dan dianalisa nilai AgNOR dengan pemeriksaan mikroskopik di laboratorium Patologi Anatomi FK USU. Data kemudian dikumpulkan untuk dianalisa Hasil: Rerata AgNOR pada stadium llB (5,13t0,89), lebih tinggi dibandingkan stadium lllB (5,01t0,87), pada subhistologis berkeratin lebih tinggi (5,17 r 0,78) dibandingkan non keratin (4,76 t1,03). Ada hubungan dan perbedaan antara nilaiAgNOR dengan respon kemoradiasi (p=0,000; p=0,032;). Nilai rerata AgNOR berbeda secara signifikan hanya antara kelompok yang komplit dan parsial dan dengan kelompok komplit dengan progresif (p<0,05) Kesimpulan: Terdapat hubungan dan perbedaan yang bermakna nilai AgNOR pada respon kemoradiasi pasien kanker serviks sel skuamosa stadium lanjut