Electronic Theses and Dissertation

Latar belakang: Kanker paru merupakan penyebab utama kematian akibat kanker di dunia dan sering terdiagnosis pada stadium lanjut. Transforming Growth Factor Beta 1 (TGF-β1) diketahui berperan dalam karsinogenesis dan berpotensi menjadi biomarker diagnostik. Cairan kurasan bronkoalveolar (BALF) merupakan media yang representatif untuk menilai biomarker terkait mikroenvironment tumor.
Tujuan: Menilai kadar TGF-β1 dalam cairan BALF pada pasien kanker paru, curiga kanker paru, dan bukan kanker paru, serta menentukan nilai cut-off TGF-β1 sebagai biomarker diagnostik.
Metode: Penelitian observasional analitik dengan rancangan cross-sectional dilakukan di RSUD dr. Zainoel Abidin Banda Aceh. Sampel cairan BALF diperoleh melalui bronkoskopi dari pasien dengan diagnosis kanker paru, curiga kanker paru, dan bukan kanker paru. Kadar TGF-β1 diukur menggunakan metode ELISA. Analisis statistik dilakukan untuk menentukan nilai cut-off, sensitivitas, spesifisitas, serta nilai prediktif positif (PPV) dan negatif (NPV).
Hasil: Nilai cut-off TGF-β1 ditetapkan pada 105,63 pg/mL. Sensitivitas tercatat sebesar 67,44% dan spesifisitas 61,90%. PPV tinggi yaitu 78,38% menunjukkan bahwa peningkatan kadar TGF-β1 berhubungan erat dengan kemungkinan keganasan. Namun, NPV rendah (48,15%) membatasi penggunaan TGF-β1 sebagai uji penyingkiran kanker paru.
Kesimpulan: Kadar TGF-β1 dalam BALF menunjukkan potensi sebagai biomarker diagnostik kanker paru dengan performa moderat. TGF-β1 dapat digunakan sebagai uji tambahan (“rule-in test”) untuk memperkuat kecurigaan klinis, namun tidak cukup andal sebagai uji tunggal. Kombinasi dengan biomarker lain atau panel diagnostik multiparameter disarankan untuk meningkatkan akurasi.
Kata Kunci: TGF-β1, kanker paru, bronkoalveolar lavage, biomarker

Background: Lung cancer remains the leading cause of cancer-related mortality worldwide and is often diagnosed at an advanced stage. Transforming Growth Factor Beta 1 (TGF-β1) plays a pivotal role in carcinogenesis and may serve as a diagnostic biomarker. Bronchoalveolar lavage fluid (BALF) represents a relevant medium to assess biomarkers reflecting the tumor microenvironment. Objective: To evaluate TGF-β1 levels in BALF among patients with lung cancer, suspected lung cancer, and non-cancer conditions, and to determine the diagnostic cut-off value of TGF-β1. Methods: This cross-sectional analytical study was conducted at dr. Zainoel Abidin General Hospital, Banda Aceh. BALF samples were obtained via bronchoscopy from patients classified as lung cancer, suspected lung cancer, and non-cancer. TGF-β1 levels were measured using ELISA, and diagnostic performance was analyzed to establish cut-off values, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results: The optimal cut-off level for TGF-β1 was determined at 105.63 pg/mL. Sensitivity was 67.44% and specificity 61.90%. A high PPV of 78.38% indicated that elevated TGF-β1 levels strongly correlated with malignancy. Conversely, the NPV was low (48.15%), limiting its role as an exclusion tool. Conclusion: TGF-β1 in BALF demonstrates potential as a diagnostic biomarker for lung cancer with moderate performance. It may serve as a supportive “rule-in” test to strengthen clinical suspicion but is insufficient as a stand-alone diagnostic tool. Combining TGF-β1 with other biomarkers in a multiparametric diagnostic panel is recommended to improve diagnostic accuracy. Keywords: TGF-β1, lung cancer, bronchoalveolar lavage, biomarker