Uji Diagnostik Pemeriksaan Kadar Transforming Growth Factor Beta 1 Cairan Pleura pada Pleuritis Tuberkulosis

Woro Hapsari Wahyuningrum, Agnes Rengga Indrati, Sylvia Rachmayati, Dewi Kartika Turbawaty

Abstract


Sulitnya penegakan diagnosis pleuritis tuberkulosis (TB) disebabkan oleh gambaran klinis yang tidak spesifik dan rendahnya sensitivitas pemeriksaan bakteriologik, akibat cairan pleura yang bersifat pausibasiler.Transforming growth factor beta 1 (TGF-β1) mampu menekan respons imun seluler terhadap M. tuberculosis, berperan dalam aktivasi TB laten, kerusakan jaringan, dan fibrosis. Penelitian ini bertujuan mengetahui peranan pemeriksaankadarTGF-β1 cairan pleura dalam penegakan diagnosis pleuritis TB. Penelitian ini adalah uji diagnostik, pengambilan data secara potong lintang. Bahan pemeriksaan berupa cairan pleura yang disimpan dalam ultra low freezer dari pasien rawat inap di RSUP Dr. Hasan Sadikin (RSHS) Bandung dan Rumah Sakit Paru Dr. H.A Rotinsulu Bandung periode Oktober 2014 ̶ Maret 2015. Total subjek penelitian 68, terdiri dari 17 pleuritis TB confirmed, 22 pleuritis TB probable, dan 29 pleuritis non TB.Kadar TGF-β1 cairan pleura pleuritis TB: 41,4 (10,4 ̶19.481) pg/mL. Pemeriksaan kadar TGF-β1 menunjukkan sensitivitas 66,7%, spesifisitas 65,5% pada nilai cut-off  >37 pg/mL. Sensitivitas pemeriksaan kadar  TGF-β1 lebih tinggi bila dibanding dengan pemeriksaan bakteriologik. Hasil negatif pada pemeriksaan bakteriologik dari subjek pleuritis TB probable, 77,3% di antaranya memberikan hasil positif pada pemeriksaan kadar TGF-β1.  Pemeriksaan ini dapat digunakan sebagai tambahan modalitas pemeriksaan laboratorium untuk mendiagnosis pleuritis TB, terutama bila didapatkan hasil negatif pada pemeriksaan bakteriologik, namun kecurigaan pleuritis TB sangat kuat.

Kata kunci: Kadar TGF-β1, pemeriksaan bakteriologik, pleuritis TB

  

Diagnostic Value of Pleural Fluid Transforming Growth Factor Beta 1 Level in Tuberculous Pleurisy

Tuberculous(TB) pleurisy was difficult to be diagnosed as it has nonspecific symptoms and low sensitivity in  bacteriological tests which are caused by paucibacillary of pleural fluid. Transforming Growth Factor Beta 1 (TGF-β1) could suppress  the immune response to M. tuberculosis infection, activating latent TB infection that involves tissue damages and fibrosis. This study aimed to determine the role of pleural fluid TGF-β1 level in diagnosing TB pleurisy. This was a cross-sectional specific descriptive observational study involving a total subjects of 68 that consisted of  17 confirmed TB pleurisy, 22 probable TB pleurisy, and 29 non-TB pleurisy. Pleural fluid collected in October 2014 ̶ March 2015 from the subjects was stored in an ultra low freezer. The which.level of TGF-β1 in pleural fluid in TB pleurisy was 41,4(10,4 ̶ 19.481) pg/mL. Pleural  fluid TGF-β1 level showed a sensitivity of 66,7%, specificity of 65,5% and a cut-off value >37pg/mL. The sensitivity level of pleural fluid TGF-β1 was higher than that of the bacteriological test. Pleural fluid TGF-β1 level can be used as an adjunct modality of laboratory test for diagnosing TB pleurisy, especially for patient with high suspiscion of TB pleurisy but yield negative result in the bacteriological test.

Key words: Bacteriological tests, TB pleurisy, TGF-β1 levels


Keywords


Kadar TGF-β1; pemeriksaan bakteriologik; pleuritis TB

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DOI: https://doi.org/10.15395/mkb.v49n4.1152

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