"Tujuan Pemeriksaan: Melakukan analisis nilai DNA EBV dalam serum penderita KNF Stadium Awal (I/II) dan Stadium Lanjut (III/IV).
Material dan Metode: Sebanyak 83 serum darah penderita kanker nasofaring (ICNF) bClj8IliS undWerenzia1e¢ diambil sebelum pcmberian tempi. Sampel dibagi menjadi 2 group berdasarkan sistem TNM (UICC) dan didapatkan: 25 sampel berasal dari sennn pendcrita KNF stadium awal (I/ll) dan 58 dari penderita stadium Ianjut (III/IV). Mcnggtmakan real time pobwmerase chain reaction (PCR) dilakukan pengukuran kadar DNA EBV dengan LMP2 sebagai gen target. Perbedaan kadar DNA EBV ditentukan menggunakan analisa dcskriptif menggunakan test non parametrik antara penderita KNF stadium awal dan stadium lanjut dan terhadap status T,N dan M.
Hasil: Pengukuran kadar senun DNA EBV pada penderita KNF stadium awa! (I/Il) sebelum memulai pengobatan, menunjukkan sebanyak I7 dari 25 sampei (66.7%) tidak terdeieksi adanya copy DNA EBV dan 8 sampe] (33.3%) terdeteksi. Pada penderita KNF stadium lanjut (Ill/IV), 37 dari 58 sampel (63.I5%) terdeteksi adanya copy DNA EBV dan 21 sampel (36.84%) tidak terdeteksi. Kadar DNA EBV pada penderim KNF stadium lanjut menunjukkan hasil yang lcbih tinggi dibandingkan dengan hasil penderita KNF stadium awal (median 24.8 copy/ml vs 0 copy/ml), dengan nilai cut off pada 7.15 copy/ml (sensitititas 60.3% dan spcsifisitas 72.0%). Kadar DNA EBV yang lcbih tinggi terdapai pula pada hasil pengukuran serum DNA EBV antara penderita KNF dengan status T3-T4, N2-N3 dan Ml dibandingkan dengan penderita KNF dengan status Tl-'I`2, N0-Nl dan M0.
Kesimpulan: Pengukuran kadar serum DNA EBV merupakan cam yang potensial untuk membedakan antara pcnderita IONIF stadium awatl (l/ll) dan Qadium lanjut (III/IV) dengan perkiraaan nilai cut off pads 7.15 copy/ml. Termasuk pula untuk membedakan antara status T,N dan M. Pcngukumn kadar DNA EBV dapat menyempurnakan penggunaan sistem TNM pada tingkst molekuler.
......To analyze the difference of pretreatment serum EBV DNA concentration between early stage (l/II) and advance stage (Ill/IV) nasopharyngeal carcinoma (NPC) patient.
Methodes: Eighty-three (83) pretreatment serum of undifferentiated with all stages of NPC were studied and devided into two groups: 25 samples cattle from early stage (I/II) NPCand 58samplesB~omadvancestage(IIl/IV)NPCasbyUlCCTNM staging system. LMP2 was used as target gene and the concentration were quantified by real-time polymerase chain reactant assay. EBV DNA concentration of the two groups were measured and the difference were accessed, including the T,N,M status with non parametric test.
Result: Pretreatment EBV DNA serum concentration from early stage (I/ll) NPC patients showed: I7 of 25 sampels (66.7%) were undetectable for copy of EBV DNA, and 8 sampels (33.3%) were detectable. Pretreatment EBV DNA from advance stage NPC showed: 37 of 58 patiens (63.l5%) were detectable for copy of EBV DNA and 21 patients were not. Pretreatment EBV DNA serum consentration ti-om advance stage NPC showed higher senzm concentration than early stage (median 24.8 copylml vs 0 copy/ml), on cuz of point prediction at 7.15 copy/ml. Higher concentration as well, were found among those patients whose had T3-T4, N2-N3 and Ml stages compared with Tl-T2, N0-Ni and M0 stages NPC.
Conclusion: EBV DNA semm concentration was found potential to differentiate between early and advance stage NPC, on out ojfpoinr prediction at 7.l5 copy/ml, as well as to differentiate T,N and M stages. EBV DNA measurement was good to improve UICC TNM staging system in clinical practice based, on molecular level."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2010
