Korelasi Kadar Matriks Metalloproteinase-9 Serum dengan Peritoneal Cancer Index pada Penderita Tumor Ovarium Ganas Tipe Epitel

Abstract

Tujuan: Mengetahui hubungan kadar matriks metalloproteinase-9 (MMP-9) dengan peritoneal cancer index (PCI) pada penderita tumor ovarium ganas tipe epitel. Metode: Penelitian ini merupakan penelitian deskriptif dengan desain case series. Subjek penelitian sebanyak 26 wanita dengan tumor ovarium ganas tipe epitel di RS H.Adam Malik Medan pada Maret sampai jumlah sampel terpenuhi. Subjek diseleksi dengan consecutive sampling. Sampel darah diambil untuk dilakukan pemeriksaan kadar matriks metalloproteinase-9 dengan metode ELISA. PCI dinilai saat operasi. Data dianalisis menggunakan statististik uji Mann-Whitney, uji t-test independent dan uji korelasi Spearman. Nilai p kurang dari 0,05 diterapkan pada setiap uji statistik sebagai signifikan. Hasil: Dari subjek penelitian 26 orang. Sebagian besar subjek penelitian berusia di atas 50 tahun, memiliki anak ≥ 1 orang dengan jenis histopatologi adenocarcinoma serosum, stadium III-IV dan sitoreduksi optimal. Tipe adenocarcinoma serosum sebanyak 16 orang (61,6%), adenocarcinoma musinosum 5 orang (19,2%) dan lainnya 5 orang (19,2%). Median kadar MMP-9 serum pada tipe adenocarcinoma serosum 1002.6 ng/mL. Pasien dengan CA-125> 500 U/mL, sitoreduksi suboptimal, skor PCI >10 memiliki kadar MMP-9 serum yang lebih tinggi yaitu median 1530.2 ng/mL. 2157.6 ng/mL. and 1942.4 ng/mL secara berurutan. Status menopause tidak menunjukkan perbedaan yang bermakna dengan nilai p 0.311. Perbedaan kadar MMP-9 serum dan skor PCI dengan stadium tidak terdapat perbedaan yang bermakna dengan nilai p 0.193 dan 0.0541. Terdapat korelasi positif antara kadar MMP-9 serum dan skor PCI dengan nilai r 0.478 dan nilai p 0.013. Kesimpulan: Terdapat perbedaan kadar MMP-9 yang bermakna pada subjek berdasarkan CA-125, sitoreduksi dan PCI. Tetapi tidak terdapat perbedaan kadar MMP-9 yang bermakna berdasarkan histopatologi, status menopause dan stadium. Tidak terdapat perbedaan skor PCI yang bermakna antara penderita tumor ovarium ganas tipe epitel stadium II dan stadium III-IV. Terdapat korelasi positif sedang yang bermakna secara statistik antara rerata kadar MMP-9 serum dengan peritoneal cancer index.

Objective: To determine correlation of Serum Matrix Metalloprotein-9 level with Peritoneal Cancer Index in Epithelial Type Ovarian Cancer Patients Methods: This study is a descriptive study with case series design on 26 subjects with epithelial type ovarian cancer at H.Adam Malik Hospital Medan in March until samples size are met. Subjects were selected by consecutive sampling and blood samples was obtained from patients and serum MMP-9 levels was measured by ELISA. PCI score was taken during operation. Data were analyzed using statistics Mann-Whitney test, t-test independent dan Spearman correlation test. A p-value less than 0.05 is applied to each statistical test as significant. Results: From 26 patients. Most of the subject of study was above 50 years, have ≥ 1 children with a kind of histopathologic type adenocarcinoma serosum, stage III-IV and optimal cytoreduction. Histopathology type of 16 patients (61.5%) were serous adenocarcinoma, 5 patients (19.2%) were mucinous adenocarcinoma, and 5 patients (19.2%) were others. The median MMP-9 serum levels was highest with serous adenocarcinoma type (1002.6 ng/mL). Patients with CA-125> 500 U/mL, suboptimal cytoreduction, PCI score >10 had high MMP-9 serum levels with median 1530.2 ng/mL. 2157.6 ng/mL. and 1942.4 ng/mL respectively. considerably higher than those with CA-125 ≤500 IU/mL. optimal cytoreduction. and PCI score ≤10. Menopausal status showed no significant difference with p-value 0.311. The comparison between MMP-9 serum levels and PCI score with staging found no significant difference with p-value 0.193 and 0.0541. There was positive correlation between MMP-9 serum levels and PCI score with r-value 0.478 and p-value 0.013. Conclusion: There is significant difference in serum MMP-9 level based on CA-125 level, cytoreduction and PCI. But serum MMP-9 level based on histopathology, menopausal state, and stage is not statistically different. PCI score is not statistically different in stage II and stage III-IV patients. There is a moderate positif correlation between serum MMP-9 level and peritoneal cancer index in epithelial type ovarian cancer patients.