1Eureka Nusra G. T. | 2Maryono Dwi Wibowo | 3Dyah Fauziah
1Resident of General Surgery Airlangga, Medical Faculty, Soetomo General Hospital Surabaya
2General Surgery Department Airlangga, Medical Faculty, Soetomo General Hospital Surabaya
1Anatomy Pathology Department Airlangga, Medical Faculty, Soetomo General Hospital Surabaya
Abstract
The incidence of thyroid carcinoma has continued to increase over the past few years. In the United States, the incidence is increasing at an annual ratio of 5.4% for men and 6.5% for women. Based on medical records at Dr. Soetomo Regional Hospital in 2014-2018, 433 patients underwent surgery for thyroid cancer, 190 (43.8%) had total thyroidectomy and 109 (25.2%) total thyroidectomy with Functional Neck Dissection. Thyroid cancer with regional lymph node metastases and distant metastases require more difficult and complicated actions which are quite high in cost of functional neck dissection, radical neck dissection or internal radiation. On the other hand, we found that the properties of Ki-67 can be used as markers of carcinoma proliferation, so we would like to find out whether examining Ki-67 can be a predictor in metastatic cases of thyroid cancer. The study was an observational analytic study with a cross sectional study design. The general research subject data were collected and the histopathological results were recorded. Ki-67 immunohistochemistry was examined in the Anatomy Pathology laboratory of Soetomo General Hospital. In this study, a total of 30 research subjects were obtained. Patients with the most age were over 50 years old with 14 patients (46.7%), aged 25-50 years were 10 patients (33.3%), and aged <25 years were 6 patients (20.0%) with an average age 47.57 ± 2.867 years. From the 30 study subjects, 15 patients underwent total thyroidectomy and FND (50%) and 15 patients underwent total thyroidectomy (50%). From this study, the mean expression of Ki-67 in thyroid cancer patients was 14.00% + 2.904%. The minimum value of Ki-67 expression is 1% and the maximum value of Ki-67 expression is 60%. Based on the data, a statistical test was performed with Pearson ChiSquare, that statistically significant differences were obtained with a value of p = 0.029 (<0.05). Regional lymph obtained cut off point value is 15%. From this study a significant difference was found between the high Ki-67 expression in non-metastases and regional lymph node metastases in patients with papillary thyroid carcinoma (p = 0.029). The higher the level of expression of Ki-67 in papillary thyroid carcinoma patients, the higher the possibility of regional lymph node metastases
Keywords: Thyroid Carcinoma, Regional Metastasis, Ki-67, Thyroidectomy