KEPEKAAN PEMERIKSAAN SITOLOGI DIBANDING DENGAN MOPSI NASOPHARING

Abstract

Incidanee of nasopharyngeal cancer is raising from year to year. It is caused by difficulties of cancer diagnosies on the early stage. The survival nasopharyngeal cancer rate that being therapy by radiation is still very low. Most of nasopharyngeal cancer are epidermo id . Hystologicaly, pharyngeal mucosal layer and cervix uteri are similar, so the mucosal swab examination can be done on the both by Papanicolou-smear. The research tendency is striving the early detection of nasopharyngeal cancer, by measure the sensitivity and spesivicity of swab examination on nasopharyng and oropharyng. The research metode is doing by cross sectional aproach, that was done by nasopharyngeal and oropharyngeal swab and biopsi for patient that being suspected and having nasopharyngeal cancer. Auer clinical check were done in ENT unit in RSUP dr Kariadi Semarang. The minimal total sample were 35. Data analysis were calculated by sensitivity and spesivisity test and positive and negative predictive value. To decide of significancy between biopsi, nasopharyngeal and oropharyngeal swab were calculated by X2 with ct = 0,05 From the respondent result gathered 50 patients that were suspected nasopharyngeal cancer. In nasopharyngeal swab, 14 preparations were lysis or hard to evaluate and for oropharyngeal swab were 3. Total number of nasopharyngeal cancer diagnosed were 33 patients, that 30 were male, and 3 were female. Mostly cases in 4th and 5th decade. The result, sensitivity and spesivicity of nasopharyng were 50% and 71,4% respectively, while positive and negative predictive value were 73,3% and 47$%respectively. On the oropharyng, sensitivity and spesivicity were 9,6 and 8 i,25 % respectively. Positive and negative predictive value were 50% and 31,7 % respectively. X2 on the nasopharyng and oropharyng were more than the table, so that was sgnivieance different on that, while between nasopharyng and biopsi were not significance different and oropharyng and biopsi were significance different. The conclusion from this researh is nasopharyngeal swab is more applicated than ompharyngeal swab in the sociaty for nasopharyngeal cancer screening, although was not precisely stright, but the diagnostic value of oropharyngeal swab was beter than nasopharyngeal swab. The suggestion after this research is doing research by technical swab that more reliable to pickup the epthelial layer for instance by brush on the nasopharyng Deteksi dini kanker nasopharing dari tahun ke tahun meningkat. Hal ini disebabkan karena sulitnya mendiagnosis kanker pada stadium awal. Survival rate kanker nasopharing yang diterapi radiasi =silt sangat rendah. Sebagian besar kanker nasopharing adalah jenis epidermoid. Secara histologis lapisan mukosa pharing dengan serviks uteri hampir menyerupai , maka pemeriksaan usapan mukosa selain bisa dilakukan di vagina juga bisa dilakukan di pharing dengan pengecatan Papanicolou. Tujuan penelitian ini untuk usaha deteksi dini kanker nasopharing dengan mengukur sensitivitas dan spesifisitas pemeriksaan usapan pada nasopharing dan oropharing Metode penelitian dilakukan dengan cara cross-sectional yaitu dengan melakukan usapan nasopharing dan oropharing serta biopsi pada penderita yang dicurigai kanker nasopharing setelah dilakukan pemeriksaan klinis di bagian THT RSUP dr Kariadi Semarang. lumlah sampel minimal 35. Analisis data dihitung dengan rumus sensitivity dan spesivisity test dan mengukur nilai ramalan positif dan negatif Untuk menentukan kemaknaan antara pemeriksaan usapan dan biopsi atau antara usapan nasopharing dan oropharing menggunakan rumus x z dengan a a 0,05. Dan responden yang terkumpul sebanyak 50 penderita yang dicurigai kanker nasopharing, untuk usapan nasopharing 14 mengalatni lisis atau sulit dievaluasi, sedang untuk oropharing 3 mengalami lisis atau sulit dievaluasi. Jumlah penderita Ca nasopharing yang didianosis dengan biopsi sebanyak 33 orang, dengan jumlah penderita laki-laki sebanyak 30 orang, dan 3 orang wanita. Kasus paling hanyak pada dekade 4 dan 5. Dari hasil penghitungan sensitivity test untuk nasopharing yaitu 50 %, spesivisity test 71,4 % , nilai ramal positif 73,3 % dan nilai ramat negatif 47,6 %. Sedang pada usapanoropharing sensitivity test sebesar 9,6 %, spesivis ity *1,25 % dan nilal ramal positiv 50 % dan nilai ramal negatif 31,7 % Ma perbedaan yang bermakna antara usapan. nasopharing dan oropharing. Sedang antara usapan nasopharing dan biopsi tidak bermakna, tetapi antara biopsi dan ompharing ada perbedaan yang bermakna. Kesimpulan pemeriksaan usapan nasopharing lebih bisa dipakai dibanding dengan oropharing bib digunakan untuk skrining di masarakat walaupun ketepatannya kurang, tetapi nilai diagnostik usapan oropharing kWh baik dibanding dengan nasopharing. Saran setelah penelitian ini adalah melakukan penelitiaa dengan tehnik usapan yang lebih bisa mengatnbil lapisan epitel misalnya dengan sikat pada nasopharing.