Patologi Klinis Tumor Marker

8/17/2019 Patologi Klinis Tumor Marker

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PENGERTIAN

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3/28

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Penggolongan Petanda Tumor berdasarkan

Jenisnya

• (*/&01* 2*3241/%5 3 #%'(1)5( ?($8%)/"#4$5/)%8(),%6") ;?@A


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• :2")2* 3 J?KB &(1'%,/)%)B A?IJ

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• +/1"2&' "1?1,/2"7 3 @',$/6") -() +$/6"',"$/$"8"+,/$' ;@Q -() !Q


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Persyaratan petanda tumor

yang ideal:

• 71*7&/&4 ;+"&(B -(+(, #")-","&'% &()&"$ 5()6

&"8%1


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• J%)66( '((, %)% 4"1.# (-( +",()-( ,.#/$ 5()6

#"#").2% +"$'5($(,() ,"$'"4., ;'")'%,%R%,(':SSTB '+"'%D%'%,(' :SST


8/28

Manfaat Petanda Tumor

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Faktor-faktor yang mempengaruhi

konsentrasi petanda tumor

D*A&A2 • !$/-.&'%B "&'&$"'%B &(,(4/1%'#" -() '.+1(% -($(2 &"

,.#/$9

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D* E&/"2

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Waktu pemeriksaan petanda tumor

• H"4"1.# ,"$(+% +"$,(#( ;/+"$('%B &"#/,"$(+%B ,"$(+% 2/$#/)(,(. $(-%/,"$(+%<

• H","1(2 /+"$('%

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Cara pemeriksaan petanda tumor

•

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Interpretasi Hasil - 1

• H"4(6%() +",()-( 6()(' '"$/1/6%& 7.6( -%+$/-.&'%'"1 7%)(& 3 '"1(%) )%1(% $.7.&() +"$1. '.(,. 0)1+.+%-

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82($(8,"$%',%8


17/28

Interpretasi Hasil - 2

• !"-/#() -(1(# +"#(),(.() &%)",%& +",()-(6()(' 3

&(-($ 2($.' ,.$.) 4%1( ,"$7(-% $"6$"'%

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4"$2('%19


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Tabel 1. BEBERAPA PETANDA TUMOR UTAMA (2,3,4)

Petanda tumorNilai

RujukanIndikasi utama

Peningkatan tidak

Spesifik/Indikasi lain/ kombinasi

dgn petanda lain

CEA < 3 ng/ml Kolorectal, gaster, tiroid,

Esofagus, payudara, bronkhuspankreas, paru

Meningkat : merokok ( 7-10ng/mL) , alkohol

AFP < 15 ng/ml Hati, tumor sel germinal Peny. Hati & empedu, kelainan Janin,

kehamilan .

PSA


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C I%)-(&() 3 0Q@B '%',/'&/+%B ")-/'&/+%B 4%/+'%

+$/',(,B &(,","$%'('% .$%)

0")'%,(' !HA ;!HA0< 3 !HA -($(2 -%4(6% R/1.#"+$/',(, 5()6 -%.&.$ -($% IQVH ;,$()'$"8,(1

.1,$('/)/6$(+25 <


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Tabel 2. INDIKASI PENGUKURAN PETANDA TUMOR (3)

PETANDA

TUMOR

SKRINING DIAGNOSIS PEMANTAUAN PROGNOSIS

CEA KelompokRisiko tinggi

C-cellcarcinoma

Kolon, payudara, paru, C-cell ca

Kolon

AFP Risiko tinggi Hepatoma, germcells

Hepatoma, germ cell Germ cell

CA 19-9 Pankreas Pankreas, duktus biliarisCA 72-4 Lambung, ovarium

CA 125 Ovarium

CA 15-3 Payudara

NSE Paru (smallcells)

Small cell, neuroblastoma

SCC Kanker serviks, kanker THT,esofagus

CYFRA 21-1 Paru (non small cell),kandung kemih

HCG Risiko tinggi Germ cell

trophoblastictumor

Germ cell trophoblstic tumor Germ cell

trophoblastictumor

PSA Laki-laki usia>50 tahun

Prostat Prostat

TPA Kandung kemih

Calsitonin Risiko tinggi C-cell C-cell C-cell

Beta-2 -

microglobulin

Mieloma multipel


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Patologi Klinis Tumor Marker

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