SIMPULAN DAN SARAN
7.1 Simpulan
Dari hasil penelitian di atas dapat disimpulkan bahwa :
Nilai diagnostik terhadap penderita nodul tiroid yang telah dilakukan FNAB dalam mendiagnosis karsinoma tiroid didapatkan :
1. Sensitivitas = 100%
2. Spesifitas = 84%
3. Nilai ramal positif = 69,2% 4. Nilai ramal negatif = 100%
7.2 Saran
1. Perlunya dilakukan penelitian lebih lanjut tentang FNAB dengan jumlah sampel yang lebih baik sehingga menghasilkan outcome penelitian yang semakin baik, karena tingginya nilai diagnostik FNAB dalam mendiagnosis suatu karsinoma tiroid.
2. Kelengkapan laporan hasil FNAB dan biopsi Patologi Anatomi pada catatan medik RSUP Dr. Kariadi Semarang perlu diperbaiki.
DAFTAR PUSTAKA
1. AACE/AAES (American Association of Clinical Endocrinologi/American Association of Endocrine Surgery) Thyroid Carcinoma Task Force AACE/AAES Medical /Surgical Guidelines for Clinical Practice Management of Thyroid Carcinoma. Endocrine Practice 2001:7(3).
2. Hegedus L. The Thyroid Nodule. N Engl J Med 2004;351:1764-71. 3. McDougall IR. Thyroid Cancer : Epidemiology and overview. In
McDougall IR (Ed.) : Management of Thyroid Cancer and Related Nodular Disease Springer Verlag. London Ltd 2006:1-20.
4. Ramli M. Kanker Tiroid, Penatalaksanaan Diagnosis dan Terapi. Deteksi Dini Kanker. Jakarta: Balai Penerbit FK UI; 2000: p 9-31. 5. Fraker DL, Skarulis M, Livalsi V. Thyroid Tumors. In: Cancer
Principles and Practice Oncology, 5th ed. Philadelphia Lippicott-Roven; 1997.p. 1629 – 48.
6. Cady B, Rossi S. Surgery of the Thyroid and Parathyroid Gland. 3rd ed. London: WB Saunders Company: 1991: p 153-162.
7. Mazzaferri EL. Thyroid Carcinoma, Papillary and Follicular.Endocrine Tumors, New York: Blackwell scientific publications ;1993.p.278 – 323.
8. Masjhur JS. Buku Ajar Tiroidologi Klinik. In: R.Djokomoeljanto, editor. Karsinoma Tiroid. Semarang: PAPDI, PERKENI; 2009. p. 201.
9. Clark DP, Faquin WC. Thyroid Cytopathology. Springer Science Inc., New York, 2005.
10. Orell SV, Manual and Atlas of Fine Needle Aspiration Cytopathology. Churchill Livingstone, Edinburgh London New York, 1986.
11. Kini SR, Guides to Clinical Aspiration Biopsy Thyroid. 1st edit. Igaku-shoin, New York Tokyo, 1987.
12. Gullia SP, Chaudhury M, Sitaramam E, Reddy KP. Diagnostic Accuracy of Fine Needle Aspiration Cytology In The Diagnosis Of Thyroid Lesions. The Internet Journal of Pathology. 2011;13.
13. Belfiore A. The Use of Fine Needle Aspiration Biopsy (FNAB) in Thyroid Disesase. 2 ed 2002. p. 3-17.
14. Caraci P, Aversa S, et al. Role of Fine Needle Aspiration Biopsy and Frozen Section Evaluation in Surgical Management of Thyroid Nodule. British Journal of Surgery. 2002;89(6):797-801.
15. Wijayahadi Y, Marmowinoto M, Reksoprawiro S, Murtedjo U. Kelenjar Tiroid, Kelainan Diagnosis dan Penatalaksanaan. Surabaya: Jawa Aji Surabaya; 2000;34-6.
16. Subekti I. Pendekatan Pasien Diagnosa dengan Nodul Tiroid dalam Deteksi Dini Kanker. Jakarta: FK UI; 2005. p. 1-16.
17. Firat M, Guney E. The Value of Fine Needle Aspiration Biopsy in The Management of Thyroid Nodules. Turkish Journal of Endocrinology and Metabolism. 2002;6.
18. Damanik R. Akurasi Pemeriksaan Klinis, Ultrasonografi dan Biopsi Jarum Halus pada Nodul Tiroid. Sub bagian Bedah Onkologi-Bagian Bedah FK UI; 2003. p. 1-16
19. De Vita, Jr, Vincent T,et al. Cancer “Principles & Practice of Oncology”. 7th ed. Lippincott, Philadelphia. 2005. p: 1502-1510. 20. Kurnia Ahmad. Penanganan Nodul Tiroid. FKUI/RSCM. Jakarta.
2007.
21. Subekti Imam. Diagnostik Medik Nodul Tiroid. FKUI/RSUPN-CM. Jakarta. 2005: p1-8.
22. Fine Needle Biopsy of Thyroid Nodules. Available at: http: www.endocrinweb.com/fna.html
23. Cibas Edmund S et al. Cytology Thyroid “Diagnostic Principles and Clinical Correlates”. 2nd ed. Saunders. 2003. p: 247-269.
24. Moore Francis D, et al. Endocrine Tumors and Malignancies. Atlas of Diagnostic Oncology. 3rd ed. Dana-Farber Cancer Institute. Edited by Arthur T. Skarin. Mosby. 2003. p:282-284.
25. Santacroce Luigi. Article eMedicine Thyroid, Papillary Carcinoma. Medical School, State University at Bari, Italy. 2006.
26. Mills, Stacey E, M.D, et al. Sternberg’s Diagnostic Surgical Pathology. 4th ed. Vol.1.A. Lippincott, Philadelphia. 2004. p: 557- 586.
27. Rosai J. Ackerman’s Surgical Pathology. 8th ed. Mosby. St Louis. 1996. p: 493-549.
28. Stevens Alan, et al. Pathology. 2nd ed. International ed. Toronto. Mosby. 2000. p:332-338.
29. Sarah Parengi RP. Thyroid Disease. California: Greenwood; 2011. 30. Nadia Khati TA, Karen S. Johnson, Michael C Hill. Ultrasound of the
Thyroid and Parathyroid Gland. 2003;19(4):162-176.
31. Schlumberger M, Pacini F. Thyroid tumors: Ed. Nucléon; 2006.
32. Mousa U GA, Ozdemir H, Moray G. Medullary Thyroid Carcinoma in a Patient with Hashimoto's Thyroiditis Diagnosed by Calcitonin washout from a Thyroid Nodule. Wiley Periodicals. 2011.
33. Gharib H, Goellner J. Fine Needle Aspiration of the Thyroid An Appraisal. 1993;118(4):282-9.
34. Djokomoeljanto R. Buku Ajar Tiroidologi Klinik. In: R.Djokomoeljanto, editor. Evaluasi Pasien dengan Kelainan Tiroid Secara Menyeluruh. Semarang: PAPDI,PERKENI; 2009. p. 141-142. 35. Suen C, Kenneth. Fine Needle Aspiration Biopsy of Thyroid. CMAJ.
2005;167
36. Clark DP, Faquin WC. Thyroid cytopathology. New York: Springer Science Inc; 2005.
37. Endocrine Surgery. A Companion to Specialist Surgical Practice. 3rd ed. Edited by Tom W.J. Lennard. Elsevier Saunders. Philadelphia. 2006. p: 43-74.
38. Pramod K Sharma M. Thyroid Cancer. WebMD LLC; 2011 [updated Jun 1, 2011; cited 2012 Jan 20]; Available from: http://emedicine.medscape.com/article/851968.
39. Koss Leopold G. Koss. Diagnostic Cytology and its Histopathologic Bases. The Thyroid, Parathyroid, and Neck Masses Other Than Lymph Nodes. 5th ed. Philadelphia. 2006
40. Koleksi pribadi Prof.Dr.H.M.Nadjib D. Lbs, Sp.PA(K)
41. Orell R. Svante , Sterett F. Gregory, Whitaker Darrel. Fine Needle Aspiration Cytology, Fourth Edition, Elsevier. 2005: p 231-244.
42. Carpi A, Nicolini A, Marchetti C, et al. Percutaneous large-needle aspiration biopsy histology of palpable thyroid nodules: technical and diagnostic performance. Histopathology. 2007;51:249-57.
43. Afroze N , Kayani N , Haasan S H. Role of Fine Needle Aspiration Cytology in the Diagnosis of Palapable Thyroid Lesions. Indian L Pathol Microbiol. 2002 ; 45(3) : 241 – 246.
44. Gulia S.P, Chaudhury M, Sitaramam E, Reddy K.P. Diagnostic Accuracy of Fine Needle Aspiration Cytology In The Diagnosis of Thyroid Lesions. The Internet Journal of Pathology. 2011 ; 13(1). DOI: 10.5580/11d5.
45. Mahar SA, Husain A, Islam M. Fine Needle Aspiration Cytology of Thyroid Nodule : Diagnostic Accuracy and Pitfalls. J Ayub Med Coll Abbottabad. 2006 oct-dec; 18(4) : 26-9.
46. Tjahjono, Djokomeljanto, Tirtosugondo. Ketepatan diagnosis Biopsi Aspirasi Jarum Halus nodul tiroid di Semarang. Kongres Ikatan Ahli Patologi Indonesia. Jakarta. 1987.
LAMPIRAN
Lampiran 1. Data-data pasien
No. Nama No. CM Usia FNAB Biopsi PA
1 Tn. P C209586 43 + + 2 Ny. AY C293253 45 + + 3 Tn. SB B101144 36 + + 4 Ny. S C326082 48 + + 5 Ny. S C301551 49 + + 6 Ny. S B061948 47 + + 7 Tn. FR C292762 39 + + 8 Ny. M C297621 55 + + 9 Tn. S C302919 35 + + 10 Ny. H C115968 42 + + 11 Ny. M C323713 65 + + 12 Ny. AH C315092 18 + + 13 Ny. EF C313234 53 + + 14 Ny. UI C313555 33 + + 15 Ny. SW C314475 27 + + 16 Ny. AS B014288 50 + + 17 Ny. M C293114 38 + + 18 Tn. NA B624655 36 + + 19 Ny. UMH B561469 35 + + 20 Ny. CWE C116966 43 + + 21 Ny. N C291673 48 + + 22 Ny. A C288456 20 + + 23 Ny. S C285587 62 + + 24 Tn. S C283048 29 + + 25 Ny. W C349411 44 + + 26 Ny. S C344450 52 + + 27 Ny. CP C136187 61 + + 28 Ny. M C122115 54 + + 29 Ny. K C121054 47 + + 30 Ny. N C334146 51 + + 31 Ny. SS C328407 57 + + 32 Ny. S C301980 50 + + 33 Ny. S A111974 47 + + 34 Ny. S C119023 40 + + 35 Ny. IS A111948 26 + + 36 Tn. MR A110132 56 + + 37 Ny. M C122827 50 + + 38 Ny. N C346445 47 + +
39 Ny. TW B309061 28 + +
40 Ny. R C182679 64 + +
Lampiran 2. Descriptive Statistics dari usia pasien dengan FNAB.
N Minimum Maximum Mean Std. Deviation
Usia 40 18.00 65.00 44.2500 11.57085
Lampiran 6. Identitas
Nama : Zen Ary Prasetyo
NIM : G2A008202
Tempat/tanggal lahir : Pati/19 Agustus 1990 Jenis kelamin : Laki-laki
Alamat : Jl. Semeru Barat 43 RT 2/RW 5 Kel. Karangrejo Kec. Gajah Mungkur-Semarang
Nomor Telepon : (024)8505881
Nomor HP : 081326055505
e-mail : zenaryprasetyo@ymail.com Riwayat Pendidikan Formal
1. SD : SD Kauman 2 Lulus tahun : 2002
2. SMP : SMP Negeri 1 Juwana Lulus tahun : 2005
3. SMA : SMA Negeri 1 Semarang Lulus tahun : 2008
4. FK UNDIP : Masuk tahun : 2008 Keanggotaan Organisasi