Ekspresi Imunohistokimia Sel Natural Killer pada Endometrium Ektopik Penderita Endometriosis

Abstract

Introduction : Women with endometriosis usually experience cellular immunity disturbances (NK cells, Macrophages, lymphocytes, and apoptosis). Decreased natural killer cell cytotoxicty in peritoneal fluid was caused by quantitative and qualitative defects or one of both. Objective : To determine immunohistochemical expression discrepancies between Natural Killer cells in the ectopic endometrium of endometriosis patients and the normal endometrium. Methods : This analytical case control study was conducted at the Departement of Obstetrics and Gynecology and pathology of Haji Adam Malik General hospital from April – July 2015. The case group comprised of ectopic endometrial block parrafins of endometriosis and control subjects. Natural killer cell expression was assesed using Allred score. Data were statistically anlaysed using the Fisher Exact and t-test with a Confidence Interval of 95%. A p value < 0.05 was considered significant. Results : 23 endometriosis and control subjects, respectively, were enrolled. Eleven endometriosis subjects were aged under 30 years old (47,8%), whereas 52.2% of non endometriosis subjects were aged 30-40 years old. All endometriosis subjects were null parity, whereas 9 non emdometriosis subjects (100%) were parity 2-4 (39.1%). Endometriosis cases were dominatly staged 4 (11 cases/47.8%). This study showed that NK cell expression based the Allred score was not significantly associated with cases of endometriosis (p>0.05). Mean Allred expression total score did not significantly differ between endometriosis and non endometriosis subjects (p>0.05) Conclusion : Mean Allred expression total score did not significantly differ between endometriosis and non endometriosis subjects.

Latar Belakang: Wanita dengan endometriosis mengalami gangguan pada selsel imunitas seluler (Sel NK, Makrofage, Limfosit dan apoptosis). Diduga penurunan sitotoksisitas sel NK pada cairan peritoneal disebabkan oleh defek kuantitatif dan kualitatif atau salah satu dari defek tersebut. Tujuan: mengetahui perbedaan ekspresi imunohistokimia sel NK pada endometrium ektopik penderita endometriosis dibandingkan endometrium normal. Metode: penelitian analitik dengan rancangan kasus kontrol, dilakukan di Dept. Obgin dan PA FK USU – RSUP H Adam Malik Medan mulai bulan April - Juli 2015. Kelompok kasus adalah parafin blok jaringan endometrium ektopik penderita endometriosis dan kontrol adalah parafin blok jaringan endometrium normal. Penilaian ekspresi sel NK menggunakan skor Allred. Analisa statistik dengan uji Fischer Exact dan t-test Independent dengan tingkat kepercayaan sebesar 95%, p <0,05 dianggap bermakna. Hasil: kasus endometriosis dan kontrol masing-masing sebanyak 23 orang. Dijumpai kasus endometriosis sebagian besar berumur di bawah 30 tahun sebanyak 11 orang (47,8%), kelompok non endometriosis berumur 30-40 tahun (52,2%). Kasus endometriosis seluruhnya paritas 0 (100%), sedangkan non endometriosis dengan paritas 2-4 sebanyak 9 orang (39,1%). Kasus endometriosis sebagian besar stadium 4 sebanyak 11 kasus (47,8%). Pada penelitian ini tidak dijumpai hubungan yang bermakna ekspresi sel NK berdasarkan skor Allred dengan kejadian endometriosis (p>0,05). Rerata total skor Allred ekspresi sel NK pada endometriosis dibandingkan dengan non endometriosis secara statistik tidak dijumpai perbedaan bermakna (p>0,05). Kesimpulan: Rerata total skor Allred ekspresi sel NK pada endometriosis dibandingkan dengan non endometriosis secara statistik tidak ada perbedaan bermakna.