Research Article

Hubungan antara Microvessel Density dan Lymphovascular Invasion dengan metastasis jauh pada pasien kanker payudara di RSUP Sanglah, Bali, Indonesia

Trisye Septiawati , Ida Bagus Tjakra Wibawa Manuaba, Putu Anda Tusta Adiputra

Trisye Septiawati
Program Pendidikan Dokters Spesialis Ilmu Bedah, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia.. Email: s.trisye.dr@gmail.com

Ida Bagus Tjakra Wibawa Manuaba
Departemen Ilmu Bedah, Divisi Bedah Onkologi, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia.

Putu Anda Tusta Adiputra
Departemen Ilmu Bedah, Divisi Bedah Onkologi, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia
Online First: December 01, 2020 | Cite this Article
Septiawati, T., Manuaba, I., Adiputra, P. 2020. Hubungan antara Microvessel Density dan Lymphovascular Invasion dengan metastasis jauh pada pasien kanker payudara di RSUP Sanglah, Bali, Indonesia. Intisari Sains Medis 11(3): 1436-1442. DOI:10.15562/ism.v11i3.823


Background: Breast cancer is the most common malignant tumor in Indonesia, with a relative frequency of 18,6%. Mortality in breast cancer most are caused by distant metastasis, which then causes multiple organ failure. To start a metastatic process requires new blood vessels (angiogenesis) and infiltration of the lymphatic system. Both can be assessed through microvessel density and lymphovascular invasion. This study aims to determine the relationship between Microvessel Density and Lymphovascular Invasion with metastasis in breast cancer patients at Sanglah General Hospital, Bali, Indonesia.
Methods: A cross-sectional analytic study was conducted at the oncology surgical clinic from January 2018 - March 2019. Of the 62 biopsy samples were stained using hematoxylin-eosin and were observed by one pathologist. MVD cut-off points are taken by calculating the mean and standard deviation. Bivariate analysis using Chi-Square Test and multivariate analysis using logistic regression test was used for statistical analysis. Data were analyzed using SPSS version 23 for Windows.
Results: From the results of a bivariate analysis, it was found that the high MVD is correlated with distant metastasis (P = 0.001) and positive LVI with metastasis (P = 0.003). There is a relationship between high MVD and tumor size (P = 0,000).
Conclusion: Multivariate analysis confirmed that high MVD and positive LVI were statistically related to the occurrence of metastasis in breast cancer patients.

 

Latar Belakang: Kanker payudara merupakan salah satu jenis kanker terbanyak di Indonesia dengan frekuensi relatif sebesar 18,6%. Kematian pada kanker payudara sebagian besar disebabkan oleh metastasis jauh yang kemudian menyebabkan kegagalan organ multipel. Untuk memulai suatu proses metastasis diperlukan pembentukan pembuluh darah baru (angiogenesis) dan juga infiltrasi sistem limfatik. Kedua hal tersebut bisa dinilai melalui microvessel density dan lymphovascular invasion. Penelitian ini bertujuan untuk mengetahui hubungan antara Microvessel Density dan Lymphovascular Invasion dengan metastasis jauh pada pasien kanker payudara di RSUP Sanglah, Bali, Indonesia.
Metode: Penelitian potong lintang analitik dilakukan pada poliklinik bedah onkologi selama Januari 2018–Maret 2019. Dari 62 sampel biopsi dilakukan pembacaan microvessel dan lymphovascular invasion yang telah lebih dulu diberikan pewarnaan hematoxylin eosin oleh 1 patologi anatomi. Cut off point MVD diambil dengan cara menghitung mean dan standar deviasi. Analisis bivariat dengan Uji Chi-Square dan analisis multivariat dengan menggunakan uji regresi logistik digunakan untuk analisis statistik. Data dianalisis dengan SPSS versi 23 untuk Windows.
HasilDari hasil analisis bivariat didapatkan hubungan antara MVD yg tinggi dengan metastasis (P = 0,001) dan hubungan antara LVI positif dengan metastasis (P = 0,003). Terdapat hubungan antara MVD dengan ukuran tumor (P = 0,000).
Simpulan: Analisis multivariat menegaskan bahwa MVD yang tinggi dan LVI positif berhubungan secara statistik dengan terjadinya metastasis pada pasien kanker payudara.

 

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