Analisis Kadar Hemoglobin, Hematokrit dan Indeks Sel Darah Merah pada Pasien Karsinoma Nasofaring Stadium Lanjut di RSUP. H. Adam Malik Medan

Abstract

Background : NPC is a type of malignancy with endemic characteristics in several geographical distributions of Southeast Asia. More than 50% of patients with NPC are admitted in an advanced stage, consequently, it has a poor outcome. Advanced stages are strongly associated with persistent inflammation, ultimately affecting the erythropoiesis process; so, it can affect hemoglobin levels, hematocrit and red blood cell index (BCI) in patients with advance NPC. Objective : This study aims to evaluate the relationship between clinical stage in patients with advanced NPC and Hb, Ht and red blood cell index (BCI) which are expected to be used as a prognostic determinant. Methods: This research is a cross-sectional study conducted using secondary data in the form of medical records. Imaging studies, CT scans, was evaluated for the size component of the primary tumor (T) and lymph node involvement (N). The independent variable in this study was the advanced stages of NPC (stages III and IV). Then analyzed by statistical analysis by using the mean difference test > 2 groups, Anova (if the data is normally distributed) and Kruskall Wallis (if the data is not normally distributed). For data with two groups, the T test and Mann Whitney test were used to determine the significance of the mean difference in clinical stage. Results: This study involved 40 respondents who were diagnosed with advance stage NPC (III and IV) who had not received therapy before with the most demographic characteristics, mostly in the age group 41-60 years (n = 22 patients, 55%), male gender as 27 patients (67.5%), with non-keratinized SCC histopathological type in 92,5% samples (n = 37 patients). Based on statistical analysis, it was found that there were significant difference in the mean hemoglobin, hematocrit and RDW (p<0.05) to the advance clinical stage. However based on clinical staging correlation analysis only RDW was found had a significant relationship with the clinical staging in advanced stages of nasopharyngeal carcinoma patients with p<0.05 and r:0.455. Conclusion: In this study, a significant difference in mean was found between Hb, Ht and RDW on clinical stage in advanced NPC patients. Based on the correlation analysis, there was a positive correlation between RDW and clinical Staging in advanced stages of NPC patients at RSUP. H. Adam Malik Medan.