PENILAIAN JUMLAH NEUTROFIL, LIMFOSIT DAN TROMBOSIT, KADAR PROTEIN REAKTIF C, KADAR ALBUMIN, RASIO NEUTROFIL LIMFOSIT, SERTA RASIO TROMBOSIT LIMFOSIT SEBELUM DAN SETELAH TERAPI PADA PENDERITA KARSINOMA PAYUDARA

Abstract

Abstract: Breast carcinoma is a type of carcinoma that has sufficiently high prevalence and can occur in men and women, with a much higher prevalence in women. In addition to the high number of cases, more than 70% of patients with breast carcinoma was found at an advanced stage. There are several studies measuring markers of inflammation and the levels of albumin in the search for an independent prognostic association in various carcinomas. The ratio of neutrophils to lymphocytes, ratio of platelets to lymphocyte, C-reactive protein, and albumin are predictors in analyzing the changes that occur before and after treatment (chemotherapy and/or surgery) in patients with breast carcinoma. This was an interventional analytical study with a cross-sectional design, conducted in Prof. Dr. R. D. Kandou Hospital Manado during the period of May 2014 to April 2015. The results showed that there were 43 females with breast carcinoma with an average age of 52.16 years. The state dof carcinoma were as follows: stage IIIA 5 patients (11.6%), IIIB 25 patients (58.1%), IIIC 11 patients (25.6%), and stage IV 2 patients (4.7%). Modality of chemotherapy plus surgery was performed on 40 patients (93%), chemotherapy only on 2 patients (4.7 %), and surgery only on 1 patient (2.3%). Among the treated patients there were significant declines in the value of neutrophils, platelets, C-reactive protein, neutrophil lymphocyte ratio, and platelet lymphocyte ratio, moreover, there were significant inclines in lymphocytes and albumin. Conclusion: Modality of chemotherapy and/or surgery in patients with breast carcinoma significantly affected the haemopoetic process (declines of neutrophil and platelet counts, NLR and TLR values), declined CRP levels, but inclined lymphocyte count as well as albumin levels when compared before and after treatment.
Keywords: breast carcinoma, C-reactive protein, albumin, neutrophil lymphocyte ratio, thrombocyte lymphocyte ratio

Abstrak: Karsinoma payudara (KPD) merupakan salah satu jenis karsinoma yang memiliki prevalensi cukup tinggi dan dapat terjadi pada pria maupun wanita, dengan prevalensi yang jauh lebih tinggi pada wanita. Selain jumlah kasus yang tinggi, lebih dari 70% penderita KPD ditemukan pada stadium lanjut. Terdapat beberapa penelitian mengukur petanda peradangan dan kadar albumin dalam mencari kaitan prognostik independen pada berbagai karsinoma. Rasio neutrofil limfosit, rasio trombosit limfosit, protein reaktif C, dan albumin menjadi prediktor dalam menganalisis perubahan yang terjadi sebelum dan setelah terapi (kemoterapi dan/atau operasi) pada pasien KPD. Penelitian ini merupakan penelitian intervensional analitik dengan desain potong lintang, yang dilakukan di RSUP Prof. Dr. R. D. Kandou Manado selama periode Mei 2014 - April 2015. Hasil penelitian mendapatkan 43 pasien KPD yang
dirawat dengan usia rata-rata 52,16 tahun. Keadaan karsinoma stadium IIIA pada 5 pasien (11,6%), IIIB 25 pasien (58,1%), IIIC 11 pasien (25,6%), dan stadium IV 2 pasien (4,7%). Pemberian modalitas kemoterapi dan operasi pada 40 pasien (93%), hanya kemoterapi 2 pasien (4,7%), dan hanya operasi 1 pasien (2,3%). Terjadi penurunan bermakna pada nilai hitung neutrofil dan trombosit, protein reaktif C, rasio neutrofil limfosit dan rasio trombosit limfosit pada pasien yang diterapi. Selain itu terjadi peningkatan bermakna pada nilai hitung limfosit dan albumin. Simpulan Tindakan yang diberikan baik kemoterapi dan/atau operasi pada pasien karsinoma payudara memengaruhi proses hemopoetik (penurunan hitung neutrofil, trombosit, nilai NLR, nilai TLR) dan penurunan kadar CRP, serta peningkatan limfosit dan kadar albumin saat dibandingkan sebelum dan setelah diberikan perlakuan.
Kata kunci: karsinoma payudara, protein reaktif C, albumin, rasio neutrofil limfosit, rasio trombosit limfosit