Hubungan antara Kadar CA-125 Preoperatif dengan Stadium Endometriosis

Abstract

Objective : Our purpose was to find out the mean CA 125 level preoperative in each endometriosis staging, the relation between Ca-125 level pre operative with endometriosis staging and the relation between complaints of endometriosis, like dysmenorrhea, dyspareunia, chronic pelvic pain and infertility with endometriosis staging. Method : An analytic correlation with cross sectional approach was done to the 32 women with suspected endometriosis who meet inclusion and exclusion criteria that will undergo either laparoscopic surgery or laparotomy in RSU Haji Adam Malik Medan, RSUD Dr. Pirngadi Medan, RSU Permata Bunda Medan and RSIA Stella Maris Medan, the Ca-125 level pre-operative was examined then the endometriosis staging was assessed according to the American Society of Reproductive Medicine after surgery. The data obtained were processed using SPSS computer program ver.19.0. using non-parametric statistical test Chi-Square Test. If eligible, then the alternative test conducted by Fisher Exact Test. Result : The Average levels of preoperative CA 125 at each stage was Stage I (22.76 ± 7.6 U / mL), stage II (20.96 ± 9.11 U / mL), stage III (66.08 ± 41.68 U / mL) and Stage IV (158.9 ± 138.5 U / mL). There was relationship found between preoperative CA 125 levels with endometriosis stage (p = 0.015). And if the stage of endometriosis were divided into 2 groups, ie groups of stage I & II (minimal mild) and group stage III & IV (moderate-severe), we also found a relationship between CA 125 preoperative staging with minimal-mild group and the group of moderate-weight (p = 0.024). We found no relationship between complaints dysmenorrhea, chronic pelvic pain dyspareunia with endometriosis staging (p = 0.602, p = 0.438 and p = 0.452). We found the relationship between complaints of infertility with endometriosis stage (p = 0.002) but this is still biased because no further observed whether pure endometriosis as a cause of infertility in the sample. Conclusion : The CA 125 levels Preoperative have a relationship with the stage of endometriosis, so it can be used as a prediction stage of endometriosis before surgery and preparation operations can be performed more leverage as bowel preparation and administration of hormonal.

Tujuan : Untuk mengetahui kadar rata-rata CA 125 preoperatif pada setiap stadium endometriosis, hubungan kadar CA 125 preoperatif dengan stadium endometriosis dan hubungan keluhan-keluhan endometriosis dalam hal ini dismenore, dispareni, nyeri pelvik kronis dan infertilitas dengan stadium endometriosis Metode : Penelitian ini bersifat analitik korelasi dengan pendekatan cross sectional terhadap 32 wanita dengan dugaan endometriosis yang memenuhi kriteria inklusi dan eklusi yang akan menjalani operasi baik laparoskopi ataupun laparotomi di RSU Haji Adam Malik Medan, RSUD Dr. Pirngadi Medan, RSU Permata Bunda Medan dan RSIA Stella Maris Medan, dilakukan pemeriksaan CA 125 preoperatif kemudian dinilai stadium endometriosis berdasarkan American Society of reproductive Medicine setelah dilakukan operasi. Data yang diperoleh diolah dengan menggunakan program computer SPSS ver.19.0. dengan menggunakan uji statistik non parametrik Chi-Square Test. Bila memenuhi syarat, maka dilakukan uji alternative dengan Fisher Exact Test. Hasil : Kadar rata-rata CA 125 preoperatif pada setiap stadium adalah Stadium I (22.76 ± 7.6 U/mL), stadium II (20.96 ± 11.9 U/mL), stadium III ( 66.08 ± 41.68 U/mL) dan Stadium IV (158,9 ± 138,5 U/mL). Dimana didapati hubungan antara kadar CA 125 preoperatif dengan stadium endometriosis (p = 0,015). Dan bila stadium endometriosis dibagi dalam 2 kelompok, yaitu kelompok stadium I & II (minimal-ringan) dan kelompok stadium III & IV (sedang-berat), maka didapati juga hubungan antara CA 125 preoperatif dengan kelompok stadium minimal-ringan dan kelompok sedang-berat (p=0,024). Tidak dijumpai hubungan antara keluhan dismenore, dispreni dan nyeri pelvik kronis dengan stadium endometriosis (p=0,602 ; p=0,438 dan p=0,452). Didapati hubungan antara keluhan infertilitas dengan stadium endometriosis (p=0,002) namun hal ini masih bias karena tidak diobservasi lebih lanjut apakah endometriosis sebagai penyebab murni infertilitas pada sampe