CA-125 sebagai Prediktor Sitoreduksi pada Pasien Kanker Ovarium Tipe Epitel

Bagja Dumas Darwizar; Gatot Nyarumenteng Adipurnawan Winarno; Jusuf Sulaeman Effendi

doi:10.24198/obgynia.v6i2.266

CA-125 sebagai Prediktor Sitoreduksi pada Pasien Kanker Ovarium Tipe Epitel

Bagja Dumas Darwizar, Gatot Nyarumenteng Adipurnawan Winarno, Jusuf Sulaeman Effendi

Abstract

Tujuan: Penelitian ini bertujuan untuk mengetahui apakah CA-125 dapat menjadi prediktor yang baik untuk sitoreduksi pada kanker ovarium tipe epitel.
Metode: Desain penelitian ini adalah cross sectional dengan pemeriksaan pasien yang diduga memiliki tumor ganas ovarium, pemeriksaan kadar CA-125 pre operasi dan jenis sitoreduksi pasca operasi. Sitoreduksi optimal dipertimbangkan jika sisa tumor terbesar berdiameter <1 cm. Nilai p numerik diuji dengan uji T tidak berpasangan jika data berdistribusi normal dengan uji alternatif Mann Whitney jika data tidak berdistribusi normal. Data kategorik nilai p dihitung berdasarkan uji Chi-Square dengan alternatif Kolmogorov Smirnov dan uji Exact Fisher jika persyaratan Chi-Square tidak terpenuhi. Nilai diagnostik CA-125 dievaluasi dan nilai cut-off optimal ditentukan. Analisis ROC digunakan untuk menentukan nilai cut-off CA-125 yang optimal. Data yang diperoleh direkam dalam bentuk khusus kemudian diolah dengan SPSS versi 25.0 for windows. Pasien yang dikumpulkan sesuai dengan kriteria selama masa penelitian adalah 109 pasien.
Hasil: Ditemukan bahwa nilai rata-rata CA-125 untuk kelompok sitoreduksi suboptimal lebih tinggi dibandingkan dengan kelompok sitoreduksi optimal (1157,63±2105,196 vs 237,53±319,432), yang signifikan secara statistik, p=0,0001 (nilai p<0,05). Cut off point CA-125 dalam penelitian ini adalah 248,55 dengan nilai sensitivitas 73,2%, nilai spesifisitas 73,6%, nilai prediksi positif 74,5%, nilai prediksi negatif 72,2%, dan akurasi 73,3%.
Kesimpulan: Data kami menunjukkan bahwa CA-125 pre-operasi adalah prediktor sedang untuk sitoreduksi yang optimal.

CA-125 as A Cyoreduction Predictor in Patient with Epithelial Ovarian Carcinoma

Abstract
Objective: This study aims to determine whether CA-125 can be a good predictor of cytoreduction in epithelial ovarian carcinoma.
Method: Cross sectional study by examining patients suspected of ovarian malignancy, checking for their preoperative CA-125 levels and post operative type of cytoreduction. Optimal cytoreduction was considered if the largest residual tumor was <1 cm in diameter. Numerical p value is tested by unpaired T test if the data is normally distributed with the alternative Mann Whitney test if the data is not normally distributed. The p value categorical data is calculated based on the Chi-Square test with the alternative Kolmogorov Smirnov and Exact Fisher tests if the requirements of the Chi-Square are not met. The diagnostic value of the CA-125 is evaluated and the optimal cut-off value is determined. The ROC analysis was plotted to determine the optimal cut-off of CA-125. The data obtained is recorded in a special form and then processed with SPSS version 25.0 for windows. Patients collected during the study period were 109 patients.
Results: It was found that mean value of CA-125 for suboptimal cytoreduction group was higher than optimal cytoreduction (1157.63±2105.196 vs 237.53±319.432), which is statistically significant, p = 0.0001 (p value <0.05). CA-125 cut off point in this research was 248.55 with sensitivity value of 73.2%, specificity value of 73.6%, the positive predictive value 74.5%, the negative predictive value 72.2% and its accuracy 73.3%.
Conclusion: Our data indicate that preoperative CA-125 is moderate predictor for optimal cytoreduction.

Key words: CA-125, cytoreduction, Epithelial Ovarian Carcinoma, Predictor

Keywords

CA-125, sitoreduksi, karsinoma ovarium tipe epitel, prediktor

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DOI: http://dx.doi.org/10.24198/obgynia.v6i2.266