Research Article

Hubungan antara Platelet Lymphocyte Ratio (PLR) dan respon Neoadjuvant Chemotherapy (NAC) CAF pada pasien Locally Advanced Breast Cancer

Aryo Wibisono , I Nengah Wiadnyana Steven Christian, Putu Anda Tusta Adiputra

Aryo Wibisono
Departemen Ilmu Bedah, Fakultas kedokteran Universitas Udayana, RSUP Sanglah Denpasar, Indonesia. Email: aryowibisono@ymail.com

I Nengah Wiadnyana Steven Christian
Departemen Bedah Onkologi, Fakultas kedokteran Universitas Udayana, RSUP Sanglah Denpasar, Indonesia

Putu Anda Tusta Adiputra
Departemen Bedah Onkologi, Fakultas kedokteran Universitas Udayana, RSUP Sanglah Denpasar, Indonesia
Online First: August 01, 2020 | Cite this Article
Wibisono, A., Christian, I., Adiputra, P. 2020. Hubungan antara Platelet Lymphocyte Ratio (PLR) dan respon Neoadjuvant Chemotherapy (NAC) CAF pada pasien Locally Advanced Breast Cancer. Intisari Sains Medis 11(2): 551-555. DOI:10.15562/ism.v11i2.754


Background: The incidence of LABC (Locally Advanced Breast Cancer) in Indonesia is estimated more than 50%, and in Bali as many as 76.3% from all of breast cancer cases. Response of NAC (Neoadjuvant chemotherapy) in LABC case is not the same on each patient. Currently, there are several biomarkers that can be a predictor of NAC response on LABC. One of them is PLR (platelet lymphocyte ratio). PLR is an easy, cheap and fast marker to be counted, but not all clinicians know its role. Lack of research in the relationship of PLR to NAC CAF (Cyclophospamide, Adriamycin, 5 Flourouracil) response in patients with LABC are currently making researchers interested in studying it.

Method: This research is observational analytics, using a retrospective cohort study.  The number of samples was 62 (consecutive sampling), obtained from the medical records of patients who had undergone NAC CAF from 2015-2019 at Sanglah Hospital Denpasar.  PLR value  and initial tumor size were calculated before undergoing chemotherapy, then assessed the NAC CAF response to tumors after undergoing 3 cycles of chemotherapy. Positive response if tumor size is reduced and  negative response if the tumor size is persists or enlarges. In this study use a cut off point of PLR 150.

Results: From 62 respondents obtained PLR value ≤ 150 had a positive response of 77.1% and 22.9% had a negative response. From these results obtained a correlation between PLR value with responses to NAC CAF in LABC patients, where low PLR values had  positive responses 1.6 times (IK 95; 1.04 - 2.47) with an output value of p = 0.018.

Conclusion: There is a correlation between PLR and NAC CAF response, where a low PLR value (PLR ≤ 150) has a positive response to NAC CAF in LABC patients.

 

Latar Belakang: Angka kejadian LABC (Locally Advanced Breast Cancer) di Indonesia diperkirakan lebih dari 50%, dan di Bali sebanyak 76,3% dari semua kasus kanker payudara. Respon NAC (neoadjuvant chemotherapy) pada kasus LABC tidak sama pada setiap penderita. Saat ini terdapat beberapa biomarker yang dapat menjadi prediktor terhadap respon NAC pada LABC, salah satunya adalah PLR (platelet lymphocyte ratio). PLR merupakan suatu marker yang mudah, murah dan cepat untuk dinilai tetapi masih banyak klinisi yang belum mengetahui perannya. Kurangnya penelitian mengenai hubungan PLR terhadap respon NAC CAF (Cyclophospamide, Adriamycin, 5 Flourouracil) pada pasien LABC saat ini membuat peneliti tertarik untuk meneliti hal tersebut.

Metode: Jenis penelitian analitik observasional menggunakan studi kohort retrospektif, dengan 62 responden (consecutive sampling), yang didapatkan dari rekam medis pasien yang telah menjalani NAC CAF dari tahun 2015-2019 di RSUP Sanglah Denpasar. Nilai  PLR  dan ukuran tumor awal dihitung sebelum kemoterapi, kemudian dinilai respon NAC CAF terhadap tumor setelah menjalani 3 siklus kemoterapi. Respon positif  yaitu jika terjadi reduksi ukuran tumor ≥ 30% dari ukuran tumor awal dan respon negatif  jika terjadi reduksi ukuran tumor < 30%. Penelitian ini menggunakan cut off point  PLR 150,0 yang didapatkan dari penelitian sebelumnya.

Hasil: Dari 62 responden didapatkan nilai PLR ≤ 150 mempunyai respon positif sebanyak 77,1% dan 22,9% respon negatif. Dari hasil tersebut didapatkan hubungan antara nilai PLR dengan respon terhadap NAC CAF pada pasien LABC, dimana nilai PLR rendah mempunyai respon positif sebanyak 1.6 kali (IK 95; 1.04 – 2.47) dengan hasil output nilai p = 0.018.

Kesimpulan: Terdapat hubungan antara PLR terhadap respon NAC CAF, dimana nilai PLR yang rendah (≤ 150) mempunyai respon positif terhadap NAC CAF pada pasien LABC.  


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