THE RELATIONSHIP BETWEEN CYTOLOGICAL FEATURES WITH FNAB METHOD AND TREATMENT RESPONSE OF LYMPHADENITIS TUBERCULOSIS PATIENT IN LOMBOK ISLAND
DOI:
https://doi.org/10.29303/jku.v11i4.797Keywords:
Limfadenitis Tuberkulosis, FNAB, Gambaran Sitologi, Respons Terapi, dan LombokAbstract
ABSTRAK
Latar Belakang: Tuberkulosis merupakan salah satu penyakit global dengan tingkat mortalitas dan morbiditas yang tinggi, dan paling banyak dijumpai pada wilayah Asia Tenggara. Indonesia menjadi negara dengan peringkat ketiga dengan kasus Tuberkulosis terbanyak di dunia. Limfadenitis Tuberkulosis adalah salah satu bentuk tersering dari infeksi Tuberkulosis ekstraparu. Salah satu gejala tersering yang ditemukan adalah pembesaran ukuran nodul kelenjar limfa dan penurunan berat badan.
Metode: Penelitian ini merupakan penelitian studi analitik prospektif dengan teknik pengambilan sampel berupa purposive sampling, dengan jumlah subjek penelitian sebanyak 51 pasien. Pengumpulan data dilakukan dari beberapa puskesmas yang tersebar di lima kabupaten/ kota di Pulau Lombok pada tahun 2021. Analisis data menggunakan uji hipotesis korelatif koefisien kontingensi melalui SPSS 28,0.
Hasil: Dari 51 subjek, ditemukan 30 di antaranya memiliki gambaran sitologi Well-organized Granuloma dan 21 lainnya memiliki gambaran sitologi Poorly-organized granuloma. Nilai P value antara gambaran sitologi dengan berat badan setelah terapi adalah 0.263 dengan nilai korelasi sebesar 0.223. Nilai P value antara gambaran sitologi dengan ukuran nodul setelah terapi adalah 0.054 dengan nilai korelasi sebesar 0.928
Kesimpulan: Tidak terdapat hubungan yang signifikan antara gambaran sitologi menggunakan metode FNAB dengan respons terapi pada pasien limfadenitis tuberkulosis di pulau Lombok.
Kata Kunci: Limfadenitis Tuberkulosis, FNAB, Gambaran Sitologi, Respons Terapi, dan Lombok
References
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14. Adhikari P, Sinha B, Baskota D. Comparison of fine needle aspiration cytology and histopathology in diagnosing cervical lymphadenopathies. Aust. Med J. 2011;4(2):97-9. doi: 10.4066/AMJ.2011.559. Epub 2011 Feb 28. PMID: 23386887; PMCID: PMC3562931.
15. Huda, M. M., Taufiq, M., Yusuf, M. A., Rahman, M. R., Begum, F., & Kamal, M. (2016). Histopathological Features of Lymph Nodes of Tuberculous Lymphadenitis Patients: Experience of 50 cases in Bangladesh. Bangladesh J. Infect. Dis., 3(2), 40-42.
16. Sarfaraz, S., Iftikhar, S., Memon, Y., et al. (2018). Histopathological and microbiological findings and diagnostic performance of GeneXpert in clinically suspected tuberculous lymphadenitis. Int. J. Infect. Dis., 76, 73-81.
17. Kamal, M. S., Hoque, M. H., Chowdhury, F. R., & Farzana, R. (2016). Cervical Tuberculous Lymphadenitis: Clinico-demographic Profiles of Patients in a Secondary Level Hospital of Bangladesh. Pak. J. Med. Sci., 32(3), 608–612. https://doi.org/10.12669/pjms.323.9550
18. Smaoui, S., Mezghanni, M. A., Hammami, B., et al. (2015). Tuberculosis lymphadenitis in a southeastern region in Tunisia: Epidemiology, clinical features, diagnosis and treatment. Int. J. Mycobacteriol., 4(3), 196–201. doi:10.1016/j.ijmyco.2015.04.004
19. Batra, S., Rajawat, G. S., Takhar, R. P., & Gupta, M. L. (2017). Pattern and predictors of paradoxical response in patients with peripheral lymph node tuberculosis. Periferik lenf nodu tüberkülozu hastalar?nda paradoksik yan?t?n özellikleri ve göstergeleri. Tuberkuloz ve toraks, 65(3), 180–185. https://doi.org/10.5578/tt.27597
20. Lekhbal, A., Chaker, K., Halily, S., et al. (2020). Treatment of cervical lymph node tuberculosis: When surgery should be performed? A retrospective cohort study. Annals of medicine and surgery (2012), 55, 159–163. https://doi.org/10.1016/j.amsu.2020.05.006
21. Mustafa, T., Brokstad, K. A., Mfinanga, S. G., et al. (2015). Multiplex Analysis of Pro- or Anti-Inflammatory Serum Cytokines and Chemokines in relation to Gender and Age among Tanzanian Tuberculous Lymphadenitis Patients. Tuberculosis research and treatment, 2015,561490.https://doi.org/10.1155/2015/561490
22. Lugina, H.R., Djannah, F., Ajmala, I.E. (2019). “Hubungan antara Gambaran Sitologis dengan Metode FNAB dan Respons Terapi pada Pasien Limfadenitis Tuberkulosis di RSUD Provinsi NTB Tahun 2019”. J. Ked. Unram. 10 (3), 521-526.
23. Chahed, H., Hachicha, H., Berriche, A., et al. (2017). Paradoxical reaction associated with cervical lymph node tuberculosis: predictive factors and therapeutic management. Int. J. Infect. Dis., 54, 4-7.
24. Yu, S. N., Cho, O.-H., Park, K.-H., et al. (2015). Late paradoxical lymph node enlargement during and after anti-tuberculosis treatment in non-HIV-infected patients. Int. J. Tuberc. Lung Dis., 19(11), 1388–1394. doi:10.5588/ijtld.15.0257
25. Jiao, Y., Chen, J., & Zeng, X. (2012). Acute paradoxical reaction of cervical tuberculous lymphadenitis prompted by a misuse of etimicin sulphate. BMJ case reports, 2012, bcr1220115458. https://doi.org/10.1136/bcr.12.2011.5458
26. Phan, M. N., Guy, E. S., Nickson, R. N., et al. (2016). Predictors and patterns of weight gain during treatment for tuberculosis in the United States of America. International J. Infect. Dis., 53,1–5. doi:10.1016/j.ijid.2016.09.006
27. Jørstad, M.D., Dyrhol-Riise, A.M., Aßmus, J. et al. Evaluation of treatment response in extrapulmonary tuberculosis in a low-resource setting. BMC Infect Dis 19, 426 (2019). https://doi.org/10.1186/s12879-019-4034-z
28. Bernabe-Ortiz, A., Carcamo, C. P., Sanchez, J. F., et al. (2011). Weight variation over time and its association with tuberculosis treatment outcome: a longitudinal analysis. PloS one, 6(4), e18474.https://doi.org/10.1371/journal.pone.0018474
29. Frediani, J. K., Sanikidze, E., Kipiani, M., et al. (2016). Macronutrient intake and body composition changes during anti-tuberculosis therapy in adults. Clin. Nutr., 35(1), 205–212. doi:10.1016/j.clnu.2015.02.007
30. Peetluk, L. S., Rebeiro, P. F., Cordeiro-Santos, M., Kritski, et al. (2020). Lack of Weight Gain During the First 2 Months of Treatment and Human Immunodeficiency Virus Independently Predict Unsuccessful Treatment Outcomes in Tuberculosis. J. Infect. Dis., 221(9), 1416–1424. https://doi.org/10.1093/infdis/jiz595
31. Khan, A., Sterling, T. R., Reves, R., et al. (2006). Lack of weight gain and relapse risk in a large tuberculosis treatment trial. American J. Resp. critical care Med., 174(3), 344–348. https://doi.org/10.1164/rccm.200511-1834OC
32. Hoa, N. B., Lauritsen, J. M., & Rieder, H. L. (2013). Changes in body weight and tuberculosis treatment outcome in Viet Nam. Int. J. Tuberc. Lung Dis., 17(1),61–66. doi:10.5588/ijtld.12.0369
33. Anaam, M. S., Alrasheedy, A. A., Alsahali, S., Alfadly, S. O., & Aldhubhani, A. H. (2019). Rate and risk factors of recurrent tuberculosis in Yemen: a 5-year prospective study. Infect. Dis., 1–9. doi:10.1080/23744235.2019.1690162
34. Padmapriyadarsini, C., Shobana, M., Lakshmi, M., Beena, T., et al. (2016). Undernutrition & tuberculosis in India: Situation analysis & the way forward. The Indian J. Med Res, 144(1), 11–20. https://doi.org/10.4103/0971-5916.193278
35. Niki, M., Yoshiyama, T., Nagai, H., et al. (2020). Nutritional status positively impacts humoral immunity against its Mycobacterium tuberculosis, disease progression, and vaccine development. PloS one, 15(8), e0237062. https://doi.org/10.1371/journal.pone.0237062
36. Muse, A. I., Osman, M. O., Ibrahim, A. M., et al. (2021). Undernutrition and Associated Factors Among Adult Tuberculosis Patients in Jigjiga Public Health Facilities, Somali Region, East, Ethiopia. Res. Rep. Trop. Med., 12, 123.
37. Kenangalem, E., Waramori, G., Pontororing, G. J., et al. (2013). Tuberculosis Outcomes in Papua, Indonesia: The Relationship with Different Body Mass Index Characteristics between Papuan and Non-Papuan Ethnic Groups. PLoS ONE, 8(9), e76077. doi:10.1371/journal.pone.0076077
38. Zhou, J., Liu, B., Liang, C., et al. (2016). Cytokine Signaling in Skeletal Muscle Wasting. Trends in Endocrinology & Metabolism, 27(5), 335–347. doi:10.1016/j.tem.2016.03.002
39. Webster, J. M., Kempen, L. J., Hardy, R. S.,et al. (2020). Inflammation and skeletal muscle wasting during cachexia. Frontiers in Physiology, 11.
2. WHO (2019) ‘WHO TB Report 2019’, WHO Library Cataloguing-in-Publication Data World
3. Dinas Kesehatan Provinsi NTB (2017) ‘Profil Kesehatan Provinsi Nusa Tenggara Barat Tahun 2017’, Provinsi Nusa Tenggara Barat Tahun 2017.
4. Ahmed, H. G. E., Nassar, A. S., & Ginawi, I. (2011). Screening for tuberculosis and its histological pattern in patients with enlarged lymph node. Pathol Res Int, 2011.
5. Gandhare, A. and Mahashur, A. (2017) ‘Tuberculosis of the lymph nodes: Many facets, many hues’, Astrocyte. doi: 10.4103/astrocyte.astrocyte_65_17.
6. Salvador, F., Los-Arcos, I., Sánchez-Montalvá, A., et al. (2015). Epidemiology and diagnosis of tuberculous lymphadenitis in a tuberculosis low-burden country. Med, 94(4), e509. https://doi.org/10.1097/MD.0000000000000509
7. Mekonnen, D., Derbie, A., Abeje, A., et al. (2019). Epidemiology of tuberculous lymphadenitis in Africa: A systematic review and meta-analysis. PloS one, 14(4), e0215647. https://doi.org/10.1371/journal.pone.0215647
8. Seol, Y. J., Park, S. Y., Yu, S. N., et al. (2017). Is the Initial Size of Tuberculous Lymphadenopathy associated with Lymph Node Enlargement during Treatment?. Infection & chemotherapy, 49(2), 130–134.https://doi.org/10.3947/ic.2017.49.2.130
9. Tanwir, F., Amed, I., Hasmi, S., et al (2013). Tuberculosis and Cervical Lymphadenopathy-A study of 175 cases in a Tertiary Care Hospital. Oral Hyg Health, 1(119), 2332-702.
10. Mathiasen, V. D., Andersen, P. H., Johansen, I. S., Lillebaek, T., & Wejse, C. (2020). Clinical features of tuberculous lymphadenitis in a low-incidence country. Int. J. Infect. Dis., 98, 366-371.
11. Thakkar, K., Ghaisas, S. M., & Singh, M. (2016). Lymphadenopathy: Differentiation between Tuberculosis and Other Non-Tuberculosis Causes like Follicular Lymphoma. Frontiers Pub Health, 4, 31. https://doi.org/10.3389/fpubh.2016.00031
12. Lee J. Y. (2015). Diagnosis and treatment of extrapulmonary tuberculosis. Tuberc. Respir. Dis., 78(2), 47–55. https://doi.org/10.4046/trd.2015.78.2.47
13. Mittal, P., Handa, U., Mohan, H., & Gupta, V. (2011). Comparative evaluation of fine needle aspiration cytology, culture, and PCR in diagnosis of tuberculous lymphadenitis. Diagnostic cytopathology, 39(11), 822-826.
14. Adhikari P, Sinha B, Baskota D. Comparison of fine needle aspiration cytology and histopathology in diagnosing cervical lymphadenopathies. Aust. Med J. 2011;4(2):97-9. doi: 10.4066/AMJ.2011.559. Epub 2011 Feb 28. PMID: 23386887; PMCID: PMC3562931.
15. Huda, M. M., Taufiq, M., Yusuf, M. A., Rahman, M. R., Begum, F., & Kamal, M. (2016). Histopathological Features of Lymph Nodes of Tuberculous Lymphadenitis Patients: Experience of 50 cases in Bangladesh. Bangladesh J. Infect. Dis., 3(2), 40-42.
16. Sarfaraz, S., Iftikhar, S., Memon, Y., et al. (2018). Histopathological and microbiological findings and diagnostic performance of GeneXpert in clinically suspected tuberculous lymphadenitis. Int. J. Infect. Dis., 76, 73-81.
17. Kamal, M. S., Hoque, M. H., Chowdhury, F. R., & Farzana, R. (2016). Cervical Tuberculous Lymphadenitis: Clinico-demographic Profiles of Patients in a Secondary Level Hospital of Bangladesh. Pak. J. Med. Sci., 32(3), 608–612. https://doi.org/10.12669/pjms.323.9550
18. Smaoui, S., Mezghanni, M. A., Hammami, B., et al. (2015). Tuberculosis lymphadenitis in a southeastern region in Tunisia: Epidemiology, clinical features, diagnosis and treatment. Int. J. Mycobacteriol., 4(3), 196–201. doi:10.1016/j.ijmyco.2015.04.004
19. Batra, S., Rajawat, G. S., Takhar, R. P., & Gupta, M. L. (2017). Pattern and predictors of paradoxical response in patients with peripheral lymph node tuberculosis. Periferik lenf nodu tüberkülozu hastalar?nda paradoksik yan?t?n özellikleri ve göstergeleri. Tuberkuloz ve toraks, 65(3), 180–185. https://doi.org/10.5578/tt.27597
20. Lekhbal, A., Chaker, K., Halily, S., et al. (2020). Treatment of cervical lymph node tuberculosis: When surgery should be performed? A retrospective cohort study. Annals of medicine and surgery (2012), 55, 159–163. https://doi.org/10.1016/j.amsu.2020.05.006
21. Mustafa, T., Brokstad, K. A., Mfinanga, S. G., et al. (2015). Multiplex Analysis of Pro- or Anti-Inflammatory Serum Cytokines and Chemokines in relation to Gender and Age among Tanzanian Tuberculous Lymphadenitis Patients. Tuberculosis research and treatment, 2015,561490.https://doi.org/10.1155/2015/561490
22. Lugina, H.R., Djannah, F., Ajmala, I.E. (2019). “Hubungan antara Gambaran Sitologis dengan Metode FNAB dan Respons Terapi pada Pasien Limfadenitis Tuberkulosis di RSUD Provinsi NTB Tahun 2019”. J. Ked. Unram. 10 (3), 521-526.
23. Chahed, H., Hachicha, H., Berriche, A., et al. (2017). Paradoxical reaction associated with cervical lymph node tuberculosis: predictive factors and therapeutic management. Int. J. Infect. Dis., 54, 4-7.
24. Yu, S. N., Cho, O.-H., Park, K.-H., et al. (2015). Late paradoxical lymph node enlargement during and after anti-tuberculosis treatment in non-HIV-infected patients. Int. J. Tuberc. Lung Dis., 19(11), 1388–1394. doi:10.5588/ijtld.15.0257
25. Jiao, Y., Chen, J., & Zeng, X. (2012). Acute paradoxical reaction of cervical tuberculous lymphadenitis prompted by a misuse of etimicin sulphate. BMJ case reports, 2012, bcr1220115458. https://doi.org/10.1136/bcr.12.2011.5458
26. Phan, M. N., Guy, E. S., Nickson, R. N., et al. (2016). Predictors and patterns of weight gain during treatment for tuberculosis in the United States of America. International J. Infect. Dis., 53,1–5. doi:10.1016/j.ijid.2016.09.006
27. Jørstad, M.D., Dyrhol-Riise, A.M., Aßmus, J. et al. Evaluation of treatment response in extrapulmonary tuberculosis in a low-resource setting. BMC Infect Dis 19, 426 (2019). https://doi.org/10.1186/s12879-019-4034-z
28. Bernabe-Ortiz, A., Carcamo, C. P., Sanchez, J. F., et al. (2011). Weight variation over time and its association with tuberculosis treatment outcome: a longitudinal analysis. PloS one, 6(4), e18474.https://doi.org/10.1371/journal.pone.0018474
29. Frediani, J. K., Sanikidze, E., Kipiani, M., et al. (2016). Macronutrient intake and body composition changes during anti-tuberculosis therapy in adults. Clin. Nutr., 35(1), 205–212. doi:10.1016/j.clnu.2015.02.007
30. Peetluk, L. S., Rebeiro, P. F., Cordeiro-Santos, M., Kritski, et al. (2020). Lack of Weight Gain During the First 2 Months of Treatment and Human Immunodeficiency Virus Independently Predict Unsuccessful Treatment Outcomes in Tuberculosis. J. Infect. Dis., 221(9), 1416–1424. https://doi.org/10.1093/infdis/jiz595
31. Khan, A., Sterling, T. R., Reves, R., et al. (2006). Lack of weight gain and relapse risk in a large tuberculosis treatment trial. American J. Resp. critical care Med., 174(3), 344–348. https://doi.org/10.1164/rccm.200511-1834OC
32. Hoa, N. B., Lauritsen, J. M., & Rieder, H. L. (2013). Changes in body weight and tuberculosis treatment outcome in Viet Nam. Int. J. Tuberc. Lung Dis., 17(1),61–66. doi:10.5588/ijtld.12.0369
33. Anaam, M. S., Alrasheedy, A. A., Alsahali, S., Alfadly, S. O., & Aldhubhani, A. H. (2019). Rate and risk factors of recurrent tuberculosis in Yemen: a 5-year prospective study. Infect. Dis., 1–9. doi:10.1080/23744235.2019.1690162
34. Padmapriyadarsini, C., Shobana, M., Lakshmi, M., Beena, T., et al. (2016). Undernutrition & tuberculosis in India: Situation analysis & the way forward. The Indian J. Med Res, 144(1), 11–20. https://doi.org/10.4103/0971-5916.193278
35. Niki, M., Yoshiyama, T., Nagai, H., et al. (2020). Nutritional status positively impacts humoral immunity against its Mycobacterium tuberculosis, disease progression, and vaccine development. PloS one, 15(8), e0237062. https://doi.org/10.1371/journal.pone.0237062
36. Muse, A. I., Osman, M. O., Ibrahim, A. M., et al. (2021). Undernutrition and Associated Factors Among Adult Tuberculosis Patients in Jigjiga Public Health Facilities, Somali Region, East, Ethiopia. Res. Rep. Trop. Med., 12, 123.
37. Kenangalem, E., Waramori, G., Pontororing, G. J., et al. (2013). Tuberculosis Outcomes in Papua, Indonesia: The Relationship with Different Body Mass Index Characteristics between Papuan and Non-Papuan Ethnic Groups. PLoS ONE, 8(9), e76077. doi:10.1371/journal.pone.0076077
38. Zhou, J., Liu, B., Liang, C., et al. (2016). Cytokine Signaling in Skeletal Muscle Wasting. Trends in Endocrinology & Metabolism, 27(5), 335–347. doi:10.1016/j.tem.2016.03.002
39. Webster, J. M., Kempen, L. J., Hardy, R. S.,et al. (2020). Inflammation and skeletal muscle wasting during cachexia. Frontiers in Physiology, 11.
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Published
2022-12-30
How to Cite
Tri Riskinie Istiharoh, Fathul Djannah, & Indana Eva Ajmala. (2022). THE RELATIONSHIP BETWEEN CYTOLOGICAL FEATURES WITH FNAB METHOD AND TREATMENT RESPONSE OF LYMPHADENITIS TUBERCULOSIS PATIENT IN LOMBOK ISLAND. Jurnal Kedokteran, 11(4), 1169–1176. https://doi.org/10.29303/jku.v11i4.797
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