Pustaka Ilmiah Universitas Padjadjaran

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Keabsahan Engrailed-2 Di Kanker Prostat (Validity Of Engrailed-2 In Prostate Cancer)

Kanker prostat merupakan keganasan di laki-laki yang paling sering ditemukan di seluruh dunia, termasuk di Asia dan menyebabkan kematian nomor dua terbanyak kelompok tersebut di negara barat. Penyebab khas kanker prostat belum diketahui pasti, tetapi ada beberapa faktor kebahayaan yang terkait. Diagnosis kanker prostat ditetapkan melalui digital rectal examination (DRE), pengukuran kadar prostate-specific antigen (PSA) dan biopsi trans-rectal ultrasonography (TRUS). Namun pemeriksaan DRE dan PSA memiliki kepekaan rendah, sehingga kurang dapat mendeteksi kanker prostat. Saat ini telah ada pemeriksaan baru yaitu yang terkait kadar protein Engrailed-2 (EN2) di air kemih dengan metode mikro enzyme-linked immunosorbent assay (ELISA). Pemeriksaan ini mudah dan tidak invasif. 7Ljuan penelitian untuk mengetahui keabsahan pemeriksaan kadar protein EN2 air kemih dengan menganalisisnya yang terkait penyakit tersebut. Penelitian ini dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung antara bulan November 2012-Maret 2013. Bentuk penelitian adalah ujian diagnostik dengan rancangan potong lintang. Subjek penelitian adalah terduga kanker prostat berdasarkan pemeriksaan DRE, kadar PSA (4 ng/mL) dan biopsi TRUS. Kadar protein EN2 air kemih diukur dengan metode mikro ELISA. Analisis statistik menggunakan uji Mann-Whitney. tabel 2×2 dan kurva ROC. Hasil biopsi TRUS di 50 subjek didapatkan yang positif kanker prostat 17 pasien/penderita dan yang bukan 33 orang. Telitian di nilai cut off >0,7 ng/mL didapatkan kepekaan 94,12%, kekhasan 63,64%, nilai duga positif 57,1%, nilai duga negatif 95,5% dan ketelitian 74%. Simpulan, pemeriksaan kadar protein EN2 air kemih metode mikro ELISA memiliki kepekaan tinggi dan kekhasan sedang, sehingga diperkirakan dapat digunakan untuk uji saring terutama bagi kanker prostat.

Prostate cancer is one of the most common malignancy of males found worldwide including in Asia, and is the second most common cause of male death in Western countries. Specific cause of prostate cancer is not yet elucidated, but there are several risk factors as well. The diagnosis of prostate cancer is confirmed by digital rectal examination (DRE), prostate-specific antigen (PSA), and a biopsy with trans-rectal ultrasonography (TRUS). However, the sensitivity of DRE and PSA examinations are low and not good enough to detect prostate cancer. Currently there is a new test called Engrailed-2 (EN2) examination with enzyme-linked immunosorbent assay (ELISA) micro method. The test is simple and uninvasive one. This study is aimed to know the validity of urinary EN2 protein level measurement to detect prostate cancer by analysing. This study was conducted at Dr. Hasan Sadikin Hospital Bandung between November 2012 until March 2013. This study was a diagnostic test with cross sectional design. The subjects of study were men whom suspected to have prostate cancer by DRE, PSA value (>4 ng/mL) and TRUS biopsy. Urinary EN2 protein levels were measured using ELISA micro method. Statistical analysis used Mann-Whitney test, table 2×2 and ROC curve. In this study there are 50 subjects, where the result of positive biopsy for prostate cancer were found on 17 subjects and the negative were on 33 subjects. The study results on cut off value of >0.7 ng/mL gave the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 94.12%, 63.64%, 571%, 95.5% and 74%, respectively. In conclusion of this study, that the urinary EN2 protein level examination using ELISA micro method has the high sensitivity and moderate specificity, thus these procedure primarily can be used for the screening of prostate cancer.