Perbandingan Ekspresi Imunohistokimn Hoxa-11 pada Wanita Penderita Prolaps Organ Pelvik dan Wanita Non Prolaps Organ Pelvik

Abstract

Objective: To determine differences of HOXA-11 immunohistochemical expression in pelvicorgan prolapse and non pelvic organ prorapse patients. Methods: This research is an unpaired analytical 2 subject research with a cross

sectional study where an immunohistochemical analysis on parrafin block of sacro- uterine ligament was conducted on pelvic organ prolapse and non pelvic organ prolapse women. The research was conducted at The Obstetric &

'Gynecol6gy Department Medicine Faculty of North Sumatera University - Adam Malik Ceneial Hospital and immunohistochemical analysis was perfoimed by the Anatomy Pathology Department of Adam Malik General Hospital. The research was

conducted from January 2016 until February 2016. Parrafin btock tissue from sacro- uterine ligament of pelvic organ prolapse patients was obtained from total vaginal

hysterectomy operation from the case group that met the inclusion criteria and control group, then HOXA-11 immunohistochemical analysis was performed. The data was subsequently analysed statistically. Two observei accuracy difference was calculated with Kappa value. Correlation between variables was analysed using significant. . Results: Majority of POP cases was third degree (65%) and the rest was fourth degree (35%). Statistically significant conelation was found between menopause status with HO)G-11 expression Allred score with p < O,05 and there was significant conelation between HoxA-11 expression with pop incidence with p 2 0,05. Howevere there was no corelation between HOXA-11 expression and p(ip degree, through Fisher exact test a p value > 0,05 was obtained. Gonclusion: Age, parity, and menopausestatus was found to be correlated with

POP incidence. Correlation was also found between menopause status with HO)G- 11 expression and between HoxA-11 expression with pop incidence

Tujuan: mengetahui perbedaan ekspresi imunohistokimia HOXA-11 pada wanita penderita prolaps organ pelvik dan wanita non prolaps organ pelvik. Metode: Penelitian ini merupakan suatu penelitian analitik 2 subjek penelitian tidak berpasangan dengan desain cross sectional study (potong lintang) dimana dilakukan pemeriksaan imunohistokimia terhadap parafin biof jaiingan -ligamentum

sakro- uterina pada wanita penderita prolaps organ pelvik dan winita nln prolaps organ

gglvik. Tempat penelitian dilakukan di Departemen Obstetri dan Ginekologi'Fakul-tas Kedokteran Universitas sumatera utara - RSUP Haji Adam Malik Medan dan pemeriksaan imunohistokimia dilakukan oleh Departemen Patologi Anatomi RSUp Haji Adam Malik Medan. Penetitian ini dilakukan mulai bulan Jaiuari 2016 ningla Februari 2016. Parafin blok jaringan ligamentum sakro-uterina pada pendelriia profaps organ pelvik yang diambil dari tindakan operasi total vaginal histerektomi dari subjek kelompok kasus yang memenuhi kriteria inklusi dan [elompok kontrol, kemudian dilakukan pemeriksaan imunohistokimiawi HOXA-11. Data kemudian dianalisis secara statistik. Perbedaan akurasi dua observer dihitung dengan nilai kappa. Hubungan antar variabel dilakukan uji statistik Fisher exact Jengan derajat kepercayaan g5% dan p<0,05 dianggap bermakna. Hasil: kasus POP terbanyak dengan derajat tll (65%) dan lainnya dengan derajat lV (35o/o). Secara statistik dijumpai adanya hubungan yang bermakna intara status menopause dengan skor Allred ekspresi HOXA-1 1 dengan nilai p < O,OS dan adanya hubungan yang bemakna antara ekspresi HOXA-11 dengan felaOian pOp dengin nilai p < 0,05. Namun tidak ada hubungan antara ekspresi HOXA-11 dengan derajat POP, dengan uii Fisher exact didapatkan nilai p>0,05. Kesimpulan: Usia, paritas dan status menopause dijumpai berhubungan dengan l9t?9irn POP. Dijumpai juga hubungan antara status menopause dengln ekspiesi Ho)G-11 dan antara ekspresi HoxA-11 dengan kejadian pop