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Herman Darmawan
Abstrak :
ABSTRAK
Background research : Air pollution due to road traffic is a serious health hazard and thus the collector toll who are continuously exposed to pollutant, may be at an increased risk. Types of main pollutants in the outdoor air pollution will significantly influence lung function. This study determined the factors that affect spirometry lung function, chest x-ray, and respiratory symptoms of collector toll working in the area of Jagorawi toll in East Jakarta. Methods: This study is a cross sectional study was conducted among collector toll of Jagorawi toll in East Jakarta in the period of December 2012 with total sampling method. This study has assessed respiratory clinical symptoms using questionnaires of Pneumobile Project Indonesia, examined spirometry, and chest x-ray. Results: A total of 129 subjects were included in this study. Most of them are men (71,3%), aged 40 to 49 years (48,8%), were over weight (46,5%), active smokers (55%), most of them have worked 15 to 19 years, did not use masker properly (65,9%), and had abnormal chest x-ray (3,9%). Results of spirometry examination showed mild restriction in 12 subjects (9,3%), mild obstruction in 2 subjects (1,6%). There are significant association between age and period of working with spirometry abnormalities (p<0,05), but no significant association found between nutritional status, smoking history, chest x-ray, using of masker, place of working with spirometry of collector toll (p>0,05). There is significant association between respiratory clinical symptoms with mild lung restriction (p<0,05). There are significant association between age and smoking history with respiratory clinical symptoms (p<0,05). There is significant association between period of working with chest x-ray abnormalities. Conclusion: This study showed that there are significant association between age and period of working with spirometry abnormalities (p<0,05), but no significant association found between nutritional status, smoking history, chest x-ray abnormalities, using of masker, place of working with spirometry abnormalities of collector toll (p>0,05).
ABSTRACT
Latar belakang penelitian: Petugas gerbang tol merupakan profesi yang mempunyai risiko sangat besar untuk terpajan zat-zat polutan yang berasal dari asap kendaraan bermotor yang akan memberikan efek berupa penurunan fungsi paru dan keluhan respirasi. Penelitian ini bertujuan untuk mengetahui gambaran spirometri, foto toraks dan keluhan respirasi pada petugas gerbang tol Jagorawi di Jakarta Timur. Metode penelitian : Penelitian ini dilakukan di wilayah Tol Jagorawi di Jakarta Timur bulan Desember 2012 dengan desain uji potong lintang. Pengambilan sampel menggunakan total sampling melalui kuesioner, pemeriksaan spirometri, foto toraks PA. Hasil : Seratus dua puluh Sembilan subjek diikutkan dalam penelitian ini, laki-laki (71,3%) terbanyak usia 40-49 tahun yaitu 63 orang (48,8%), berat badan lebih 60 orang (46.5%) , perokok aktif 71 orang (55%) dengan IB ringan 41 orang (31,8%), bekerja selama 15-19 tahun sebanyak 46 orang (30,7%). Prevalens kelainan spirometri sebanyak 14 orang (10,9%) yaitu restriksi ringan 12 orang (9,3%) dan obstruksi ringan didapatkan pada 2 orang (1,6 %). Penggunaan APD masker buruk (65,9%), kelainan foto toraks (3,9%), keluhan respirasi (10,1%). Secara statistik terdapat hubungan bermakna antara usia, masa kerja dengan kelainan obstruksi. Terdapat hubungan bermakna antara usia, masa kerja dengan kelainan restriksi. Terdapat hubungan bermakna antara keluhan respirasi dan indeks brinkman dengan kelainan restriksi. Terdapat hubungan bermakna antara masa kerja dengan kelainan foto toraks. Terdapat hubungan bermakna antara kebiasaan merokok dan usia dengan keluhan respirasi. Kesimpulan : Penelitian ini menunjukkan terdapat hubungan bermakna antara usia, masa kerja dengan kelainan obstruksi. Hubungan bermakna antara usia, masa kerja dengan kelainan restriksi. Hubungan bermakna antara keluhan respirasi dan indeks brinkman dengan kelainan restriksi. Hubungan bermakna antara masa kerja dengan kelainan foto toraks. Hubungan bermakna antara kebiasaan merokok dan usia dengan keluhan respirasi.
2013
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UI - Tesis Membership  Universitas Indonesia Library
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Gatot Sudiro Hendarto
Abstrak :
Tujuan penelitian potong lintang ini adalah menggambarkan tingkat keterkontrolan asma, kualitas hidup, dan kepatuhan pengobatan serta melihat hubungan antara keterkontrolan asma dengan kualitas hidup dan kepatuhan pengobatan. Sebanyak 132 pasien asma poli rawat jalan RSUP Persahabatan menyatakan kesediaan dan mengikuti penelitian ini dengan lengkap. Data diambil melalui wawancara dan pengamatan cara pakai obat. Sebesar 64 pasien (48,5%) menderita asma yang tidak terkontrol dan 68 pasien (51,5%) termasuk dalam asma yang terkontrol. Gambaran kualitas hidup menunjukkan nilai rerata domain gejala sebesar 4,83 (±1,49), domain keterbatasan aktivitas sebesar 5,99 (±0,86), domain fungsi emosi sebesar 5,13 (±1,63), dan domain pajanan lingkungan sebesar 3,89 (±1,88). Gambaran kepatuhan pengobatan pada penelitian ini sebesar 45,5% pasien minum obat sesuai anjuran dokter, 38,6% pasien rutin kontrol ke petugas kesehatan, dan 45,5% menggunakan obat inhalasi dengan benar. Domain pajanan lingkungan berdampak lebih besar terhadap gangguan kualitas hidup dibandingkan dengan domain lainnya. Terdapat hubungan antara keterkontrolan asma dengan kualitas hidup (r=0,307, p<0,05) dan hubungan antara keterkontrolan asma dengan kepatuhan pengobatan (penggunaan dosis obat, rutin kontrol, dan penggunaan obat inhalasi) (p<0.05). ...... The aim of this cross-sectional study was to describe the level of asthma control, quality of life, medication compliance, and assess correlation between the level of asthma control, quality of life, and compliance with treatment. A hundred and thirty two patients with asthma in outpatient ward of RSUP Persahabatan hospital have provided consent and completed study. Data collection were conducted from interviews and observation how to use the drug. Sixty four patients (48.5%) had uncontrolled asthma and 68 patients (51.5 %) included in the controlled asthma. The mini asthma quality of life questionaire showed the mean symptom domains score of 4.83 (±1.49), activity limitations domain score of 5.99 (± 0.86), emotional function domain score of 5.13 (±1.63 ), and the environmental stimuli domain of 3.89 (±1.88). Medication compliance revealed that 45,5% used medication dose as recommended by physician, 38,6% visited the physician for routine follow up, and 45,5% used the inhaled medication correctly. Environmental stimuli had more impact in quality of life compared to symptoms, activity limitation and emotional function. There is a relationship between the domain of quality of life with asthma control level (r=0,307, p<0,05) and there is a relationship between medication dose as recommended by physician, visiting the physician for routine follow up and using the inhaled medication correctly with asthma control level (p <0.05).
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013
T39286
UI - Tesis Membership  Universitas Indonesia Library
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Erni Mudhiati S
Abstrak :
Latar belakang penelitian: Tumor sel germinal di mediastinum relatif jarang terjadi. Tumor ini dapat bersifat jinak maupun ganas, yang bersifat ganas mempunyai prognosis buruk. Pada saat ini terapi multimodaliti dapat meningkatkan angka tahan hidup pasien tumor sel germinal mediastinum. Penelitian ini bertujuan untuk mengetahui angka tahan hidup keseluruhan atau overall survival rate, karakteristik pasien dan faktor-faktor yang mempengaruhi angka tahan hidup pasien tumor sel germinal mediastinum di RSUP Persahabatan Jakarta. Metodologi penelitian : Penelitian ini merupakan kohort retrospektif pada populasi pasien yang didiagnosis tumor sel germinal mediastinum periode Januari 2007 sampai dengan Desember 2012. Penelitian dilakukan di RSUP Persahabatan dengan pengamatan sejak Januari 2007 sampai Desember 2013. Pengambilan sampel menggunakan rumus proporsi untuk menganalisis karakteristik dan faktor-faktor yang mempengaruhi angka tahan hidup sedangkan angka tahan hidup dianalisis sesuai dengan jumlah sampel yang memenuhi kriteria inklusi dan ekslusi. Data penelitian diambil dari catatan rekam medis RSUP Persahabatan. Hasil : Angka tahan hidup keseluruhan atau overall survival rate tumor sel germinal mediastinum pada penelitian ini adalah angka tahan hidup 1 tahun sebesar 42,1%, 2 tahun sebesar 22,8%, 3 tahun sebesar 15,8%, 4 tahun sebesar 10,5% dan 5 tahun sebesar 8,8% sedangkan masa tengah tahan hidup keseluruhan 23 minggu (5,75 bulan). Karakteristik tumor sel germinal mediastinum didapatkan lebih banyak pada laki-laki (80%) dengan median usia 21 tahun dan terutama pada kelompok usia 20-29 tahun (43,3%). Gejala klinis terbanyak adalah sesak napas (66,7%), tampilan pasien terbanyak PS2 (50%) dengan jenis tumor sel germinal mediastinum terbanyak adalah teratoma (53,3%) diikuti nonseminoma (40%) dan seminoma (6,7%). Faktor-faktor yang mempengaruhi angka tahan hidup tumor sel germinal mediastinum adalah tampilan pasien, terapi, penyulit dan lokasi tumor. Kesimpulan : Pada analisis bivariat, tampilan pasien, lokasi tumor, penyulit dan terapi bermakna mempengaruhi angka tahan hidup 1 tahun tetapi pada analisis multivariat hanya variabel lokasi tumor yang bermakna mempengaruhi angka tahan hidup 1 tahun. ...... Background research : In mediastinal germ cell tumors are relatively rare. These tumors can be benign or malignant , which has a poor prognosis malignant . At this time multimodaliti therapy can improve the survival rate of patients mediastinal germ cell tumors . This study aims to determine the overall survival rate, patient characteristic and factors affecting the survival rate of patients mediastinal germ cell tumors in the Persahabatan hospital Jakarta. Research methodology : This study is a retrospective cohort in a population of patients diagnosed germ cell tumors of the mediastinum period January 2007 to December 2012 . The study was conducted in the of Persahabatan hospital with observations from January 2007 to December 2013. Sampling using the formula proportions to analyze the characteristic and factors that influence survival rate where as the survival rate was analyzed according to the number of samples that meet the inclusion and exclusion criteria . Data were taken from the medical record of Persahabatan hospital. Results : The overall survival rate of mediastinal germ cell tumors in this study was survival rate 1 year 42,1 %, 2 years 22,8%, 3 years 15,8 %, 4 years 10,5% and 5 years 8.8 % while the overall survival of the middle period of 23 weeks are 5,75 months. Mediastinal germ cell tumor characteristic found more in males ( 80 % ) with a median age of 21 years and especially in the age group 20-29 years ( 43,3 % ). Most clinical symptoms are shortness of breath ( 66,7 % ), most patients display a PS2 ( 50 % ) with mediastinal germ cell tumors are teratomas majority ( 53,3 % ) followed nonseminoma ( 40 % ) and seminomas ( 6,7 % ). Factors affecting the survival rate of mediastinal germ cell tumors are views of patients, treatment, complications and location of the tumors. Conclusion : In bivariate analysis, display the patient, location of tumor, and treatment complications significantly affect 1 year survival rate but variable in the multivariate analysis only tumor location was significantly affect 1 year survival rate.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
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Husnun Nisa Ratna Ningrum
Abstrak :
Pendahuluan: Timoma merupakan tumor mediastinum dengan kelompok lesi neoplastik yang heterogen sehingga penatalaksanaan dan prognosisnya berbedabeda. Penelitian ini ingin melihat angka tahan hidup timoma dan faktor-faktor yang mempengaruhinya. Metode penelitian: Penelitian ini menggunakan metode kohort retrospektif terhadap timoma di RSUP Persahabatan antara Januari 1997 sampai Desember 2012. Data diambil dari rekam medis. Analisis kesintasan menggunakan Kaplan- Meier sedangkan perbandingan survival menggunakan uji Log-Rank dan analisis multivariat dengan analis Regresi Cox. Hasil penelitian: Sebanyak 43 subjek penelitian dianalisis dan didapatkan 1-year survival rate sebesar 72,1%, 3-year survival rate 58,1% dan overall survival rate 55,8%. Histopatologi timoma menurut pembagian WHO masing-masing mempunyai 5-year survival rate sebesar 73,7% pada tipe A, 55,6% pada tipe AB, 100% pada tipe B1, 25% pada tipe B2 sedangkan tipe C semuanya meninggal pada bulan ke-23. Dengan uji perbandingan Log-Rank didapatkan perbedaan bermakna secara statistik antara tipe A-B2 (p 0,009), tipe A-C (p 0,001), tipe ABC (p 0,032) dan tipe B1-C (p 0,018). Stage timoma menurut pembagian Masaoka masing-masing mempunyai 5-year survival rate sebesar 100% pada stage I, 90% pada stage II,57,1% pada stage III, 26,7% pada stage IV A dan 20% pada stage IV B. Didapatkan perbedaan bermakna antara stage I-IV A (p 0,012), I-IV B (p 0,007), II-IV A (p 0,002) dan II-IV B (p 0,002). Tindakan pembedahan extended thymo thymectomy (ETT) mempunyai 5-year survival rate sebesar 83,3%, debulking sebesar 27,3% dan tanpa pembedahan sebesar 42,9%. Didapatkan perbedaan bermakna antara ETT-debulkling (p 0,001) dan antara ETT-tidak dibedah (p 0,01). Tidak terdapat perbedaan angka tahan hidup timoma yang bermakna berdasarkan umur, jenis kelamin maupun ada tidaknya miastenia gravis. Analisis multivariat memperlihatkan faktor yang paling berpengaruh terhadap angka tahan hidup timoma adalah stage menurut Masaoka. Kesimpulan: Jenis histopatologi menurut WHO, stage menurut Masaoka dan tindakan pembedahan merupakan faktor yang mempengaruhi angka tahan hidup timoma. Faktor yang paling berpengaruh adalah stage menurut Masaoka. ...... Introduction: Thymoma is a mediastinal tumor with a heterogeneous group of neoplastic lesions, in such that it applied varies management and prognosis. This study wanted to see thymoma survival rate and the factors that influence it. Methods: This study used a retrospective cohort method to thymoma at Persahabatan Hospital between January 1997 and December 2012. Data retrieved from medical records. Survival analysis using the Kaplan-Meier while survival comparisons using the Log-Rank test and multivariate analysis using the Cox Regression analysis. Results: A total of 43 subjects were analyzed and found 1-year survival rate of 72.1%, 3-year survival rate of 58.1% and overall survival rate of 55.8%. Histopathology division of thymoma according to the WHO each have 5-year survival rate of 73.7% in type A, 55.6% in type AB, 100 % in type B1, 25% in type B2 while type C all died in month-23. Using the Log-Rank test comparisons found statistically significant differences between type A-B2 (p 0.009), type A-C (p 0.001), type AB-C (p 0.032) and type B1-C (p 0.018). Thymoma stage division according to Masaoka each has a 5-year survival rate of 100 % in stage I, 90% in stage II, 57.1% in stage III, 26.7% in stage IV A and 20% in stage IV B. Obtained significant differences between stage I - IV A (p 0.012), the I - IV B (p 0.007), IIIV A (p 0.002) and II-IV B (p 0.002). Surgery extended thymo thymectomy (ETT) has a 5-year survival rate of 83.3%, 27.3% and debulking without surgery by 42.9%. Obtained significant differences between the ETT-debulkling (p 0.001) and between ETT-no surgery (p 0.01). There was no significant difference in survival rate of thymoma based on age, gender and the presence of myasthenia gravis. Multivariate analysis showed that the most influential factors on the survival rate thymoma are stage divisions according to Masaoka. Conclusions: Histopathological type according to the WHO, stage divisions according to Masaoka and surgery are affecting factors of thymoma survival rate. The most dominant factor is the stage divisions according to Masaoka.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
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Masdi Mufrodi
Abstrak :
Latar belakang: Penggunaan obat hemostatik pada hemoptisis masih kontroversial, sebagian ahli meragukan manfaat obat-obat ini, namun sebaiknya diberikan karena berbagai penelitian menunjukan obat ini berpengaruh pada mekanisme penghentian perdarahan. Untuk efektifitas karbazokrom belum ada penelitian penggunaannya pada pasien hemoptisis. Tujuan: Mengetahui efektivitas pemberian karbazokrom (cromeR) 3x50 mg iv ditambah vitamin K 3x10 mg iv dan vitamin C 3x200 mg dibanding dengan vitamin K 3x10 mg iv ditambah vitamin C 3x200 mg iv dalam mengontrol batuk darah. Metode: Penelitian ini merupakan studi eksperimental (uji klinis), randomisasi, tersamar ganda, dilakukan mulai bulan Juli 2012 s/d Desember 2013 di RSUP Persahabatan Jakarta. Kelompok perlakuan mendapat karbazokrom (cromeR) 3x50 mg iv ditambah vitamin K 3x10 mg iv dan vitamin C dan kelompok kontrol mendapatkan vitamin K 3x10 mg iv ditambah vitamin C 3x200 mg iv saja. Dilakukan pengamatan sampai bebas batuk darah 1x24 jam atau maksimal 7 hari. Hasil: Subjek dalam penelitian ini diperoleh 134 orang dengan rata-rata usia 45 tahun, laki-laki 72,4 %, perempuan 27,6% dan diagnosis terbanyak adalah Tb paru 58% kemudian bekas TB 25%. Kelompok perlakuan batuk darah yang terkontrol 95,7%, sedangkan kelompok kontrol 66,7% dengan nilai p<0.001. Kelompok perlakuan lama perdarahannya lebih singkat rata-rata 2 hari sedangkan kelompok kontrol 4 hari dengan nilai p<0.001. Laju perdarahan pada kelompok perlakuan secara bermakna lebih cepat berkurang jumlah perdarahannya dibandingkan kelompok kontrol dengan nilai p<0.001.Tidak ditemukan efek samping pada kedua kelompok subyek. Biaya obat hemostatik tiap hari dikalikan lama batuk darah lebih besar pada kelompok perlakuan rata-rata Rp172.760,- sedangkan kelompok kontrol Rp 118.400,-. Kesimpulan: Pemberian karbazokrom (cromeR) 3x50 mg iv ditambah vitamin K 3x10 mg iv dan vitamin C 3x200 mg iv lebih efektif dalam mengontrol batuk darah dibanding dengan vitamin K 3x10 mg iv ditambah vitamin C 3x200 mg iv. ...... Background: Use of hemostatic drugs on hemoptysis remains controversial, some experts doubt the benefits of these drugs, however, it should be given because some research shows these drugs give influence to the mechanisms of haemostasis. There is no research about the effectiveness of carbazochrome for patient with hemoptysis. Objective: To find out the effectiveness of the provision carbazochrome (cromeR) 3x50 mg iv plus vitamin K 3x10 mg iv and vitamin C 3x200 mg iv compared with vitamin K 3x10 mg iv plus vitamin C 3x200 mg iv to controlling hemoptysis. Methods: This study was a randomized double-blind controlled trial conducted from July 2012 until December 2013 in the Persahabatan Hospital of Jakarta. The treatment group received carbazochrome (cromeR) 3x50 mg iv plus vitamin K 3x10 mg iv and vitamin C 3x200 mg iv, whereas control group obtained vitamin K 3x10 mg iv and vitamin C 3x200 mg iv only. Observed up to free of hemoptysis 1x24 hours or up to 7 days. Results: Subjects in this study were obtained 134 people with an average age of 45 years, men 72.4%, women 27.6% and is the highest diagnosis of pulmonary Tuberculosis (Tb) 58% and post Tb25%. Treatment group was 95.7% controlled results, whereas the control group 66.7% with p <0.05. Treatment group have shorter bleeding time, on average 2 days, while the control group is 4 days with p< 0.001. The rate of bleeding in the treatment group significantly reduced faster than the control group with p < 0.001. No adverse reactions in the two groups. Hemostatic drug costs per day times hemoptyis long-time was greater in the treatment group average of Rp 172.760,- while the control group Rp 118.400,- Conclusion: Giving carbazochrome (cromeR) 3x50 mg iv plus vitamin K 3x10 mg iv and vitamin C 3x200 mg iv more effective to control hemoptysis than vitamin K 3x10 mg iv and vitamin C3x200 mg iv.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
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Andika Chandra Putra
Abstrak :
Latar Belakang: Faktor transkripsi Hypoxia inducible factor-1 (HIF-1 merupakanpengatur utama hipoksia, termasuk menyebabkan penekanan sistem perbaikan deoxyribose nucleic acid (DNA), sehingga menghasilkan instabilitas genetik pada sel kanker. Varian genetik HIF-1α C1772T (P582S) dan G1790A (A588T) dipercaya mempunyai aktivitas transkripsi yang lebih tinggi.Peranan polimorfisme HIF-1α ini sudah diteliti pada beberapa jenis kanker seperti kanker ginjal, payudara, ovarium, tetapi belum ada penelitian pada kanker paru. Metode: Polimorfisme HIF-1α diperiksa dengan menggunakan direct sequencing dengan total sampel 83 pasien kanker paru (42 adenokarsinoma, 30 skuamous sel karsinoma, empat adenoskuamous sel karsinoma dan tujuh kanker paru karsinoma sel kecil (KPKSK) dan 110 subjek sehat sebagai kontrol. Hubungan polimorfisme HIF-1α dengan kelainan genetik/epigentik loss of heterozygot (LOH) TP53, LOH 1p34, LOH retinoblastoma-1 (RB1), inaktivasi p16 dan kelainan epidermal growth factor receptor (EGFR) kemudian diperiksa. Hasil: Frekuensi polimorfisme HIF-1α pada kanker paru dan kontrol telah sesuai dengan keseimbangan Hardy-Weinberg. Pada penelitian ini tidak ditemukan perbedaan frekuensi genotipe C1772T atau G1790A antara kanker paru dengan kontrol sehat. Tetapi, frekuensi varian HIF1A C1772T ditemukan tinggi bermakna di pasien kanker paru dengan LOH TP53 (p=0,015). Pada pasien adenokarsinoma, individu dengan varian alel memiliki frekuensi tinggi LOH TP53 (p=0,047), LOH 1p34 (p=0,009) atau keduanya (LOH TP53 dan LOH 1p34) (p=0,008). Aktivitas transkripsi juga diperiksa secara in vitro dan ditemukan HIF1A varian pada sel kanker paru A549 mempunyai aktivitas yang meningkat secara bermakna dibanding wild type HI1F1A baik di kondisi normoksia atau hipoksia, terutama P582A di sel dengan mutan p53 (p< 0,0005 dan p< 0,005). Kesimpulan: Penelitian ini mengindikasikan polimorfisme gen HIF-1α mempunyai peranan penting dalam karsinogenesis paru terutama pada adenokarsinoma, diduga melalui peningkatan instabilitas genetik. ...... Background and objective: The transcription factor, hypoxia-inducible factor-1 (HIF-1), is a master regulator of hypoxia, including repression of DNA repair systems, resulting in genomic instability in cancer cells. The roles of the polymorphic HIF-1a variants, C1772T (P582S) and G1790A (A588T), which are known to enhance transcriptional activity, were evaluated in lung cancers. Methods: HIF-1a polymorphisms were assessed by direct sequencing in a total of 83 lung cancer patients (42 adenocarcinomas, 30 squamous cell, four adenosquamous cell and seven small cell lung carcinomas) and in 110 healthy control subjects. The relationship between these polymorphisms and the frequently observed genetic and/or epigenetic aberrations, TP53 loss of heterozygosity (LOH), 1p34 LOH, retinoblastoma-1 (RB1) LOH, p16 inactivation and epidermal growth factor receptor aberrations, was then assessed. Results: There were no significant differences in genotype frequencies for either C1772T or G1790A between lung cancer patients and healthy controls. However, the frequency of the HIF1A C1772T variant allele was significantly higher in lung cancer patients with TP53 LOH (P = 0.015). Among adenocarcinoma patients, individuals with variant alleles of either polymorphism showed significantly higher frequencies of TP53 LOH (P = 0.047), 1p34 LOH (P = 0.009), or either of these (P = 0.008) in the tumours. The in vitro transcriptional activity of these HIF1A variants in A549 lung cancer cells was significantly greater than that of the wild type under either normoxic or hypoxic conditions, especially for P582S in cells containing mutant p53 (P < 0.0005 and P < 0.005, respectively). Conclusions: These findings indicate that functional polymorphisms in the HIF-1a gene may have an important impact on lung carcinogenesis, especially in adenocarcinomas, possibly by increasing genomic instability.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
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UI - Tesis Membership  Universitas Indonesia Library
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Kasum Supriadi
Abstrak :
[ABSTRAK
Pendahuluan. Kanker paru jenis karsinoma bukan sel kecil (KPKBSK) terdiri dari nonskuamosa dan skuamosa. Kanker paru jenis karsinoma bukan sel kecil nonskuamosa adalah adenokarsinoma dan karsinoma sel besar. Saat ini terapi kanker paru sangat berkembang dari agen kemoterapi sampai terapi target terutama EGFR-TKI. Penelitian ini bertujuan untuk menilai angka tahan hidup pasien KPKSBK nonskuamosa yang mendapat kemoterapi lini pertama dibandingkan terapi EGFR-TKI di RSUP Persahabatan. Metode. Penelitian ini adalah penelitian retrospektif antara tahun 2010 sampai 2013 dari rekam medis pasien KPKBSK non skumosa yang mendapatkan kemoterapi lini pertama dan EGFR-TKI. Pasien dikemoterapi dengan platinum baseddan EGFR-TKI diterapi gefitinib 1x250 mg/hari atau erlotinib 1x150 mg/hari. Angka tahan hidup dinilai dari mulai tegak diagnosis sampai pasien meninggal atau saat penelitian dihentikan. Hasil. Dari 96 sampel KPKBSK non skuamosa terdiri dari 48 pasien yang mendapat kemoterapi lini pertama dan 48 pasien yang diterapi EGFR-TKI. Berdasarkan karakteristik pasien, usia terbanyak adalah 40-60 tahun (kemoterapi 32 (66,7%) dan EGFR-TKI 31 (64,6%) dengan jenis kelamin laki-laki yang mendominasi (kemoterapi 25(52,1%), EGFR-TKI 27 (56,2%). Pasien merokok yang mendapat kemoterapi lini pertama 41,7% dan EGFR-TKI 56,3% dengan IB terbanyak untuk kemoterapi (IB ringan 27,1%) dan untuk EGFR-TKI (IB sedang 22,9%). Jenis histologi adenokarsinoma 95,8% dengan dominasi stage IV 89,6% (kemoterapi 91,7% dan EGFR-TKI 87,5%) disertai tampilan status 2 59,4%. Angka tahan hidup pasien (ATH) 6 bulan 74%, ATH 1 tahun 22,90% dan ATH 2 tahun 6,20%. Masa tengah tahan hidup (MTTH) pasien yang mendapat EGFR-TKI lebih lama sedikit dibandingkan yang mendapat kemoterapi lini pertama (263 hari versus 260 hari. Kesimpulan. Masa tahan hidup 1 tahun pasien KPKBSK non skuamosa yang diterapi EGFR-TKI sedikit lebih lama dibandingkan kemoterapi lini pertama (263 hari vs 260 hari). Sedangkan ATH 1 tahun pasien kemoterapi lini pertama lebih besar dibandingkan EGFR-TKI (25% vs 20,8%). Faktor yang paling mempengaruhi angka tahan hidup adalah stage dengan nilai p<0,05.
ABSTRACT
Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital. Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued. Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days). Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.;Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital. Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued. Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days). Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.;Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital. Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued. Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days). Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.;Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital. Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued. Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days). Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05., Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital. Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued. Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days). Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.]
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
T58765
UI - Tesis Membership  Universitas Indonesia Library
cover
Ririen Razika Ramdhani
Abstrak :
ABSTRAK
Latar Belakang: Kanker paru dan tuberkulosis TB adalah dua masalah kesehatan di seluruh dunia dengan angka kesakitan dan kematian yang tinggi. Meningkatnya kasus TB aktif dan reaktivasi TB laten pada pasien kanker paru serta dampak buruknya terhadap prognosis pasien memerlukan upaya untuk melakukan deteksi TB laten pada pasien kanker paru. Penelitian ini bertujuan untuk mengetahui berapa besar proporsi TB laten pada pasien kanker paru, karakteristiknya dan hubungan antar keduanya.Metode: Penelitian ini menggunakan desain potong lintang dan sampel dikumpulkan secara consecutivesampling terhadap 86 pasien kanker paru baru terdiagnosis di Rumah Sakit Umum Pusat Persahabatan Jakarta tahun 2015 hingga 2016. Pemeriksaan sputum Xpert MTB/RIF dilakukan untuk menyingkirkan kemungkinan TB aktif. Penentuan TB laten dilakukan dengan pemeriksaan Interferon Gamma Release Assay IGRA menggunakan alat QuantiFERON-TB Gold-in-Tube QFT-GIT .Hasil: Pemeriksaan TB laten mendapatkan hasil IGRA 11 pasien 12,8 , IGRA - 59 pasien 68,6 dan IGRA indeterminate I 16 pasien 18,6 . Karakteristik sosiodemografi pasien kanker paru dengan TB laten adalah 63,6 laki-laki, rerata usia 56 tahun, 36,4 diimunisasi BCG, 9 dengan kontak erat TB, 72,7 dengan riwayat merokok. Karakteristik klinis pasien tersebut 90 memiliki status gizi normal lebih dengan nilai tengah indeks massa tubuh IMT 19,12 18,24-29,26 kg/m2, nilai tengah hitung limfosit total 1856 1197-4210 sel/ul, 9 dengan komorbid diabetes mellitus, 81,8 tumor paru mengenai lokasi khas predileksi TB paru. Jenis kanker terbanyak adalah adenokarsinoma 81,8 dengan stage lanjut 81,8 dan status tampilan umum 2-3 63,6 . Karakteristik yang menunjukkan hubungan bermakna dengan hasil IGRA adalah lokasi tumor yang mengenai daerah lesi khas TB secara radiologis. Hitung limfosit total yang rendah berhubungan dengan hasil IGRA I dengan nilai tengah 999,88 277-1492,60 sel/ul.Kesimpulan: Proporsi TB laten pada pasien kanker paru di RSUP Persahabatan adalah 12,8 . Karekteristik pasien kanker paru yang berhubungan dengan TB laten adalah lokasi tumor yang mengenai daerah lesi khas TB walaupun belum dapat disimpulkan hubungannya secara biologis. Hasil IGRA I pada pasien kanker paru dengan hitung limfosit total yang rendah menunjukkan keterbatasan sensitivitas IGRA dalam mendeteksi infeksi TB laten pada pasien imunokompromais.Kata Kunci : infeksi TB laten, kanker paru, IGRA, hitung limfosit total
ABSTRACT
Background Lung cancer and pulmonary tuberculosis TB are two major public health problems associated with significant morbidities and mortalities. The increased prevalence of active TB and latent TB reactivation in lung cancer patients and the negative effect of pulmonary TB in lung cancer prognosis underline the need for a through screening of lung cancer patients for latent TB infection LTBI . The aims of this study are to determine the proportion of LTBI in lung cancer patients, their characteristics and the relationship between them.Methods This study used a cross sectional design and sample was collected using consecutive sampling of the 86 newly diagnosed treatment naive lung cancer patients from a referral respiratory hospital, Rumah Sakit Umum Pusat Persahabatan Jakarta in 2015 to 2016. The presence of LTBI was determined by Quantiferon TB Gold In Tube QFT GIT after having Mycobacterium TB not detected result from Xpert MTB RIF sputum test. Demographic characteristics and cancer related factors associated with LTBI were investigated.Results There are 11 patients 12,8 with IGRA result and 16 patients 18,6 with IGRA indeterminate I result. Sociodemographic characteristics of lung cancer patients with latent TB are 63,6 male, mean of age 56 years, 36,4 with BCG immunization, 9 had TB close contacts history, 72,7 with a history of smoking. The clinical characteristics of these patients are 90 had a normal nutritional status with the median body mass index BMI 19,12 18,24 29,26 kg m2, the median of total lymphocyte count is 1856 1197 4210 cells ul, 9 with diabetes mellitus as comorbid, 81,8 of lung tumour located in the typical predilection for pulmonary tuberculosis. Most types of lung cancer are adenocarcinomas 81.8 with advanced stage 81,8 and the WHO performance status of 2 3 63,6 . Characteristics having significant relationship with IGRA results is the tumour located in the typical TB area radiologically. Low total lymphocyte count is associated with indeterminate IGRA results with median 999,88 277 1492,6 cells ul.Conclusion The proportion of latent TB in lung cancer patients is 12,8 . Characteristics of patients with lung cancer associated with latent TB is the location of the tumor lesions typical of the area although it can not be concluded biologically. Having indeterminate IGRA results in lung cancer patients with a low total lymphocyte count showed the limitations of QFT GIT in detecting latent TB infection in immunocompromised patients.Key words latent TB infection, lung cancer, IGRA, total lymphocyte count
2016
T55572
UI - Tesis Membership  Universitas Indonesia Library
cover
Garinda Alma Duta
Abstrak :
Latar belakang: Efusi pleura tuberkulosis (TB) adalah bentuk umum dari TB ekstra paru. Proporsi efusi pleura pada kasus TB adalah terbesar kedua setelah keganasan di RSUP Persahabatan. Diagnosis definitif ditegakan dengan menemukan basil Mycobacterium tuberculosis (M.tb) dari cairan pleura mapun jaringan pleura walaupun kurang sensitif. Analisis cairan pleura dan pemeriksaan kadar adenosine deaminase (ADA) dapat membantu dalam mendiagnosis efusi pleura pada kasus TB terutama pada negara dengan insidens TB menengah hingga tinggi. Tujuan: Tujuan penelitian ini adalah membandingkan profil efusi pleura pada kelompok TB dan non-TB. Metode: Penelitian potong lintang dilakukan terhadap 411 catatan medis subjek dengan efusi pleura yang menjalani prosedur diagnostik di RSUP Persahabatan dari bulan Januari 2013 hingga 31 December 2015 secara retrospektif. Semua jaringan dan cairan diperiksa untuk pemeriksaan mikrobiologi, histopatologi, analisis cairan pleura dan ADA. Total 273 subjek dieksklusikan dan 138 subjek memenuhi kriteria inklusi untuk TB (n=65) dan non-TB (n=73). Hasil: Nilai tengah usia pada kelompok TB adalah 27 (15-69) tahun dengan proporsi 34 (75%) laki-laki berbeda bermakna dengan nilai tengah usia pada kelompok non TB yaitu 51 (16-75) tahun yang terdiri atas 38 (52%) perempuan. Pada kelompok TB rentang nilai ADA adalah 5,9 hingga 437,6 U/L dengan nilai tengah 103 U/L sedangkan pada kelompok non TB rentang 3,4 hingga 155 U/L dengan nilai tengah 19,9 U/L. Protein cairan pleura pada kelompok TB memiliki rerata 5,6 (SD 1,1) mg/dL berbeda bermakna dibandingkan pada rerata kelompok non TB yaitu 4,9 (SD 1,6) mg/dL. Sensitivitas ADA dengan titik potong 60 IU/dL adalah 89% dengan spesifitas 77% untuk kepositifan TB. Protein cairan pleura dengan titik potong 5 g/dL memberikan sensitivitas dan spesifitas sebesar 60% dan 52%. Pada penelitian ini kombinasi titik potong ADA dengan kadar 60 IU/L dan protein dengan kadar 5 g/dL meningkatkan spesifisitas menjadi 78% dan sensitivitas menjadi 66%. Kesimpulan: Hasil ADA dan protein cairan pleura harus diintepretasikan bersama temuan klinis dan hasil uji konfirmasi lain. ...... Background: Pleural effusion is a common form of extra pulmonary tuberculosis (TB). Effusion due to pleural TB is second biggest proportion after malignancy in Persahabatan Hospital. The definitive diagnosis was established by determining the basil of Mycobacterium tuberculosis (M.tb) in the pleural fluid or pleural tissue but less sensitive. Pleural fluid analysis and adenosine deaminase (ADA) level can aid in the diagnosis of TB pleural effusions commonly used in the countries with a moderate to high incidence of TB. Objectives: The aim of the study is comparing the profile of pleural effusion in TB and non-TB group. Methods: This is retrospective cross sectional study on 411 subjects with pleural effusions who underwent diagnostic procedure at Persahabatan Hospital by January 1st 2013 to December 31th 2015. All data from tissue and fluid sample of microbiological, histopathological, pleural fluid and ADA examinations were taken from medical records. Total 138 patients met our inclusion criteria for TB (n=65) and non-TB (n=73) and 273 patients were excluded. Results: Median of age in tuberculosis group age median was 27 (15-69) years old and consisted of 34 male (75%). Median of age in non-TB group was 51 (16.75) years old and consisted of 38 female (52%). In TB groups ADA range from 5.9 to 437.6 U/L with median ADA level 103 and in non TB groups ADA level range from 3.4 to 155 U/L with median 19.9 U/L. In TB groups protein level mean 5.6 (SD 1.1) mg/dL non TB 4.9 (SD 1.6) mg/dL. By using cut off the sensitivity of ADA level 60 IU/dL were 89% with specifity 77%. Protein level cutoff at 5 g/dL the sensitivity and specifity were 60% and 52%. This study showed a combination of ADA and protein as a cut off increasing specifity up to 78% and sensitivity 66%. Conclusion: The results of ADA and protein of pleural fluid should be interpreted in parallel with clinical findings and the results of comfirmation tests.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2016
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Ratna Andriani
Abstrak :
Kanker paru jenis karsinoma sel kecil (KPKSK) pada umumnya bersifat agresif dibandingkan subtipe kanker paru lainnya. Kanker paru jenis karsinoma sel kecil mempunyai doubling time cepat, fraksi pertumbuhan cepat dan bermetastasis dengan cepat dan luas dibandingkan kanker paru jenis karsinoma bukan sel kecil (KPKBSK). Kanker paru jenis karsinoma sel kecil bersifat kemosensitif dan radiosensitif meskipun 95% pasien akhirnya meninggal. Penelitian ini ingin melihat karakteristik, angka tahan hidup dan faktor yang mempengaruhi. Metode: Penelitian dilakukan dengan metode kohort retrospektif dari rekam medis pasien kanker paru jenis karsinoma sel kecil di RSUP Persahabatan periode 1 Januari 2008 hingga 31 Desember 2012. Data diuji dengan analisis kesintasan Kaplan Meier. Hasil: Subjek dalam penelitian ini diperoleh 34 orang dengan jenis kelamin laki-laki 32 subjek (94,1 %) dengan usia rata-rata 59 tahun, 34 subjek (100 %) perokok. Keluhan utama subjek paling banyak sesak napas dan keluhan tambahan paling dominan adalah berat badan turun dan sebagian besar subjek tidak mendapat terapi baik kemoterapi maupun radioterapi (38,2 %). Karakteristik tumor paling dominan stage ekstensif 32 subjek (94,1 %), status tampilan PS ≤ 2 pada 30 subjek (88,2 %) dan metastasis paling dominan adalah efusi pleura pada 23 subjek (67,6 %). Masa tengah tahan hidup pasien KPKSK adalah 78,75 hari (2,5 bulan) untuk stage terbatas adalah 365 hari (12 bulan) dan stage ekstensif adalah 61 hari (2 bulan). Masa tengah tahan hidup pasien KPKSK yang diterapi adalah 182 hari (6 bulan) dan yang tidak diterapi adalah 27 hari (1 bulan). Faktor yang mempengaruhi angka tahan hidup adalah tampilan dan terapi. Kesimpulan: Angka tahan hidup 1 tahun pasien KPKSK 11,8 % dan masa tengah tahan hidup 78,75 hari. Faktor yang mempengaruhi angka tahan hidup pasien KPKSK adalah tampilan dan terapi. ...... Small cell lung cancer (SCLC) are generally aggressive than other subtypes of lung cancer. Small cell lung cancer has a rapid doubling time, rapid growth fraction and could metastasize rapidly and widely compared to non-small cell lung cancer (NSCLC). Small cell lung cancer is chemosensitive and radiosensitive although 95% of patients eventually died after underwent therapy. This study aims to determine the characteristics, survival rate and factors which influenced SCLC patients. Method: The study was conducted by using retrospective cohort of SCLC patients medical records in Persahabatan Hospital, Jakarta, Indonesia from January 1, 2008 until December 31, 2012. Data obtained were tested by Kaplan Meier analysis of survival. Results: Subjects in this study were 34 SCLC patients, with majority of male 32 subjects (94.1%), mean age of 59 years old and all of the subjects (100%) were smokers. The majority chief complaint was shortness of breath, the additional complaint was weight loss and most of the subjects did not receive either chemotherapy or radiotherapy treatment (38.2%). The majority of tumor characteristics were extensive disease in 32 subjects (94.1%), performance status ≤ 2 in 30 subjects (88.2%) and the most common metastatic was pleural effusion in 23 subjects (67.6%). Median survival time of SCLC patients were 78.75 days (2.5 months). Median survival time of SCLC patients with limited disease were 365 days (12 months) and extensive disease were 61 days (2 months). Median survival time of SCLC patients treated were 182 days (6 months) and not treated were 27 days (1 month). Factors which influenced median survival time were performance status and treatment. Conclusion: The 1-year survival rate of SCLC patients was 11.8 % and median survival time was 78.75 days. Factors which influenced the median survival rate of SCLC patients were performance status and treatment.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
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