KARSINOMA EPIDERMOID SERVIKS UTERI Penn Aktifitas Proliferasi Terhadap Respon Radiasi Histologi

Abstract

Backgrounds. The result of radiation therapy for epidermoid carcinoma of the uterine cervix remains unsatisfactory. Among other factors, proliferation actifity plays an important role to determine the success of radiation therapy . Objectives. 1.To prove the proliferation activity of the epidermoid carcinoma of the uterine cervix plays an important role in determining the result of radiation therapy. 2. To study cells proliferation activity of the epidermoid carcinoma of the uterine cervix before radiation therapy both which has poor or good histological radiation response. Material and Method. Case control study is done,66 samples biopsies of epidermoid carcinoma of the uterine cervix was collected from patient in Dr.Kariadi Hospital before radiation therapy during the year 2000 - 2001. Case study group consisted of 33 samples which have poor histological radiation response, while the rest (33 samples) as control groups which have good histological radiation response .The degree of proliferation activity before radiation therapy was examined using AgNOR staining method.. The mean value of AgNORs of each group were analized using t- test and chi square test. Result. The profile patient differ unsignificantly between case study group and control group in term of age and degree of differentiation. The proliferation activity differs significantly between poor histological radiation response group with good histological radiation response group (3,2567 + 0,652 vs 4,5594 + 0,6954 3 P = 0,0001). Cut off point (COP) of 4 is based on receiver of curve calculation. Odds ratio is 16,7. Conclusion. It was found that the proliferation activity of the poor histological radiation response group significantly different compared with good histological radiation response. Number of total poor histological radiation response was higher among patient with low proliferation activity (AgNORs droplet < 4) than high proliferation activity (AgNORs droplet 4). The chance was 16,7 times greater. Key words : Epidermoid carcinoma of the uterine cervix, proliferation activity, AgNOR, histological response to radiation. Latar Belakang. Keberhasilan terapi radiasi pada penderita karsinoma epidermoid serviks uteri masih kurang memuaskan, di mana salah satu faktor yang paling berperan dalam menentukan keberhasilan terapi radiasi adalah aktifitas proliferasi. Tujuan. Membuktikan bahwa aktifitas proliferasi karsinoma epidermoid serviks uteri berperan terhadap basil terapi radiasi dengan mengetahui perbedaan tingkat aktifitas proliferasi sel sebelum terapi pada kelompok respon radiasi histologi jelek dan kelompok respon radiasi histologi baik. Bahan dan Cara. Dengan pendekatan case control ditentukan 66 sampel biopsi karsinoma epidermoid serviks uteri sebelum terapi yang dirawat di RSUP Dr. Kariadi pada tahun 2000 — 2001. Sebagai kelompok studi kasus adalah 33 sampel dengan basil respon radiasi histologi jelek dan sebagai kelompok pembanding adalah 33 sampel dengan hasil respon radiasi histologi baik. Masing-masing kelompok ditentukan tingkat aktifitas proliferasi sebelum terapi radiasi dengan menggunakan metode pewarnaan AgNORs. Rerata butir AgNORs pada masing-masing kelompok dibandingkan dengan uji statistik 1-test dan chi square test. Hasil. Karakteristik penderita berbeda sedara tidak bermakna antara kelompok studi dan pembanding dalam hal umur dan derajat diferensiasi. Aktifitas proliferasi berbeda secara bermakna antara kelompok respon radiasi histologi jelek dan kelompok respon radiasi histologi baik. (3,2567 + 0,652 vs 4,5594 + 0,6954 -) P = 0,0001). Dengan menggunakan receiver operator curve didapatkan cut of point = 4 dan rasio odds = 16,7. Kesimpulan. Terdapat perbedaan tingkat' aktifitas proliferasi antara kelompok respon radiasi histologi jelek dan kelornpok respon radiasi histologi baik, di mana aktifitas proliferasi pada kelompok respon radiasi histologi jelek lebih rendah daripada kelompok respon radiasi histologi baik. Di samping itu, aktifitas proliferasi rendah ( < cut of point ) mempunyai kemungkinan untuk menghasilkan respon radiasi histologi jelek 16,7 kali dibandingkan dengan aktifitas proliferasi tinggi. ( cut of point ) Kata kunci : Karsinoma epidermoid serviks uteri, aktifitas poliferasi, AgNOR, respon radiasi histologi.