Hubungan Kadar D-Dimer Dan Jenis Histopatologi Kanker Paru Karsinoma Bukan Sel Kecil Terhadap Respons Kemoterapi Berdasarkan Recist 1.1

Elman Dani Firdaus, Andreas Infianto, Indri Windarti, Retno Ariza S Soemarwoto, Diyan Ekawati, Fransisca T.Y. Sinaga, Gatot Sudiro Hendarto, Apri Lyanda, Pusparini Kusumajati, Adhari Ajipurnomo

Sari


Kanker paru tetap menjadi penyebab utama kematian terkait kanker secara global, terutama pada pria di Indonesia. Sekitar 80 % kasus  didiagnosis sebagai Kanker Paru Bukan Sel Kecil (KPKBSK), terutama Adenokarsinoma dan Karsinoma Sel Skuamosa. Kadar D-Dimer yang meningkat, yang menunjukkan keadaan hiperkoagulasi, dapat menjadi penanda potensial untuk memprediksi hasil pengobatan dan prognosis keseluruhan.  Metode: Dalam penelitian ini, 61 pasien KPKBSK yang menjalani tiga siklus kemoterapi lini pertama dilibatkan. Sebelum pengobatan, kadar D-Dimer diukur, dan jenis histopatologi ditentukan melalui pemeriksaan patologi anatomi. Respons kemoterapi dinilai menggunakan RECIST 1.1. Distribusi respons: Partial Response (27,9 %), Stable Disease (19,7 %), dan Progressive Disease (52,5 %). Terdapat perbedaan signifikan secara statistik dalam kadar D-Dimer antar kelompok tersebut (p = 0,001). Kelompok Partial Response memiliki median kadar D-Dimer 1.229 ng/mL (Mean Rank = 18,32), kelompok Stable Disease menunjukkan mean 1.335,67 ng/mL (SD = 624,30; Mean Rank = 21,13), dan kelompok Progressive Disease memiliki median 2.586 ng/mL (Mean Rank = 41,44). Kadar D-Dimer ≥1.654 ng/mL secara signifikan terkait dengan peningkatan risiko Progressive Disease, dengan sensitivitas 78,1 % dan spesifisitas 76 %. Subtipe histopatologi (Adenokarsinoma vs. Karsinoma Sel Skuamosa) tidak berkorelasi signifikan dengan respons kemoterapi (p = 0,717). Kadar D-Dimer berkorelasi dengan respons kemoterapi pada pasien KPKBSK, menunjukkan potensi penggunaannya sebagai prediktor, sedangkan jenis histopatologi tidak memengaruhi hasil terapi.


Kata Kunci


Adenokarsinoma; D-Dimer; Karsinoma Sel Skuamosa; KPKBSK; RECIST

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Referensi


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DOI: https://doi.org/10.33024/jikk.v12i7.20247

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